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01.
medRxiv (Medicine) 2026-06-22

Reliable quantification of renal function from frozen blood samples

BACKGROUND: Differences in renal function may affect Alzheimer disease (AD) blood biomarker levels independent of AD pathology. Although renal function was unaccounted for in foundational AD blood biomarker studies, there is potential to address this through quantification of estimated glomerular filtration rate (eGFR) from frozen serum and plasma samples. However, the validity of eGFR evaluation from long-term frozen blood samples is unknown. METHODS: Adults aged 50-85 with at least 2 vascular risk factors were recruited from vascular surgery or cardiology clinics in Tucson, Arizona from 2022-2025. Individuals with creatinine assessments in point-of-care whole blood (POC-WB) and frozen serum and plasma samples using the iSTAT (Abbott) were included. eGFR was calculated using the 2021 CKD-EPI creatinine equation without race. Agreement between POC-WB and frozen blood samples was assessed using Cohen's kappa with linear weights. RESULTS: 134 participants (mean [SD] age: 72.6 [7.5] years, 39.6% female, 23.1% chronic kidney disease) had POC-WB eGFR available. Frozen serum and plasma samples had strong agreement with POC-WB for eGFR (Kw= 0.90-0.95, P

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

Ghost Attractor Networks: Basin-Structured Dynamical Decoders for Closed-Loop Sequential Generation

arXiv:2606.18315v1 Announce Type: cross Abstract: Sequential output generation with large-scale Transformer and diffusion decoders pays a memory cost that grows with sequence length, plus iterative per-step computation. Replacing them with small feed-forward decoders restores efficiency but produces unstructured latent representations that limit closed-loop control: phase-conditioned action generation and cross-step latent carry-over both require a latent geometry with stable basins. This article proposes Ghost Attractor Networks, a theoretically derived dynamical decoder whose latent evolves under a learned potential with drift and produces a basin-attractor structure by construction. Three desiderata (multi-modality, decoder-level single-pass switching, and constant memory) motivate the potential-drift form, and mode transitions arise as saddle-node bifurcations with ghost-attractor escape. A hierarchical phase-space decomposition separates first-order basin convergence from second-order proprioceptive refinement. Empirically, a Ghost trained end-to-end with a behavioral-cloning and contrastive objective exhibits the predicted gradient-flow contraction in its potential, with the gradient norm decaying by 67 percent across five integration steps on 1430 held-out samples. Ghost is evaluated as a robotic action decoder. A 2.3-million-parameter Ghost matches the offline accuracy of a 1.07-billion-parameter Diffusion Transformer at 462 times fewer parameters and 32 times lower latency, and beats five alternative 2M-parameter decoders (MLP, Neural ODE, CVAE, Transformer, 1-step Diffusion) on offline mean squared error by 5.9 to 29 percent. On the LIBERO-10 closed-loop benchmark, phase conditioning on Ghost's basin-structured latent yields a 13.5 percentage-point success-rate gain over a feed-forward MLP baseline, and persistent-latent ensembling reaches a 95.7 percent final success rate.

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

SpAArSIST: Sparsified AASIST for Efficient and Reliable Anti-Spoofing

arXiv:2606.11674v1 Announce Type: cross Abstract: We present SpAArSIST, a deployment-oriented refinement of the widely used AASIST graph pooling backend for self-supervised learning (SSL) based anti-spoofing. Motivated by redundant operations in public implementations, we replace learned pooling and stack-node attention with explicit, lightweight choices: separate train and inference graph pooling ratios $(k_{\mathrm{tr}},k_{\mathrm{inf}})$, magnitude-based node scoring, and mean aggregation of graph nodes. The best overall configuration (rank 1) cuts backend compute by 20.7% (195.045M $\rightarrow$ 154.706M MACs) and model size by 4.1% (611.8k $\rightarrow$ 586.4k params), while improving out-of-domain robustness on In-the-Wild to 2.82% EER and 0.078 minDCF (from 4.64% and 0.133) and remaining competitive on ASVspoof5. We further provide a composite selection score that summarizes accuracy, calibration, and compute to support balanced deployment-oriented model choice.

