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01.
arXiv (CS.AI) 2026-06-12

Intelligence as Managed Autonomy: Failure, Escalation, and Governance for Agentic AI Systems

arXiv:2605.27628v2 Announce Type: replace Abstract: As autonomous and agentic AI systems scale in robotic and human-machine environments, managing hallucination and persistent but unjustified action remains an open challenge. Rather than attributing these failures solely to model or alignment limitations, this paper explores the architectural vulnerability of unbounded autonomy - the presumption that an agent should continue operating regardless of rising uncertainty. It introduces a theory of managed autonomy that defines intelligent behavior through the formal capacity to detect epistemic drift, suspend reasoning, attempt recovery, and ultimately surrender control when reliability diminishes. We instantiate this theory via the SMARt (Self-Managing Multi-tier Autonomous Reasoning with Regulated/Revoked transitions) model, a four-layer framework featuring Stable, Meta-cognitive, Assisted, and Regulated states. By developing a timed, guarded Petri net formulation, we establish theoretically bounded properties for the system, demonstrating how architecture can formally mandate escalation, constrain invalid outputs, and ensure governance reachability under specified conditions. We further analyze how incorporating domain-specific trigger sets across varied operational settings (e.g., healthcare, robotics, etc.) can systematically preserve safety, assuming completeness and soundness criteria are met. Because these triggers are designed to be adaptive, the SMARt model accommodates the safe, controlled expansion of an agent's operational scope over time. We conclude that formalizing failure management within the autonomy lifecycle is a crucial step toward realizing reliable and governed artificial intelligence.

02.
arXiv (CS.AI) 2026-06-19

Reinforcement-aware Knowledge Distillation for LLM Reasoning

arXiv:2602.22495v3 Announce Type: replace-cross Abstract: Reinforcement learning (RL) post-training has recently driven major gains in long chain-of-thought reasoning large language models (LLMs), but the high inference cost of such models motivates distillation into smaller students. Most existing knowledge distillation (KD) methods are designed for supervised fine-tuning (SFT), relying on fixed teacher traces or teacher-student Kullback-Leibler (KL) divergence-based regularization. When combined with RL, these approaches often suffer from distribution mismatch and objective interference: teacher supervision may not align with the student's evolving rollout distribution, and the KL regularizer can compete with reward maximization and require careful loss balancing. To address these issues, we propose RL-aware distillation (RLAD), which performs selective imitation during RL – guiding the student toward the teacher only when it improves the current policy update. Our core component, Trust Region Ratio Distillation (TRRD), replaces the teacher-student KL regularizer with a PPO/GRPO-style likelihood-ratio objective anchored to a teacher–old-policy mixture, yielding advantage-aware, trust-region-bounded distillation on student rollouts and naturally balancing exploration, exploitation, and imitation. Across diverse logic reasoning and math benchmarks, RLAD consistently outperforms offline distillation, standard GRPO, and KL-based on-policy teacher-student knowledge distillation.

03.
medRxiv (Medicine) 2026-06-15

Epileptogenicity alters intrahippocampal ripple propagation

Objective: Tracing the propagation of high-frequency oscillations (HFOs) aids in localizing epileptogenic regions and improving surgical outcomes. We examined how hippocampal epileptogenicity influences the propagation properties of the HFOs it generates. Methods: We analyzed non-REM sleep stereo-EEG from 49 patients (68 hemispheres) with verified hippocampal contacts. Hippocampi were stratified by excitability: 28 seizure onset zone (SOZ), 22 more-irritative non-SOZ (>6 interictal epileptiform discharges [IED]/min), and 18 less-irritative non-SOZ (

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

Agentic Large Language Models for Automated Structural Analysis of 3D Frame Systems

arXiv:2606.06525v2 Announce Type: replace-cross Abstract: Large language models (LLMs) have emerged as powerful foundation models with strong reasoning capabilities across domains. Beyond reactive text generation, agentic LLMs enable autonomous workflow execution through modular task decomposition and coordinated tool use. In structural engineering, recent efforts have developed agentic LLMs for automated analysis of plane frames. However, their extension to 3D frames remains underexplored due to challenges in irregular geometric representation, topological consistency, and long-horizon reasoning. This paper proposes an agentic LLM framework for automated structural analysis of 3D frames from natural language inputs. Irregular 3D frames are represented by projection onto a 2D plan, where orthogonal gridlines define spatial coordinates and a matrix of number of stories encodes vertical extrusion of each grid cell. Building on this representation, the framework establishes a multi-agent pipeline: a problem analysis agent parses input into structured JSON; a floor decomposition agent derives the spatial layout of each floor; the 3D geometry is assembled by node, girder, slab, and column agents; support and load agents assign boundary and loading conditions, and code translation agents generate executable SAP2000 script. Evaluated on ten representative 3D frames, the proposed framework achieves an average accuracy of 90% across repeated trials, demonstrating consistent and reliable performance.

