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01.
arXiv (CS.LG) 2026-06-11

Seeing Before Colliding: Anticipatory Safe RL with Frozen Vision-Language Models

arXiv:2606.11266v1 Announce Type: new Abstract: The cost signal that constrained-RL algorithms optimize against is almost always reactive: the simulator emits a non-zero cost only after a collision has begun, and the Lagrange multiplier of PPO-Lagrangian grows only after the episode budget has been exceeded. At race speeds, where collisions are instantaneous and irreversible, any safety mechanism that waits for cost to accumulate is structurally too late. We present VLM-Safe-RL, a framework that integrates a frozen vision-language model into the CMDP Lagrangian update as an anticipatory cost term. The framework comprises four contributions: (i) Decoupled Dual-Path CLIP, independent reward/cost paths that respect the CMDP's factorization; (ii) VLM-Lagrange, an augmented multiplier update that incorporates a per-step VLM cost as an anticipatory term; (iii) Confidence Gating, a Bayes-optimal weight derived from a logistic noise model on the CLIP margin; and (iv) VLMPPOLag, the composed algorithm. On Safety-Gymnasium FormulaOne L2, our principal evaluation ($n{=}5$ seeds, $10^{6}$ steps, budget $d_{lim}{=}25$) VLMPPOLag$+$Conf is the only configuration in our default budget comparison that simultaneously retains substantive return ($J_r{\approx}40$) and holds cost within budget on a majority of seeds; the five constraint-aware baselines (PPOLag, CPO, CPPOPID, CPO-CLG, PPOLag-RND) each fail at least one requirement. The mechanism generalizes to held-out MetaDrive Medium (catastrophe rate $41\%{\to}26\%$, 95\% bootstrap CI $[-26,-5]$\,pp) and shows directionally consistent transfer to Bullet Safety-Gym; we report honestly where it does not (MetaDrive Easy/Hard, Qwen2-VL backbone) and trace the Hard failure to a Lagrangian-regulation pathology rather than the VLM signal itself. To our knowledge, this is the first work to use frozen VLM signals as an anticipatory cost term inside the CMDP Lagrangian update.

02.
arXiv (CS.LG) 2026-06-16

Airport Terminal Passenger Queue Forecasting for Departure Gates and Security Checkpoints

arXiv:2606.07622v2 Announce Type: replace Abstract: Accurate passenger queue forecasting in airport terminals is essential for efficient departure operations, as it enables proactive congestion management. However, time-varying passenger demand and heterogeneous facility usage across multiple departure facilities make forecasting challenging. In this work, we propose a passenger queue forecasting framework that learns historical passenger flow patterns from operational data. The proposed model employs a Transformer-based architecture to capture temporal dependencies and inter-facility correlations using past queue length and waiting time at departure gates and security checkpoints, together with passenger throughput at check-in islands. The learned representations are mapped to two facility-specific prediction heads to predict queue length and waiting time at departure gates and security checkpoints. Experimental results demonstrate accurate forecasts up to two hours ahead. The proposed approach offers practical real-time decision support for proactive queue management and staff reallocation in airport terminal operations.

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

RollArt: Disaggregated Multi-Task Agentic RL Training at Scale

arXiv:2512.22560v2 Announce Type: replace-cross Abstract: Agentic Reinforcement Learning (RL) trains LLMs through multi-turn interactions with environments, producing workloads that mix compute-bound prefill, bandwidth-bound decoding, CPU-heavy environment execution, and bursty reward evaluation. Existing systems either colocate all stages on a single GPU cluster or decouple them only at a coarse granularity, overlooking hardware heterogeneity and incurring substantial synchronization overhead across stages. We present ROLLART, a system for multi-task agentic RL on disaggregated infrastructure. ROLLART maps each pipeline stage to best-fit hardware, routing prefill-heavy tasks to compute-optimized GPUs, decode-heavy tasks to bandwidth-optimized GPUs, and environments to CPU clusters. It decouples rollout at the trajectory level, allowing generation, environment interaction, and reward scoring to proceed independently, so that slow or failed environments never block the others. ROLLART offloads stateless reward computation to serverless infrastructure and overlaps rollout with training via staleness-bounded asynchronous weight synchronization. Our results demonstrate that ROLLART effectively improves training throughput and achieves 1.31–2.05 \(\times\) training time reduction compared to various RL systems. We also evaluated ROLLART by training a hundreds-of-billions-parameter MoE model for Qoder product on an Alibaba cluster with above 3,000 GPUs, demonstrating its stability and scalability.