04.
medRxiv (Medicine) 2026-06-22

The impact of changes in age-based eligibility criteria on seasonal influenza vaccine uptake in England between 2019 and 2024: A retrospective cohort study

Objectives: To examine changes in seasonal influenza vaccine uptake among clinical risk groups over periods of differing age-based eligibility. Design: Retrospective cohort study. Setting: Individuals in England registered in the Clinical Practice Research Datalink Aurum. Participants: Between 1,239,802 (2019/20) and 1,289,330 (2023/24) individuals aged 40-69 years in clinical risk groups. Interventions: Natural experiment involving temporary expansion of age-based eligibility for influenza vaccination to include 50-64-year-olds from 2020/21 to 2022/23. Main outcome measures: Influenza vaccine uptake from 1st September to 28th February, incidence rate ratio (IRR) of vaccine uptake across consecutive seasons within age groups, and the ratio of IRRs between age groups. Results: Influenza vaccine uptake increased in all age groups in 2020/21 relative to 2019/20. The increase was larger in individuals aged 50-64 years (13.3%; IRR 1.50, 95% CI 1.50-1.51) compared with those aged 40-49 years (8.3%; IRR 1.35, 95% CI 1.34-1.35) and 65-69 years (6.8%; IRR 1.34, 95% CI 1.33-1.35). From 2020/21 to 2022/23, vaccine uptake decreased, with a more pronounced decline among those aged 40-49 years (-5.4%) compared with age-eligible groups (50-64 years: -3.0%; 65-69 years: -3.1%). The reversion of age eligibility in 2023/24 was associated with a larger decrease in uptake among those aged 50-64 years (-9.6% vs 2022/23; IRR 0.79, 95% CI: 0.79-0.79) compared with those aged 40-49 years (-4.9%; IRR 0.87, 95% CI: 0.87-0.88) and 65-69 years (-3.3%; IRR 0.97, 95% CI: 0.96-0.97). Patterns were broadly consistent across clinical risk groups. Conclusions: The COVID-19 pandemic saw a general increase in seasonal influenza vaccine uptake in clinical risk groups. This increase was larger and more sustained in 50-64 year-olds who had also become eligible based on age. Our findings highlight the potential gains in vaccine coverage among clinical risk groups based on expanded age-based eligibility.

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

Towards Unified Song Generation and Singing Voice Conversion with Accompaniment Co-Generation

arXiv:2606.07015v2 Announce Type: replace-cross Abstract: While song generation and singing voice conversion (SVC) have evolved significantly, they have long been developed isolated: the former lacks zero-shot speaker cloning, while the latter overlooks vocal-accompaniment synergy. To bridge this gap, we propose UniSinger, the first end-to-end framework unifying speaker cloning song generation and accompaniment co-generation SVC. Building on the multimodal diffusion transformer, we construct a unified speaker embedding space transferring speaker representation from SVC to song generation, endowing fine-grained cross-task timbre control. To mitigate multi-task optimization conflicts, we design a curriculum learning strategy using task-specific modality masking to guide the model to gradually master the generative mechanisms among semantic content, vocal timbre, and accompaniment. Experiments show state-of-the-art performance on both tasks and realizes complementary benefits, offering new possibilities for intelligent music production.

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

Spin counting via projection noise measurement of mesoscopic solid-state spin ensemble

arXiv:2606.14437v1 Announce Type: new Abstract: Quantum projection noise is the fundamental noise source for the population measurement of spin ensembles. While projection-noise-limited measurements have been extensively studied in atomic systems, corresponding experiments on solid-state spin ensembles remain challenging due to dominant classical readout noise. Here, we report direct measurement of the quantum projection noise of mesoscopic ensembles of nitrogen-vacancy (NV) spin defects at room temperature. Our experiment is enabled by a high optically-detected magnetic resonance (ODMR) contrast of over 20% for a single crystallographic orientation of the defect spins, obtained by combining polarization-selective optical excitation with spin-to-charge conversion. We use our protocol to demonstrate projection noise measurements and spin counting from nanoscale NV ensembles of up to 43 spins. We further demonstrate that the protocol allows for significant gains in sensitivity for magnetometry applications without need for cryogenic operation or high bias magnetic fields.