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

Querying an astronomical database using large language models: the ALeRCE text-to-SQL system

arXiv:2606.18108v1 Announce Type: cross Abstract: We develop a text-to-SQL (structured query language) system based on large language models (LLMs) using in-context learning and apply it to the Automatic Learning for the Rapid Classification of Events (ALeRCE) astronomical database. ALeRCE is a community broker for the Zwicky Transient Facility and the Vera C. Rubin Observatory. The system enables users to query the database in natural language (NL) and generates executable SQL queries. To develop and evaluate the system, we constructed a dataset of 110 NL/SQL pairs. We propose a step-by-step generation framework comprising four modules: schema linking, query classification, prompt decomposition, and self-correction. The performance of thirteen LLMs is evaluated using in-context learning and prompt engineering techniques. Text-to-SQL performance is assessed using the perfect-match (PM) rate for row identifiers (e.g., object identifiers) and column identifiers (i.e., column names). The proposed step-by-step framework consistently outperforms a direct-inference baseline, while the self-correction module consistently reduces execution errors. For Claude Opus 4.6, PM performance on row (column) identifiers is high for simple queries, reaching 0.97 (0.94), and decreases with query complexity to 0.44 (0.72) for medium queries and 0.59 (0.49) for hard queries. Among the thirteen evaluated models, the best-performing LLMs for the text-to-SQL task are Claude Opus 4.6, Gemini 2.5 Pro, Gemini 3 Flash, and GPT-5.2-Codex.

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

Dense Supervision, Sparse Updates: On the Sparsity and Geometry of On-Policy Distillation

arXiv:2606.13657v1 Announce Type: new Abstract: On-policy distillation (\textsc{OPD}) has recently become a prominent post-training recipe as it combines two desirable ingredients: on-policy student trajectories and dense teacher supervision, yet how this hybrid changes a model's parameters remains unclear. Across several language and vision-language model pairs and use cases, our analysis yields two main findings. On sparsity, \textsc{OPD}-style updates are small and coordinate-sparse. They are distributed across layers and are usually FFN-heavy. This sparse structure is operationally useful: training only the discovered subnetwork recovers nearly the same performance as full \textsc{OPD}. However, the sparsity-inducing SGD optimizer underperforms AdamW in our optimizer ablation, likely because dense teacher supervision preserves heterogeneous coordinate-wise gradient scales where AdamW's adaptive scaling remains useful. On geometry, the updates are numerically full-rank but spectrally concentrated; they lie mostly away from the principal singular subspaces of the source weights and fall disproportionately on coordinates where the source weights are close to zero. These findings suggest that dense teacher supervision does not turn \textsc{OPD} into ordinary dense parameter rewriting; instead, \textsc{OPD} retains important geometric signatures of on-policy post-training.

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

The KG-ER Conceptual Schema Language

arXiv:2508.02548v3 Announce Type: replace-cross Abstract: We propose KG-ER, a conceptual schema language for knowledge graphs that describes the structure of knowledge graphs independently of their representation (relational databases, property graphs, RDF) while helping to capture the semantics of the information stored in a knowledge graph.