04.
arXiv (quant-ph) 2026-06-15

Optimal Decoding of Small Codes by Density Matrix Propagation

arXiv:2606.14455v1 Announce Type: new Abstract: Accurate and efficient decoding is a crucial component for achieving fault-tolerant quantum computing. Realistic circuit-level noise introduces temporal correlations and degeneracy, making optimal (maximum-likelihood) decoding computationally intractable in general. As a result, practical decoders rely on heuristic approximations, and it is generally difficult to quantify how suboptimal they are, as this strongly depends on the code and noise model considered. In this work, we study the accuracy of practical decoding algorithms under circuit-level noise by comparing them against a maximum likelihood decoding benchmark. Our approach propagates the density matrix through the full memory experiment and computes the optimal decoding decision for each syndrome history. We introduce pruning techniques with rigorous bounds, allowing us to access larger numbers of syndrome-extraction rounds. We apply this framework to small instances of the repetition code and a cellular automaton code, and benchmark minimum-weight perfect matching (MWPM), belief propagation with ordered statistics decoding (BP+OSD), Tesseract, and Planar decoders against optimal decoding. While standard decoders remain close to optimal for the repetition code, we find significant deviations for the cellular automaton code, with BP+OSD deteriorating already in experimentally relevant noise regimes. Moreover, the pruning method developed here highlights that, at low physical error rates, only a narrow fraction of syndrome histories contributes significantly to the logical error rate.

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

On the Benefits of Weight Normalization for Overparameterized Matrix Sensing

arXiv:2510.01175v2 Announce Type: replace Abstract: While normalization techniques are widely used in deep learning, their theoretical understanding remains relatively limited. In this work, we establish the benefits of (generalized) weight normalization (WN) applied to the overparameterized matrix sensing problem. We prove that WN with Riemannian optimization achieves linear convergence, yielding an exponential speedup over standard methods that do not use WN. Our analysis further demonstrates that both iteration and sample complexity improve polynomially as the level of overparameterization increases. To the best of our knowledge, this work provides the first characterization of how WN leverages overparameterization for faster convergence in matrix sensing.

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

MinhwaNet: Faithful but Insufficient Object Grounding in Korean Folk Painting

Authors:

Korean folk painting (minhwa) is built from a small vocabulary of auspicious symbols, a tiger for protection, a pair of birds for marital harmony, a peony for wealth, that recur across many of its painted genres. This suggests an obvious computational approach, identify which symbols appear in a painting and read the genre from the inventory. Working with a public corpus that pairs whole paintings, eight-field bilingual curatorial captions, and a separate set of expert object crops, we find that this approach does not work. A model given only a list of which symbols a painting contains predicts the genre far worse than a model that fuses the image with the curatorial text, and forcing the genre representation to be object-grounded actively hurts accuracy. The visual evidence on which the genre prediction rests is nonetheless localized and inspectable. A leakage-safe object evidence map projected from a part-level detector is spatially faithful to where curators isolated symbolic objects and to a patch-based surrogate's own gradient saliency. We name this configuration a faithful-but-insufficient dissociation. The part-level explanation is honest about what the part-level model sees, yet the genre target turns on how symbols are arranged rather than on which ones appear. The same lens separates a content label that survives transfer to held-out source institutions, genre, from a style label that does not, era, a prediction we confirm on two further labels in the corpus. We release the multimodal system, a worked-example reading of one painting's evidence map against its catalogue, and a set of evaluation cautions that recur in long-tailed heritage collections.