07.
medRxiv (Medicine) 2026-06-11

Vascular Phenotyping in Parkinson's Disease: Diabetes Mellitus Operationalizes a Microvascular Metabolic Syndrome Cluster Across PPMI Diagnostic Cohorts

Background: Diabetes mellitus elevates Parkinson's disease (PD) risk, via hypothesized cerebrovascular mediation. Whether the diabetes/prediabetes vascular-risk phenotype concentrates in cardiometabolic risk or macrovascular events across prodromal and clinically diagnosed PD remains unresolved. Objectives: To quantify the vascular-risk burden associated with diabetes/prediabetes across the PPMI diagnostic cohorts to test whether this association differs by cohort. Methods: Cross-sectional analysis of 413 PPMI participants (76 healthy controls, 145 prodromal PD, 192 clinically diagnosed PD) examined diabetes/prediabetes (n = 73) and seven vascular risk factors. The Vascular Burden Score (0 to 7) was a priori partitioned into microvascular and macrovascular sub-scores. Modified Poisson regression estimated adjusted prevalence ratios (aPR), adjusted for age, sex, and body mass index. A cohort-by-diabetes interaction tested cross-cohort consistency. Sensitivity analyses incorporated nigral diffusion tensor imaging (PD-risk biomarker) and FreeSurfer white matter hypointensity volume (cerebrovascular marker). Results: Diabetes/prediabetes elevated Vascular Burden Score ({beta} = 0.53, 95% CI 0.29 to 0.77, p < 0.001) versus non-diabetic participants, with a non-significant cohort-by-diabetes interaction (F = 0.29, p = 0.747). Three microvascular factors survived false discovery rate correction: obesity (aPR 2.28), hypertension (aPR 1.60), and hyperlipidemia (aPR 1.45). Macrovascular events showed no diabetic amplification ({beta} = -0.06, p = 0.25). In the imaging-phenotyped subset, Vascular Burden Score components contributed classifier variance distinct from nigral microstructure. Conclusions: Diabetes/prediabetes operationalize a microvascular cluster stable across prodromal and idiopathic PD. Cardiometabolic phenotyping may complement established PD-risk biomarkers (dopamine transporter SPECT, nigral diffusion), pending longitudinal validation linking vascular phenotype to dopaminergic markers.

08.
arXiv (CS.CV) 2026-06-19

DiffMath: Symbol- and Graph-Aware Latent Diffusion Transformer for Handwritten Mathematical Expression Generation

Handwritten Mathematical Expression Generation (HMEG) is challenging due to the complex two-dimensional layouts and long-range structural dependencies of mathematical expressions. Existing methods typically rely on explicit spatial supervision, such as symbol-level bounding boxes, which incurs high annotation costs and limits scalability. In this work, we propose DiffMath, a symbol- and graph-aware latent diffusion framework that leverages the hierarchical structure inherent in LaTeX as a structural prior, eliminating the need for positional supervision. First, we design a Relational Abstract Syntax Tree (RelAST), a generation-oriented representation that distills MathML trees into compact triplet sequences [S, R, D], where each token directly encodes a symbol identity, spatial relation, or nesting depth. Second, we introduce MathVAE, which learns structure-preserving latent representations through symbol-aware and relation-aware perceptual regularization, ensuring that the latent space captures both character semantics and spatial topology. Third, MathDiT performs conditional denoising in this structured latent space, further guided by a global symbol-count prior via Adaptive Layer Normalization (AdaLN) to improve structural coherence. Experiments show that DiffMath produces structurally consistent handwritten expressions, achieves superior performance over existing methods, and improves the accuracy of downstream OCR models through synthetic data augmentation.

09.
medRxiv (Medicine) 2026-06-18

Rare Coding Variants Reveal Distinct Genetic Architectures Across Multidimensional Sleep Phenotypes

Sleep and circadian traits have been widely studied using common variants, but the contribution of rare coding variation remains unclear. We analyzed rare coding variants in 397,065 whole-exome sequenced UK Biobank participants across 36 sleep phenotypes from self-report, diagnoses, sleep medication use and accelerometry, and meta-analyzed results with 171,536 whole-genome sequenced All of Us participants of diverse ancestries, with replication in the Mass General Brigham Biobank (N = 31,275). We identified 260 genes associated with sleep phenotypes, including novel associations with sleep medication use in 29 genes and 24 out of 29 have not previously been reported with any sleep phenotypes. We observed modest but significant rare variant heritability and strong genetic correlations between sleep medication use, insomnia and fatigue. Temporal gene expression trajectory analyses indicate that genes associated with self-reported sleep traits show constant high prenatal expression, whereas genes linked to sleep medication phenotypes exhibit peak expression in the late prenatal period. These findings highlight distinct biological mechanisms captured by different measurement sources of sleep phenotypes and reveal rare-variant-informed targets for therapeutic discovery.