08.
arXiv (CS.CV) 2026-06-12

Spatially Grounded Concept Bottleneck Models via Part-Factorized Attention

Concept bottleneck models (CBMs) predict a layer of human-named attributes before predicting a class, which makes their decisions auditable. On fine-grained recognition tasks the concept heads are usually free to attend anywhere in the image, so a head named for one body region can be satisfied by evidence on another. This work studies a part-factorized CBM that removes that freedom by construction. The method has three components built on a frozen DINOv3 vision transformer. A learned foreground gate, trained on DINOv3 patch features, suppresses background patches inside the part attention. A set of part queries cross-attends to patch features and each of the 312 CUB attributes is routed, through a fixed concept-to-part map, to read only from the part token its name implies. A learnable two-dimensional Gaussian prior, injected additively in log space into the attention logits, breaks the permutation symmetry among part queries; its means are initialized from the dataset-average keypoint location of each part, which requires no per-image keypoint supervision at training or test time. On CUB-200-2011 the spatial-prior model matches a fully supervised baseline (88.85% versus 88.95% top-1) while raising pointing accuracy by 16 points (52.6% versus 36.4%). Replacing bounding-box supervision with a PCA foreground target and combining it with the Gaussian prior removes all per-image supervision and reaches 88.6% top-1 at about 70% pointing accuracy. A keypoint-fraction sweep shows that 0.5% of the training set (about 27 images) suffices to initialize the prior with no measurable loss. Removing part identity entirely is the harder case: without any spatial prior, pointing accuracy collapses to $2.9\%$.

09.
arXiv (CS.LG) 2026-06-17

Conditional Attribution for Root Cause Analysis in Time-Series Anomaly Detection

arXiv:2604.17616v3 Announce Type: replace Abstract: Root cause analysis (RCA) for time-series anomaly detection is critical for the reliable operation of complex real-world systems. Existing explanation methods often rely on unrealistic feature perturbations and ignore temporal and cross-feature dependencies, leading to unreliable attributions. We propose a conditional attribution framework that explains anomalies relative to contextually similar normal system states. Instead of using marginal or randomly sampled baselines, our method retrieves representative normal instances conditioned on the anomalous observation, enabling dependency-preserving and operationally meaningful explanations. To support high-dimensional time-series data, contextual retrieval is performed in learned low-dimensional representations using both variational autoencoder latent spaces and UMAP manifold embeddings. By grounding the retrieval process in the system's learned manifold, this strategy avoids out-of-distribution artifacts and ensures attribution fidelity while maintaining computational efficiency. We further introduce confidence-aware and temporal evaluation metrics for assessing explanation reliability and responsiveness. Experiments on the SWaT and MSDS benchmarks demonstrate that the proposed approach consistently improves root-cause identification accuracy, temporal localization, and robustness across multiple anomaly detection models. These results highlight the practical utility of conditional attribution for explainable anomaly diagnosis in complex time-series systems. Code and models are available at: https://github.com/dfki-av/Conditional-Attribution-for-Root-Cause-Analysis-in-Time-Series-Anomaly-Detection.

10.
arXiv (CS.AI) 2026-06-12

Benchmarking AI Agents for Addressing Scientific Challenges Across Scales

arXiv:2606.12736v1 Announce Type: new Abstract: AI agents are increasingly being developed to accelerate scientific discovery, yet their practical capabilities in real research settings remain poorly understood. Existing benchmarks for AI agents rarely capture the complexity, heterogeneity, and extended reasoning required by scientific work, whereas benchmarks for scientific tasks often reduce research to static, direct problems and provide limited support for interactive evaluation. Here, we introduce SciAgentArena, a systematic benchmark for evaluating AI agents in real-world scientific research scenarios drawn from emerging needs across multiple domains. SciAgentArena comprises approximately 200 tasks with stepwise verification and an interactive, agent-agnostic environment for assessing diverse AI agents. Using this benchmark, we find that current agents can contribute effectively to well-specified data-analysis workflows, particularly when the task structure and evaluation criteria are clear. However, their performance remains uneven across scientific contexts: agents struggle to generate genuinely novel insights, sustain self-directed exploration, and formulate robust solutions for open-ended research questions. We further characterize common failure modes across agents and identify opportunities for improving their reliability, autonomy, and scientific reasoning. Together, SciAgentArena provides a practical framework for measuring progress in AI agents for science and for guiding the design of future agents capable of addressing complex scientific challenges. Full codes, tasks, and datasets can be accessed via this link: https://sciagentarena.github.io/.