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

When and How Severely: Scenario-Specific Safety Envelopes for Driving VLAs

arXiv:2606.14238v1 Announce Type: cross Abstract: Safety certification of Vision-Language-Action (VLA) driving planners under ISO 21448 (SOTIF) rests on an Operational Design Domain (ODD) specification that answers two complementary questions: when does the planner start to fail, and how severely does it fail once it does? We evaluate Alpamayo R1, a 10B-parameter open-weight driving VLA, on 15,968 (clip, attack) pairs. We find a conservative-aggregate gap: an aggregate safe threshold of $\sigma \leq 50$ under a 15% average displacement error (ADE) budget masks well-sampled scenarios that tolerate the top of the tested grid ($\sigma = 70$). A Gaussian Mixture Model (GMM) on the changed-explanation subset identifies six discrete severity bands (BIC-optimal $k{=}6$), so two perturbation conditions with the same mean error can differ materially in their share of high-severity (C4/C5) failures. Joining the two analyses on the same corpus surfaces a finding neither yields in isolation: the scenarios with the loosest noise thresholds are not those with the lowest high-severity rate: STOP_SIGNAL concentrates roughly $4\times$ the C4/C5 share of LANE_KEEPING despite tolerating a larger $\sigma$. A deployable SOTIF ODD specification for driving VLAs therefore requires a two-dimensional safety envelope, not a single aggregate value per hazard.

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

Multi-Fidelity SINDy: Sparse Discovery of Nonlinear Dynamical Systems with Fidelity-Weighted Measurements

arXiv:2606.15690v1 Announce Type: new Abstract: Data from simulations and experiments are rarely noise-free and often exhibit heterogeneous levels of fidelity. Measurement uncertainty may vary across repeated observations, sensing devices, or even within a single experiment. This work addresses the problem of discovering nonlinear dynamical systems from such inhomogeneous data. We extend the Sparse Identification of Nonlinear Dynamical Systems (SINDy) framework to account for variable noise levels by combining Ensemble SINDy and Weak SINDy within a weighted regression formulation derived from generalized least squares. A statistical justification for the weighting strategy is also provided. The methodology is validated on several benchmark systems, including ordinary and partial differential equations. In addition, we show the benefit of multi-fidelity integration for forecasting the dynamics of a double pendulum system. The results confirm that the proposed approach mitigates the adverse effects of heteroscedastic noise and that repeated, low-cost, low-quality measurements can improve model recovery, in some cases matching or outperforming reconstructions obtained using only high-fidelity data.

09.
arXiv (quant-ph) 2026-06-12

Relativistic Locality from Electromagnetism to Quantum Field Theory

arXiv:2412.11532v2 Announce Type: replace Abstract: Electromagnetism is the paradigm case of a theory that satisfies relativistic locality. This can be proven by demonstrating that, once the theory's laws are imposed, what is happening within a region fixes what will happen in the contracting light-cone with that region as its base. The Klein-Gordon and Dirac equations meet the same standard. We show that this standard can also be applied to quantum field theory (without collapse), examining two different ways of assigning reduced density matrix states to regions of space. Our preferred method begins from field wave functionals and judges quantum field theory to be local. Another method begins from particle wave functions (states in Fock space) and leads to either non-locality or an inability to assign states to regions, depending on the choice of creation operators. We take this analysis of quantum field theory (without collapse) to show that the many-worlds interpretation of quantum physics is local at the fundamental level. We argue that this fundamental locality is compatible with either local or global accounts of the non-fundamental branching of worlds, countering an objection that has been raised to the Sebens-Carroll derivation of the Born Rule from self-locating uncertainty.

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

Maximin Relative Improvement: Fair Learning as a Bargaining Problem

arXiv:2602.04155v2 Announce Type: replace-cross Abstract: When deploying a single predictor across multiple subpopulations, we propose a fundamentally different approach: interpreting group fairness as a bargaining problem among subpopulations. This game-theoretic perspective reveals that existing robust optimization methods such as minimizing worst-group loss or regret correspond to classical bargaining solutions and embody different fairness principles. We propose relative improvement, the ratio of actual risk reduction to potential reduction from a baseline predictor, which recovers the Kalai-Smorodinsky solution. Unlike absolute-scale methods that may not be comparable when groups have different potential predictability, relative improvement provides axiomatic justification including scale invariance and individual monotonicity. We establish finite-sample convergence guarantees under mild conditions.