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

DreamReg: Belief-Driven World Model for 2D-3D Ultrasound Registration

Ultrasound (US) is widely used for surgical navigation, yet real-time registration between intraoperative 2D slices and preoperative 3D volumes remains challenging due to partial observability, speckle noise, and the action-dependent US acquisition. Existing methods are one-shot or short-horizon, making it hard for them to gather evidence over time or capture how surgeons adjust probe motion based on on-screen feedback. We propose DreamReg, a belief-driven world-model framework that formulates 2D-3D registration as belief updating over rigid transformations. DreamReg maintains a latent belief state that summarizes past observations and poses information, and continuously refines the transformation through learned dynamics as new slices arrive. During training, DreamReg is exposed to probe-motion trajectories that mimic clinical scanning behavior and learns to update its belief by conditioning pose refinement on the current US observation. During inference, DreamReg refines registration via internal imagination: it rolls out the learned world model to simulate candidate probe motions and their predicted observations, and integrates these imagined outcomes to converge to an accurate rigid transformation. Experiments on CAMUS and u-RegPro datasets demonstrate improved robustness and competitive registration accuracy for real-time guidance compared with state-of-the-art methods.

12.
arXiv (CS.CL) 2026-06-15

SIMMER: Benchmarking Latent Failures in LLM Executable Planning with a World Model

Large language models (LLMs) are increasingly deployed as planners for autonomous agents in household environments. While existing benchmarks evaluate whether LLM-generated plans execute successfully, they overlook a critical type of failure: latent failures. Unlike immediate failures that trigger instant feedback at execution time and enable timely correction, latent failures do not immediately halt plan execution but silently compromise goal achievement. In severe cases, they cause irreversible harm. To address this gap, we introduce SIMMER, a benchmark for evaluating latent failures in LLM planning through a human-curated symbolic world model grounded in the kitchen domain. SIMMER defines a world model comprising 77 actions, 262 unique objects, and approximately 46,800 possible interactions that are semantically realistic, derived from real-world cooking scripts. It then leverages a state machine executor that validates plans against the world model and detects immediate precondition violations, latent hazards, and irreversible failures. Experiments across six LLMs show that even frontier models achieve at most 17% error-free plans. Moreover, up to 56% of plans contain latent failures, the majority of which lead to irreversible consequences. We further demonstrate that explicit state reasoning via counterfactual foresight simulation can reduce latent failures by up to 72% and irreversible cases by up to 75%, suggesting a promising direction for more robust LLM planners.

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

LoHoSearch: Benchmarking Long-Horizon Search Agents Beyond the Human Difficulty Ceiling

Search agent benchmarks exemplified by BrowseComp have rapidly saturated over the past year, with the strongest models surpassing 90% accuracy. Since these benchmarks are predominantly human-authored, annotators lack a global perspective on entity statistics and cannot systematically maximize search space size and structural complexity. This creates a difficulty ceiling that is hard to break. To address this, we introduce LoHoSearch (Long-Horizon Search Agents), a challenging benchmark comprising 544 human-verified questions across 11 domains. LoHoSearch is constructed via an automated pipeline built upon a knowledge graph covering over 7 million Wikipedia entities, which selects relations with large search spaces and assembles them into structurally complex questions with KG-verified unique answers. Our evaluation demonstrates that even the strongest model achieves only 34.74% accuracy, and existing context management strategies (best +6.8%) yield far smaller gains than on prior benchmarks. LoHoSearch provides a more demanding standard for evaluating long-horizon reasoning and context management in search agents.