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

PPDM: Pixel Puzzling Diffusion Model for Speed and Memory Efficient Volumetric Medical Image Translation

Diffusion models have demonstrated superior fidelity for medical image-to-image translation, but their extension to high-resolution 3D volumes is severely constrained by prohibitive computational cost and GPU memory requirements. Existing memory-efficient strategies often compromise global volumetric consistency or fine anatomical detail. In this work, we propose the Pixel Puzzling Diffusion Model (PPDM), a simple and effective framework for memory- and speed-efficient 3D medical image translation. PPDM introduces a reversible pixel puzzle-unpuzzle operator that trades spatial resolution for channel dimensionality, substantially reducing activation memory while preserving global context. To further improve efficiency and stability, we adopt a direct bridge diffusion formulation that starts from the conditional input rather than pure noise, enabling the model to focus on task-relevant residuals. In addition, a puzzle-gradient loss is incorporated to enforce spatial coherence and suppress grid-like artifacts introduced by spatial rearrangement. We evaluate PPDM on multiple challenging 3D medical image translation tasks, including low-count PET denoising, joint PET denoising and attenuation correction, and cross-modal MRI translation. Across all tasks, PPDM consistently matches or outperforms full 3D diffusion models while reducing training GPU memory usage by up to an order of magnitude and significantly accelerating inference, and it outperforms existing memory-efficient diffusion approaches based on latent compression or frequency decomposition. These results demonstrate that PPDM provides a practical and scalable solution for high-fidelity 3D diffusion-based medical image translation under limited computational resources.

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

Seed-Guided Semi-Supervised Clustering by A-Contrario Anomaly Detection

arXiv:2606.18833v1 Announce Type: new Abstract: This paper introduces a semi-supervised clustering framework grounded in the statistical duality between grouping principles and anomaly detection. We address the challenge of robust cluster definition in noisy environments – a task where partitioning algorithms often over-assign outliers and density-based methods remain sensitive to heuristic global parameters. Drawing on a-contrario statistical reasoning and Gestalt proximity principles, we define a cluster as a maximal subset of data points containing no anomalies relative to a null hypothesis of uniform randomness. Central to this approach is the Perception algorithm, which utilises a principled expectation-based threshold ($\mathbb{E} < 1$) to identify outliers without manual parameter tuning. By treating clustering as the dual of anomaly detection, we employ an iterative ``clustering-by-exclusion'' mechanism. The algorithm is seed-guided, leveraging minimal user-provided labels to initialise robust cluster medians and form initial groups, which are subsequently expanded by admitting non-anomalous points. This approach naturally isolates fringe points, isolated noise, and emerging unknown clusters. We evaluate the method on synthetic and real-world benchmarks, including image and text datasets represented through raw, linear-reduced, and neighbourhood-preserving embeddings. Results demonstrate that with as few as 10–30 seeds per cluster, the proposed method achieves competitive and often very strong performance under a practical low-tuning benchmarking protocol, while maintaining linear scalability with respect to both observations and dimensionality for a fixed number of seeded clusters and iterations.

13.
bioRxiv (Bioinfo) 2026-06-21

ReSeT: a taxonomy-aware reference genome selection tool

Motivation: Reference genome composition determines which taxa a profiling pipeline can detect and distinguish, and becomes of critical importance for high-resolution profiling where taxonomic boundaries begin to blur. Existing selection tools optimize within-taxon representativeness but disregard discrimination across taxa, leaving open whether explicitly accounting for inter-taxon discrimination during selection improves profiling. Results: Here we present ReSeT, a facility-location-based reference genome selection tool that operates on arbitrary pairwise distance matrices, extended with a tunable inter-taxon discrimination term and per-genome selection cost, and solved by local search. We benchmark ReSeT against established selection methods on three viral datasets spanning varying degrees of taxonomic ambiguity. On the high-ambiguity SARS-CoV-2 datasets, appropriately tuned ReSeT selections matched or exceeded the strongest alternatives in terms of profiling accuracy, whereas on the low ambiguity IAV dataset VSEARCH remained dominant. Interestingly, we find that the novel inter-taxon discrimination term contributed weakly, indicating that ReSeT's facility-location formulation and selection cost drives ReSeT's performance. We further propose a novel taxonomic ambiguity index, computable from ReSeT's inputs, that summarizes the taxonomic ambiguity of reference genomes and aligns with where ReSeT improves over existing selection methods. Availability and implementation: ReSeT is implemented in Python ([&ge;]3.10) and is freely available under the MIT license. The source code is available on GitHub at https://github.com/JaspervB-tud/ReSeT and ReSeT can also be installed directly from the Python Package Index (PyPI) via pip install reset-bio.