11.
arXiv (CS.LG) 2026-06-15

Neural ARFIMA model for forecasting BRIC exchange rates with long memory

arXiv:2509.06697v3 Announce Type: replace-cross Abstract: Exchange rate forecasting remains a challenging problem, particularly for emerging economies, where the observed time series exhibit pronounced long-memory dependence, nonlinear dynamics, and sensitivity to macro-financial drivers. Classical models such as ARFIMA capture long-range persistence but fail to adequately represent nonlinear relationships, while modern machine learning approaches often neglect the underlying long-memory structure in macroeconomic series. To address this gap, we propose a Neural AutoRegressive Fractionally Integrated Moving Average (NARFIMA) model that integrates ARFIMA-based long-memory modeling with neural networks for nonlinear function approximation, while incorporating exogenous macroeconomic and uncertainty indicators. The framework provides a unified approach for capturing persistence, nonlinear dynamics, and external shocks. We establish asymptotic stationarity of the NARFIMA process and develop conformal prediction intervals for distribution-free uncertainty quantification. Empirical results for BRIC exchange rates show that NARFIMA consistently outperforms a broad range of forecasting benchmarks across multiple horizons, underscoring the importance of explicitly modeling long-memory dependence in exchange rate dynamics. The `narfima' R package provides an implementation of our approach.

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

Temporally Consistent and Controllable Video Generation of 2D Cine CMR via Latent Space Motion Modeling

Cine cardiac magnetic resonance is the gold standard for assessing cardiac function, but the scarcity of public datasets limits the development of advanced data-driven models. To address this limitation, we propose a generative method for synthesizing temporally coherent and anatomically consistent cardiac sequences. Our text-to-video framework decouples cardiac spatial structure from temporal motion. First, a fine-tuned diffusion model synthesizes an initial frame from a clinical text prompt, controlling anatomical features. Then, a latent flow model conditioned on a cardiac phase embedding generates the complete cardiac motion, ensuring spatial consistency and temporal control. Our model generates anatomically and pathologically diverse sequences with high temporal coherence and strong fidelity to input prompts, achieving a FID of 31.68 for image realism and a CLIP score of 31.04 for text-image alignment. These experimental results highlight its potential to produce high-fidelity, on-demand medical data, offering a scalable solution to data scarcity.

13.
Nature (Science) 2026-06-17

The ancestors of eukaryotic cells contained a mix of genes from various microbes

Authors: Unknown Author

Reconstruction of the ancestral gene repertoire of eukaryotic cells reveals traces of a series of close, long-term interactions with diverse microorganisms, and a role of viruses in gene exchange. The findings challenge the view that eukaryotic cells evolved from a simple merger of just two organisms. A series of gene-transfer events might have taken place in complex microbial communities.

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

Misinformation Propagation in Benign Multi-Agent Systems

Multi-agent systems, in which multiple large language model agents solve problems through turn-based interaction, are increasingly deployed in high-stakes settings such as medical diagnosis, legal analysis, and forensic decision-making. Their reliability can be at risk when single agents reason from incorrect or misleading context, e.g., from tool calls, since errors may propagate through agent interactions. This work studies this risk by injecting intent-based misinformation into benign single-agent and multi-agent systems across reasoning, knowledge, and alignment tasks. We find that misinformation can degrade single-agent performance and persists across multi-agent debate, with agents often retaining answers introduced by misinformed peers. Nevertheless, multi-agent debate reduces the resulting performance degradation compared to single-agent prompting, especially when most agents are not exposed to misinformation. Robustness depends on group composition and decision protocol. Consensus can be more stable than voting under peer pressure, while majorities can often steer misinformed agents back toward correct answers. Our results show that misinformation robustness in multi-agent systems depends on the underlying model and also on how agents exchange information and aggregate decisions.