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

RoboPIN: Grounded Embodied Reasoning via Pinned Chain-of-Thought

arXiv:2606.15753v1 Announce Type: new Abstract: Embodied reasoning requires models to perceive task-relevant objects and spaces in physical environments and maintain consistent visual grounding throughout multi-step reasoning. However, current vision-language models rely on text-only or coordinate-augmented chain-of-thought, where entity references remain implicit and ambiguous. This may cause the reasoning process to decouple from visual evidence, entity references to drift across steps, and a causal disconnection between the reasoning trajectory and the final answer, with these problems further amplified in multi-view scenarios due to cross-view appearance changes. To address these issues, we propose Pinned Chain-of-Thought (\pincot{}), a structured reasoning paradigm that pins every reasoning step to visual evidence. \pincot{} introduces the concept of \reasoninganchor{}, which binds each task-relevant entity to a structured visual anchor with entity name, unique identity, view index, and spatial grounding, enabling consistent entity tracking across reasoning steps and views. We build a fully automated data generation pipeline to construct \dataset{}, a high-quality \pincot{}-formatted reasoning dataset. We then train \method{} through three-stage post-training that progressively injects embodied knowledge, structured reasoning ability, and process-supervised alignment, with rewards that directly constrain both anchor localization and identity consistency during reasoning. On 14 benchmarks covering embodied spatial reasoning, multi-view reasoning, and pointing, \method{} with only 4B parameters consistently outperforms 7B level open-source embodied models, achieving a 12\% average improvement over the strongest 7B baseline, Mimo-Embodied. Further analysis shows that \pincot{} improves grounding accuracy and cross-step identity consistency, validating the effectiveness of process supervision.

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

Retrofitters, pragmatists and activists: Public interest litigation for accountable automated decision-making

arXiv:2511.03211v4 Announce Type: replace-cross Abstract: This paper examines the role of public interest litigation in promoting accountability for AI and automated decision-making (ADM) in Australia. Since ADM regulation faces political and geopolitical headwinds, effective governance will have to rely on the enforcement of existing laws. Drawing on interviews with Australian public interest litigators, technology policy activists, and technology law scholars, the paper positions public interest litigation as part of a larger ecosystem for transparency, accountability and justice with respect to ADM. The paper explores the tactics and strategies of what one participant described as 'retrofitting' old laws to ADM. These go beyond creative legal argumentation, to encompass practices of community-building, collaboration on theories of change, canny selection of clients and causes of action, and the alignment of the interests of stakeholders in litigation. Naturally, the paper also contends with the limits of these strategies, and of the Australian legal system. Where limits are, however, capable of being overcome, the paper presents findings on urgent needs: the enabling institutional arrangements without which effective litigation and accountability will falter. The paper is relevant to law and technology scholars; individuals and groups harmed by ADM; public interest litigators and technology lawyers; civil society and advocacy organisations; and policymakers.

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

When Iterative RAG Beats Ideal Evidence: A Diagnostic Study in Scientific Multi-hop Question Answering

Retrieval-Augmented Generation (RAG) extends large language models (LLMs) beyond parametric knowledge, yet it is unclear when iterative retrieval-reasoning loops meaningfully outperform static RAG, particularly in scientific domains with multi-hop reasoning, sparse domain knowledge, and heterogeneous evidence. We provide the first controlled, mechanism-level diagnostic study of whether synchronized iterative retrieval and reasoning can surpass an idealized static upper bound (Gold Context) RAG. We benchmark eleven state-of-the-art LLMs under three regimes: (i) No Context, measuring reliance on parametric memory; (ii) Gold Context, where all oracle evidence is supplied at once; and (iii) Iterative RAG, a training-free controller that alternates retrieval, hypothesis refinement, and evidence-aware stopping. Using the chemistry-focused ChemKGMultiHopQA dataset, we isolate questions requiring genuine retrieval and analyze behavior with diagnostics spanning retrieval coverage gaps, anchor-carry drop, query quality, composition fidelity, and control calibration. Across models, Iterative RAG consistently outperforms Gold Context, with gains up to 25.6 percentage points, especially for non-reasoning fine-tuned models. Staged retrieval reduces late-hop failures, mitigates context overload, and enables dynamic correction of early hypothesis drift, but remaining failure modes include incomplete hop coverage, distractor latch trajectories, early stopping miscalibration, and high composition failure rates even with perfect retrieval. Overall, staged retrieval is often more influential than the mere presence of ideal evidence; we provide practical guidance for deploying and diagnosing RAG systems in specialized scientific settings and a foundation for more reliable, controllable iterative retrieval-reasoning frameworks.