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

Exploring Extrinsic and Intrinsic Properties for Effective Reasoning with Code Interpreter

Reasoning with a Code Interpreter (CI) has emerged as an effective paradigm for enhancing the reasoning capabilities of large language models (LLMs) through executable computation and iterative verification. Despite its growing adoption, the behavioral properties underlying effective code reasoning remain largely underexplored. In this work, we investigate code reasoning from two distinct perspectives inspired by prior studies of natural language reasoning: extrinsic properties, represented by crucial tokens, and intrinsic properties, represented by code-specific cognitive behaviors. Across multiple LLMs, we find that stronger CI reasoning models consistently exhibit a higher prevalence of crucial tokens and cognitive behaviors, particularly verification, backtracking, and backward chaining. Building on these observations, we examine how these properties can be leveraged during both inference and training. At inference time, appending code-specific crucial tokens improves performance on several reasoning capabilities, including mathematical, ordering, and optimization, while yielding limited benefits elsewhere. At training time, augmenting a state-of-the-art framework with code-specific cognitive behaviors improves supervised fine-tuning and reinforcement learning performance in two of three evaluated models. Further analysis shows that these behaviors reduce overthinking in incorrect responses and improve token efficiency, while also revealing factors that limit gains in a certain model. Our findings provide the first systematic characterization of effective reasoning with CI and demonstrate both the potential and limitations of leveraging key properties to improve CI-based reasoning.

15.
arXiv (quant-ph) 2026-06-11

Large Fluctuations in Open Quantum Systems

arXiv:2606.11822v1 Announce Type: new Abstract: We study statistics of atypical measurement outcomes in the steady states of driven open quantum systems. In equilibrium, the probability distribution over the phase space, as encoded in, e.g., the Wigner function, is analytic in the phase-space coordinates. We show that this property is generically lost in driven dissipative systems: their {\it large-deviation function} develops lines and surfaces across which its derivatives are discontinuous. As an illustrative example, we consider a parametrically driven Kerr oscillator coupled linearly and/or nonlinearly to a dissipative bath. Rare fluctuations in the amplitude and phase of the induced oscillations are governed by semiclassical instanton trajectories of the corresponding Keldysh-Lindblad action. We demonstrate that a given fluctuation can be realized through multiple distinct instanton trajectories. The competition between these trajectories leads to abrupt switching of the dominant instanton and, consequently, to non-analytic features in the large-deviation function.

16.
arXiv (math.PR) 2026-06-15

Stability of Synthetic Ricci Curvature Lower Bounds for Inverse Limit Extended Metric Measure Spaces

arXiv:2606.14322v1 Announce Type: cross Abstract: We show that every Polish extended metric measure space arises as an inverse limit of metric measure spaces up to isomorphism. We then prove that synthetic Ricci curvature lower bounds and several functional inequalities, including the log-Sobolev, Talagrand, Poincaré, and dimension-free Harnack inequalities are stable under inverse limit. We discuss applications to infinite-dimensional spaces, including abstract Wiener spaces and their quotient spaces.

17.
arXiv (CS.AI) 2026-06-15

A fully GPU-based workflow for building physics emulators of hypersonic flows

arXiv:2606.13742v1 Announce Type: cross Abstract: The ability to resolve complex physical phenomena with high fidelity and at low computational cost is central to addressing key challenges in modern engineering. A prime example lies in hypersonic flows, where the precise prediction of the full flowfield topology, in particular with respect to shock wave location and intensity, is critical. Yet supersonic and hypersonic flows continue to be a stumbling block for traditional reduced-order models and neural emulators that struggle to capture steep gradients in flow states with physical consistency in applications of industrial relevance. To that end, we introduce a fully GPU based workflow that integrates accelerated data generation with the training of neural emulators augmented by uncertainty quantification and physics-aware refinement. Our workflow is enabled by a differentiable high-fidelity solver (JAX-Fluids) which we employ for rapid dataset creation and residual-based improvement of the neural emulator to enhance physical consistency. Building on this framework, we first present a suite of model architectures and analyze their scaling behavior to expose their strengths and shortcomings. We then show that residual-based refinement enables training on cases where only mesh and input parameters are available, substantially reducing residuals and improving physical consistency. Together, differentiable simulation and residual-based refinement yield physics emulators that remain reliable beyond their training distribution, a key requirement for deploying surrogates in real-world engineering design loops.