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

A Compositional Framework for Open-ended Intelligence

arXiv:2606.15386v1 Announce Type: new Abstract: Open-ended intelligence is the capacity to adapt to novel problems and environments that are substantially different from those in training. We formalize open-ended intelligence as the closure induced by a finite primitive set \(P\) and a set of composition operators \(C\). We characterize properties of the induced closure \(\mathcal{L}(P,C)\) that support unbounded compositional generation across families of tasks and worlds. A mathematics of open-ended intelligence requires two pillars: a minimal set of representational primitives (e.g., states, actions) and algorithmic primitives (e.g., nearest neighbor), together with composition motifs (e.g., recursion, sequencing) that reflect an acquired compositional grammar. The closure of these two pillars enables the generation of infinite adaptive responses across a wide range of settings. The mathematics supports complementary research agendas, including evaluation metrics for explanation and interpretability, as well as building architectures where compositional generalization is native. We propose next primitive prediction as a novel architectural objective, where the training objective encourages the acquisition of reusable algorithmic primitives and their compositional grammar, such that new solutions are generated through recombination. Curriculum learning and self-play enable lifelong learning and expansion of the closure by discovering reusable primitives and transition motifs across families of tasks and worlds. We ground the framework through case studies in physics, evolution, and neuroscience.

16.
bioRxiv (Bioinfo) 2026-06-18

Structure-Based Immunoinformatics Design of a CTB-Adjuvanted Multi-Epitope Mucosal Vaccine Against Helicobacter pylori

Background: Helicobacter pylori coloniz the gastric mucosa of nearly half of the global population and is classified as a Group I carcinogen by the World Health Organization due to its strong association with gastric cancer. The growing prevalence of antibiotic-resistant H. pylori strains significantly compromises current therapeutic strategies, emphasizing the urgent need for effective prophylactic approaches. Research design and methods; In this study, a novel multi-epitope vaccine was designed targeting H. pylori, incorporating epitopes from four key virulence proteins: BabB, SabB, SabA, and VacA. Using an immunoinformatics-guided structural vaccinology approach, B- and T-cell epitopes were predicted, prioritized based on immunogenicity, conservation, population coverage, and non-homology to human proteins, and assembled into the final vaccine construct. To enhance immunogenicity and specifically stimulate mucosal immune responses, the cholera toxin B subunit (CTB) was fused at the N-terminal via an EAAAK linker, a novel application in H. pylori multi-epitope vaccines. The PADRE universal epitope and additional linkers were incorporated to optimize epitope presentation and helper T-cell activation. Results: Comprehensive evaluations of physicochemical, antigenic, allergenic, and toxic properties were conducted, followed by secondary and tertiary structure modeling, refinement, and validation. Conformational B-cell epitopes were mapped, and molecular docking, binding affinity analysis, energy minimization, and molecular dynamics simulations confirmed structural stability and receptor interactions. Codon optimization and in silico cloning predicted efficient expression in Escherichia coli, while immune simulations suggested robust humoral and cellular responses. Conclusions: This study presents a promising multi-epitope vaccine candidate against H. pylori, offering a rational framework for future experimental validation and potential clinical application.

17.
Science (Express) 2026-05-21

DNA polymerization activates RNA cleavage of a reverse transcriptase–like antiviral enzyme | Science

Authors: Unknown Author

Defense-associated reverse transcriptases (DRTs) transcribe noncoding RNAs (ncRNAs) for antiviral defense, but the mechanisms of ncRNA-independent DRTs remain unclear. In this work, we show that a single DRT4 mediates RNA-targeting antiphage defense by integrating DNA polymerase, exonuclease, and RNA endonuclease activities. First, through an equilibrium between its DNA polymerase and exonuclease activities, DRT4 senses phage infection, as elevated dNTP levels shift the equilibrium toward polymerase activity, thereby promoting protein-primed single-stranded DNA (ssDNA) synthesis. Second, ssDNA of sufficient length, phage DNA-binding proteins, and deoxyguanosine triphosphate collectively activate an unusual RNA endonuclease activity of DRT4, excising 3′–guanosine monophosphate from both phage and host RNA to terminate infection. These findings reveal a distinctive immune strategy combining nucleic acid synthesis and degradation, expanding the functional landscape of DRTs for new DNA- and RNA-processing technologies.

18.
medRxiv (Medicine) 2026-06-15

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

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

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

MEAL: A Benchmark for Continual Multi-Agent Reinforcement Learning

arXiv:2506.14990v3 Announce Type: replace Abstract: Benchmarks play a central role in reinforcement learning (RL) research, yet their computational constraints often shape what is studied. Despite the motivation of lifelong learning, most continual RL papers consider only 3-10 sequential tasks, as CPU-bound environments make longer sequences impractical. Meanwhile, continual learning in cooperative multi-agent settings remains largely unexplored. To address these gaps, we introduce MEAL (Multi-agent Environments for Adaptive Learning), the first benchmark for continual multi-agent RL. By leveraging JAX and GPU acceleration, MEAL enables training on sequences of 100 tasks in a few hours on a single GPU. We find that long task sequences reveal failure modes that do not appear at smaller scales.