17.
arXiv (CS.AI) 2026-06-19

SARLO-80: Worldwide Slant SAR Language Optic Dataset 80cm

arXiv:2606.20523v1 Announce Type: cross Abstract: Multimodal foundation models have advanced rapidly thanks to large optical benchmarks, but comparable resources for synthetic aperture radar (SAR) remain limited. Existing SAR–optical datasets largely rely on low-resolution, intensity-only Ground Range Detected~(GRD) products and do not preserve complex-valued SAR measurements or native acquisition geometry, which restricts physically grounded multimodal learning. In particular, large-scale public datasets combining very-high-resolution (VHR) SAR SLC, aligned optical imagery, and natural-language descriptions are still lacking. We present a VHR SAR–optical–text dataset built from open-access Umbra spotlight acquisitions distributed as Sensor Independent Complex Data (SICD). From around 2,500 worldwide scenes (VV/HH, 20cm–2m native resolution), we standardize all SAR data to an 80cm slant-range grid via band-limited FFT resampling and tile the imagery into 1024 by 1024 patches. For each SAR patch, we retrieve a high-resolution optical tile and warp it into the SAR grid using local coordinate correspondences for local pixel-level alignment. We further generate three caption variants (SHORT/MID/LONG) per sample to support vision–language training and evaluation. Our dataset contains 119,566 triplets (complex and amplitude slant-range SAR patch, aligned optical patch, natural-language description) covering 257 locations across 72 countries and a broad range of land types and infrastructures. We release fixed train/validation/test splits and the full preprocessing and baseline code to enable reproducible benchmarks for multimodal alignment on cross-modal retrieval and conditional generation in native SAR geometry. The dataset is publicly available on the Hugging Face Hub at https://huggingface.co/datasets/ONERA/SARLO-80.

18.
medRxiv (Medicine) 2026-06-16

Development of an automated, imaging-based preoperative screening model for early identification of malnutrition in an abdominal surgery cohort

Background: Clinical malnutrition affects one in five abdominal surgery patients and increases postoperative complications and mortality. Current screening occurs after admission, closing the window for preoperative nutritional intervention. No objective, scalable preoperative screening tool exists. Objective: To determine whether automated volumetric CT-based body composition analysis improves preoperative identification of surgical patients at risk for clinical malnutrition compared to clinical variables or single slice imaging alone. Methods: Retrospective cohort study of adults undergoing elective abdominal surgery at a quaternary academic medical center (2018 to 2021) with a preoperative CT scan within 90 days and complete nutrition assessment. Clinical malnutrition was diagnosed by a registered dietitian using ASPEN/AND criteria. Three sex stratified Elastic Net models were compared: (1) base clinical variables; (2) base plus L3 single slice skeletal muscle index and attenuation; and (3) base plus comprehensive 3D volumetric quantification of five muscle groups and two fat depots. Discrimination (AUROC), calibration (Brier score), and clinical utility (decision curve analysis) were assessed via 10-fold cross-validation. Results: Among 1,143 patients (52.4% female; mean age 60.5 years), 231 (20.2%) were diagnosed with malnutrition. Malnourished patients had significantly higher complication rates (36.4% vs. 15.4%, p

19.
arXiv (CS.AI) 2026-06-16

Toward Vibe Medicine: A Self-Evolving Multi-Agent Framework for Clinical Decision Support

arXiv:2606.15504v1 Announce Type: new Abstract: In recent years, the advances of large language models and autonomous agents have revolutionized the healthcare field, facilitating diagnosis and improving treatment results. However, most existing AI systems rely on pre-trained knowledge and predefined pipelines, which struggle to learn dynamically from the interactive chat session history that contains patient outcomes and past failures. To address this limitation, we propose VIBEMed, a multi-agent framework with a built-in self-evolution mechanism and architecture-level safety sandbox for robust clinical decision support. The system integrates three specialized agents, including a Clinical Diagnostic Agent (CDA) for hypothesis generation, a Therapeutic Execution Agent (TEA) for treatment planning, and a Clinical Evolution Manager Agent (CEMA) that distills longitudinal clinical feedback into reusable knowledge, transforming multimodal patient information into personalized medical decisions. Through self-evolution mechanism, the framework enables iterative updates across memory, model behavior, and decision strategies, allowing the system to improve over time. Experimental results show that VIBEMed demonstrates superior performance through its evolving mechanism in complex clinical cases, particularly in tasks that require integrated decision-making and longitudinal planning. The framework also supports reliable end-to-end decisions in challenging scenarios such as oncology treatment planning, highlighting its feasibility in real-world clinical contexts. Overall, VIBEMed provides a practical path beyond static AI systems toward adaptive, experience-driven clinical decision support, demonstrating the value of combining multi-agent collaboration with continuous evolution for advancing precision medicine.