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

A solvable model for unsupervised federated learning

arXiv:2606.13045v1 Announce Type: cross Abstract: We introduce a theoretical framework for analyzing federated learning in a generative setting through a teacher-multiple interacting students scenario, in which each student receives a distinct realization of the data, either through a different noise corruption or by accessing a different subset, possibly of varying size. Using theoretical tools in equilibrium disordered system, we analytically show that interactions among students systematically enhance learning performance: highly noisy students require fewer samples to recover the underlying pattern, while low-noise students achieve a larger overlap with the ground-truth signal. We derive the optimal Bayesian conditions for teacher recovery as functions of the sample complexity, noise level, and interaction strength, and validate these predictions through numerical simulations. The resulting dynamics can be mapped onto equilibrium sampling in a Restricted Boltzmann Machine with a structured hidden layer, providing a principled theoretical understanding of how interactions improve distributed generative modeling.

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

Ternary Mamba: Grouped Quantization-Aware Training of W1.58A16 State Space Models

arXiv:2606.18114v1 Announce Type: cross Abstract: State Space Models (SSMs) such as Mamba-2 offer linear-time inference but their memory footprint limits edge deployment. Prior ternary SSM work (Slender-Mamba) trains from scratch on 150B tokens; we show a pretrained checkpoint suffices, reducing the marginal token budget by 1,000x. Using grouped quantization-aware training (QAT) with knowledge distillation from a frozen FP16 teacher, we compress Mamba-2 1.3B to 3.61x (2,687 to 744 MB) and achieve 48.1% zero-shot accuracy (7-task average) in just 102M tokens (4 GPU-hours, single H100) – approaching Bi-Mamba's 48.4% (within +/-0.9pp CI). This QAT-from-pretrained setting reveals zero-ratio collapse, a novel instability caused by learnable quantization scales that does not arise in from-scratch training. We further show that post-hoc correction strategies effective for Transformers fail for SSMs due to error accumulation through the recurrence. These results demonstrate that ternary SSMs do not require expensive from-scratch training: QAT from pretrained checkpoints with KD is a data-efficient alternative.

22.
medRxiv (Medicine) 2026-06-15

Non-Parametric Ancestry Adjustment for Polygenic Scores

Modern polygenic risk scores (PRS) exhibit shifts correlated with ancestry, leading to erroneous predictions for non-European individuals when models are trained on predominantly European cohorts. Such shifts arise from, among other factors, (1) algorithmic limitations in the ability of PRS model training to detect causal variants, rather than nearby variants with ancestry-dependent correlations to the causal one, (2) under-representation of alleles with higher prevalence in non-European populations in the association study training, and (3) gene-by-environment interactions where the environment is correlated with genetic ancestry. Current ancestry-adjustment methodologies often discretize individuals into population categories and apply a simple affine mapping to reduce these genetic ancestry biases. However, such approaches provide suboptimal adjustments, particularly for admixed individuals. In this work, we introduce a detailed theoretical characterization of ancestry-dependent biases and propose novel methods based on non-parametric neighborhood techniques that provide more accurate empirical results and admit statistical consistency guarantees. Extensive experiments using the UK Biobank demonstrate the effectiveness of the proposed methods.

24.
Nature (Science) 2026-06-17

Cucurbituril-based anion-conducting membranes with supramolecular nanopores

作者:

Nanoporous anion-conducting membranes have gained considerable interest for their potential to reduce resistance in electrochemical devices1–4. Current pore-forming methods, such as backbone engineering through polymers of intrinsic microporosity5,6 or covalent organic and metal–organic frameworks7,8, however, suffer from limited structural control, mechanical fragility or demanding synthesis. Here we establish a supramolecular strategy that overcomes these limitations by constructing uniform, dynamic nanopores. Co-assembly of the rigid macrocyclic host cucurbit[7]uril with the cationic polymer guest quaternized poly(piperidinium-terphenyl) yields a robust network of nanometre-scale channels while simultaneously enhancing mechanical and chemical stability. The dynamic host–guest interactions allow the pore structure to fluctuate on picosecond and angstrom scales. This transient environment supports low-friction hydroxide migration through a Grotthuss mechanism, producing a marked enhancement in ionic conductivity. This bottom-up design principle provides a versatile new tool for molecularly engineering transport pathways and promises to advance electrochemical reactors with respect to energy efficiency, operational stability and the production of high-purity products. A supramolecular strategy, in which uniform, dynamic nanopores are constructed, overcomes the limitations of limited structural control, mechanical fragility or demanding synthesis in nanoporous anion-conducting membranes, providing a versatile tool for molecularly engineering transport pathways.

25.
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.