20.
arXiv (CS.AI) 2026-06-19

FlowEdit: Associative Memory for Lifelong Pronunciation Adaptation in Flow-Matching TTS

arXiv:2606.20518v1 Announce Type: new Abstract: Flow-matching text-to-speech systems achieve remarkable zero-shot quality but remain static after deployment: pronunciation errors on out-of-vocabulary proper nouns persist unless the model is retrained. We introduce FlowEdit, a life-long adaptation framework for frozen flow-matching TTS that learns pronunciation corrections as latent conditioning edits rather than weight updates. When corrective feedback is provided, FlowEdit optimizes a token-level perturbation in the text embedding space, then stores the correction in a Modern Hopfield Network serving as content-addressable episodic memory. At inference, corrections are retrieved via soft attention with a similarity gate, enabling fuzzy morphological matching. On our curated benchmark of 312 multilingual proper nouns across 18 language families, FlowEdit reduces target-word Phoneme Error Rate by 92.7% relative to the zero-shot baseline while maintaining identical general-speech quality. Corrections complete in approximately 15 seconds on a single GPU.

21.
arXiv (quant-ph) 2026-06-16

MAPS: A Novel Multi-Axial Projective Sphere for Geometrically Visualizing Higher d-Valued Quantum State-Space of Qudits

Authors:

arXiv:2606.15801v1 Announce Type: new Abstract: Visualizing the d-valued quantum state-space of quantum systems serves as a foundational pillar for the scientific research and practical applications in quantum computing and information science, where d >= 2. The 2-valued quantum states of a qubit are elegantly visualized on the three-dimensional Bloch sphere. In contrast, expanding this geometrical paradigm to visualize higher d-valued quantum states of a qudit (d >= 3), e.g., a qutrit (d=3), ququadit (d=4), and quintit (d=5), leads to severe structural and topological complexities. This paper introduces a new generalized three-dimensional framework to effectively visualize higher d-valued quantum states of a qudit, in the aspects of ease of illustration, structural simplicity, and natural representation for researchers and engineers. We called this new framework the "multi-axial projective sphere (MAPS)", which consists of n projectional intersecting spatial axes, where d-1

22.
arXiv (CS.CV) 2026-06-15

Stream3D: Sequential Multi-View 3D Generation via Evidential Memory

View-conditioned 3D generators such as SAM 3D, TRELLIS, and Hunyuan3D produce high-quality object reconstructions from a single view, but real-world visual observation often arrives as long monocular streams. Naively applying these generators to each streaming frame independently leads to severe temporal inconsistency in the generated results. To address this problem, we propose Stream3D, the first training-free streaming mechanism that turns a frozen view-conditioned 3D generator into a streaming generator with constant cross-chunk memory. Stream3D achieves this by maintaining a compact evidential memory, which selectively caches the most informative historical frames based on a proposed evidence score mechanism. As the stream progresses, the memory dynamically updates to retain a fixed number of informative frames, preventing the memory footprint from growing linearly with sequence length. This also prevents degradation over long sequences and keeps the underlying generator completely unchanged without retraining, architectural modifications, or auxiliary losses. Evaluated on both realistic and synthetic streaming benchmarks, Stream3D outperforms latent-transport baselines, including KV-cache reuse and flow-based feature editing, across both photometric and geometric metrics. More details can be found at: https://stream-3d.github.io/stream3d.github.io/.