20.
medRxiv (Medicine) 2026-06-11

Effects of Resveratrol as an Adjunct to a Low-Calorie Diet in Postmenopausal Women with Obesity and Knee Osteoarthritis

Background. Obesity is a modifiable risk factor for osteoarthritis and may contribute to pain, functional impairment, inflammation, and cartilage degradation. Resveratrol has potential anti-inflammatory and chondroprotective effects, but its efficacy as an adjunct to dietary intervention remains unclear. Objective. This study evaluated whether resveratrol supplementation provides additional benefits when combined with a low-calorie diet in postmenopausal women with obesity and knee osteoarthritis. Methods. A total of 97 postmenopausal women with obesity and knee osteoarthritis were included in this randomized controlled clinical study. Participants received either a 10-day low-calorie diet alone or the same diet combined with 150 mg/day trans-resveratrol. Anthropometric parameters, body composition, biochemical markers, pain intensity, functional status, and urinary CTX-II were assessed at baseline and follow-up. Results. Both interventions were associated with reductions in body weight, BMI, waist and hip circumferences, fat mass, glucose, HOMA-IR, lipid parameters, hsCRP, VAS, WOMAC, LAI, and urinary CTX-II. Compared with diet alone, resveratrol supplementation did not provide additional benefits for anthropometric parameters, glucose metabolism, lipid profile, or WOMAC score. However, the resveratrol group showed a greater reduction in hsCRP and urinary CTX-II. The obesity class did not modify the treatment effect. Conclusion. A short-term low-calorie diet improved metabolic, inflammatory, and osteoarthritis-related parameters in postmenopausal women with obesity and knee osteoarthritis. The addition of resveratrol did not enhance weight loss or improve most metabolic outcomes but was associated with greater reductions in hsCRP and urinary CTX-II. These findings suggest a potential anti-inflammatory and cartilage-related effect of resveratrol, which requires confirmation in longer randomized trials.

21.
Nature (Science) 2026-06-10

Molecular glue degraders of HuR suppress BRAF-mutant colorectal cancer

Authors:

BRAF gain-of-function mutations, particularly BRAF(V600E), affect roughly 10% of all patients with colorectal cancer (CRC), and portend poor prognosis with limited therapeutic interventions. BRAF inhibitors such as encorafenib are ineffective due to MAPK pathway reactivation driven by BRAF dimerization. Combined inhibition of BRAF and EGFR, although approved therapies, results in short survival benefits and frequent treatment resistance and relapse1–3. Here, through rational chemical library design coupled with parallel proteomic screening, we identified dHuR as a molecular glue degrader of human antigen R (HuR), an RNA-binding protein that drives tumour growth, invasion and therapy resistance. dHuR binds to the CRBN ubiquitin ligase to create a unique benzofuran-tethered composite surface to recruit HuR as a neosubstrate by engaging its β-hairpin G-loop degron, as revealed by the cryo-electron microscopy structure of the ternary complex. dHuR abrogated BRAF expression by inducing its exon 18 skipping, and demonstrated superior suppression of BRAF-mutant CRC tumours including those gaining resistance to BRAF inhibitors. Finally, we performed kinome library CRISPR screening and revealed that inactivation of EGFR or MEK enhanced dHuR cytotoxicity, thus establishing a combinatorial strategy to treat patients with refractory BRAF-mutant CRC. Molecular glue&nbsp;degraders of the RNA-binding protein HuR have therapeutic potential for BRAF-mutant cancers.

22.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

23.
arXiv (CS.LG) 2026-06-19

PaAno+: Multiscale Encoding and Cross-Variable Attention for Time Series Anomaly Detection

arXiv:2606.20055v1 Announce Type: new Abstract: Time-series anomaly detection has significant practical value for industrial and medical monitoring, as well as other critical domains. Current Transformer- and large-model-based detection approaches incur excessive computational overhead, while existing lightweight alternatives are constrained by insufficient feature extraction and inadequate modeling of dependencies across multivariate variables. To mitigate the above drawbacks, this study develops a lightweight, efficient anomaly detection model, dubbed PaAno, within the patch-oriented representation learning paradigm. In the encoder module, a multiscale feature-extraction backbone is constructed using convolutional kernels with differentiated receptive fields to capture hierarchical temporal characteristics; subsequent cross-scale adaptive attention aggregation, combined with residual connection optimization, further stabilizes feature representation learning. A cross-variable fusion attention module is embedded to explicitly characterize inter-variable correlations, empowering the model to identify anomalous patterns amid intricate operational conditions. Moreover, a novel pretext task based on temporal patch-window sorting is customized to uncover intrinsic structural properties of time series, and triplet loss is leveraged to optimize the patch embedding space for enhanced feature discrimination. Extensive experiments on the TSB-AD benchmark demonstrate that the proposed PaAno achieves state-of-the-art detection accuracy on both univariate and multivariate tasks, yielding significant performance gains across evaluation metrics, including VUS-PR, relative to the original PaAno. Leveraging a compact network design, the presented model achieves favorable computational efficiency, enabling deployment on resource-limited terminals for real-time anomaly inference.

24.
arXiv (CS.LG) 2026-06-18

MOLAR: Learning Multimodal Molecular Representations from Noisy Labels

arXiv:2606.18390v1 Announce Type: new Abstract: Motivation: Noisy labels are a common challenge in molecular property prediction because molecular annotations are often obtained from assays, curated databases, or weak annotation pipelines rather than directly observed clean biological states. Treating recorded labels as reliable supervision can cause models to memorize corrupted observations and learn misleading molecular evidence. In multimodal molecular representation learning, this issue can be amplified by graph-text fusion or alignment, which may propagate label-induced errors across modalities. Results: We propose MOLAR, a noise-aware framework for learning multimodal molecular representations from noisy labels. MOLAR separates latent clean-property inference from recorded-label observation: graph and text views contribute residual evidence to a clean-property distribution, and a categorical label-observation channel maps this distribution to recorded labels for training. This formulation derives posterior label reliability and modality-specific molecular evidence from the model. Experiments on naturally noisy molecular benchmarks and controlled label-flipping benchmarks show that MOLAR consistently outperforms representative baselines. Visualization analyses further show that MOLAR provides interpretable reliability and modality-evidence diagnostics.

25.
arXiv (CS.LG) 2026-06-17

Domain-Validity-Gated Metamorphic Testing of Scientific ML Surrogates

arXiv:2606.17529v1 Announce Type: cross Abstract: Scientific machine-learning (SciML) surrogates approximate expensive simulations, but exact expected outputs for arbitrary inputs are unavailable (the oracle problem). Metamorphic testing checks relations across executions, yet a candidate relation is not automatically valid: its preconditions, output mapping, and the numerical floor of the scoring operator determine whether a violation is meaningful. We study how candidate metamorphic relations (MRs) can be screened for domain validity and turned into executable, oracle-free test assets for SciML surrogates. We propose (i) a domain-validity rubric that admits a candidate only when its tolerance dominates the operator's numerical floor and its preconditions hold; (ii) an MR-card executable-asset format recording source cases, transformations, metrics, tolerances, and typed relation-level verdicts; and (iii) a case-study protocol on MeshGraphNets cylinder-flow surrogates, with a claim ledger binding every result to a tracked artifact. On a MeshGraphNets checkpoint, node permutation holds to machine precision, mirror-y is a bounded out-of-distribution stress finding rather than an exact symmetry, and absolute conservation stays deferred while a reference-relative guard passes. The same readings hold across held-out trajectories, a checkpoint roster, three further architectures, and PhysicsNeMo. On a second CFD task (compressible airfoil) the predicate instead rejects incompressible continuity on physical grounds, showing it reasons about domain validity rather than running a fixed checklist. On a second PDE family, FNO Burgers and heat surrogates run full admit/reject/execute verdicts. The evidence spans two CFD tasks and a second PDE family, supporting a validity-aware bridge from candidate MRs to auditable SciML test assets that separates model-level violations from out-of-domain applications.