23.
arXiv (CS.AI) 2026-06-16

MedCollab: IBIS-Guided Multi-Agent Collaboration with Hierarchical Disease Relation Chains for Clinical Diagnosis

arXiv:2603.01131v3 Announce Type: replace-cross Abstract: Clinical diagnosis is a gradual process of evidence integration, in which physicians move from symptoms and medical history to examinations, competing hypotheses, disease relations, and treatment decisions. Large language models have advanced medical text understanding and generation. Yet their clinical use remains limited by weak evidence grounding, opaque reasoning, and inconsistent links among differential diagnosis, final diagnosis, diagnostic basis, and treatment planning. We introduce MedCollab, a multi-agent framework for full-cycle clinical diagnosis and report generation. MedCollab coordinates specialist and examination agents according to patient records. It structures agent deliberation with an Issue-Based Information System (IBIS) protocol, so that each diagnostic position is supported by patient-specific evidence and medical knowledge. It also builds Hierarchical Disease Relation Chains (HDRC) to connect accepted hypotheses through progression, complication, and comorbidity relations. During multi-round deliberation, a verifier-guided consensus module evaluates evidence support, medical plausibility, and logical conflicts. It then adjusts agent contributions and filters unsupported reasoning. Experiments on ClinicalBench and MIMIC-IV show that MedCollab outperforms leading LLMs and medical multi-agent baselines in diagnostic accuracy, evidence consistency, and clinical reasoning quality. These results indicate that structured and auditable collaboration can produce more faithful and clinically coherent diagnostic reports.

24.
medRxiv (Medicine) 2026-06-19

Specific epigenetic age acceleration measures are associated with oral health outcomes in U.S. adults

Objectives: Oral health conditions impact a significant proportion of the global population. Chronological age is a known risk factor; however, characterization of epigenetic age remains limited and is expected to provide additional insight into biological mechanisms. Materials and Methods: The National Health and Nutrition Examination Survey (NHANES) was used to analyze the effect of epigenetic age measures of DunedinPoAm, and epigenetic age acceleration (EAA) of Horvath, Hannum, Weidner, Lin, VidalBralo, PhenoAge, GrimAge, and GrimAge2, on various oral health outcomes from survey and examination results. Univariable and multivariable logistic regression were performed, adjusting for sex, race-ethnicity, education, poverty income ratio categories, and dental insurance coverage status. Results: DunedinPoAm was associated with the last dental appointment being for an existing issue (p=0.0093), poor general oral condition (p=0.0226), limiting food due to teeth problems (p=0.0031), and recommendation to see a dentist within the next two weeks (p=0.0171). EAAs for PhenoAge, GrimAge, and GrimAge2, were associated with a smaller number of oral health outcomes, whereas EAAs for Horvath, Hannum, Weidner, Lin, and Vidal-Bralo showed no associations. Conclusions: In a representative U.S. population, DunedinPoAm was most consistently positively associated with different adverse oral health outcomes compared with other epigenetic aging measures. Tracking specific epigenetic ages such as DunedinPoAm, EAA GrimAge, EAA GrimAge2, and PhenoAge, may aid in additional monitoring of oral health outcomes. Understanding specific aging-related CpGs associated with oral health may aid in elucidating underlying molecular mechanisms.

25.
medRxiv (Medicine) 2026-06-11

Allostatic Load in Endometrial Cancer Disparities

Background: Endometrial cancer incidence and mortality are increasing, particularly among Black women and for aggressive subtypes. Allostatic load (AL), a composite measure of physiologic dysregulation across metabolic, cardiovascular, and immune systems, varies by racial category and tumor subtype in other cancers. Endometrial cancer is strongly associated with obesity, and it is unknown whether AL scores maintain sufficient heterogeneity to evaluate differences across subgroups or with clinical outcomes. Objective: To describe the performance of AL scoring in endometrial cancer patients and examine associations with tumor characteristics (grade/histology) and survival outcomes. Methods: We evaluated AL among 398 participants newly diagnosed with endometrial cancer. AL score was calculated by assigning 1 point for each ''high-risk'' value (by clinical reference range or distribution-based) for 15 biologic variables for vital signs, anthropometrics, blood-based biomarkers, and medical comorbidities. Results: Distribution-based thresholds for variables were used to preserve heterogeneity in this obesity-dominant context. Overall, 68.7% of Black women had high AL compared to White (56.7%), Hispanic (56.7%), and other race (32.3%) women. Decision tree analyses revealed grade-dependent associations between AL and survival. For women with low-grade tumors, higher AL was associated with poorer overall survival. For high-grade tumors, intermediate AL ([≥]4,