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01.
arXiv (CS.CV) 2026-06-17

OmniDrive: An LLM-Choreographed Multi-Agent World Model with Unified Latent Co-Compression for Multi-View Driving Video Generation

Generative world models for autonomous driving face two unresolved tensions: heterogeneous control injection, where free-form language, HD-maps, trajectories, and camera poses reside in incompatible representational spaces, and post-hoc cross-view fusion, where per-camera latents fail to encode global 3-D geometry. We trace both to a single root cause: the absence of a shared symbolic interlingua aligning language, geometry, and pixels at the latent-token level. We present DRIVE-CHOREO, an LLM-choreographed multi-agent world model that recasts controllable multi-view video generation as latent choreography. Three Qwen2.5-VL agents - a Director parsing user intent into a structured WorldScript, a Cartographer grounding it into spatially-anchored layout tokens, and an Auditor feeding cross-view critiques back as auxiliary supervision - jointly author a single position-aware token sequence. This sequence is co-compressed with the multi-view video via a view-time permutation that enforces inter-camera geometry within the convolutional receptive field of a 3-D VAE. On nuScenes, DRIVE-CHOREO sets new state-of-the-art multi-view consistency and BEV mAP (21.6) with competitive FVD (45.7); a detector trained purely on our synthetic data gains +2.4 NDS on the real validation split, validating downstream utility.

02.
arXiv (CS.AI) 2026-06-24

Breaking the Filter Bubble: A Semantic Pareto-DQN Framework for Multi-Objective Recommendation

arXiv:2606.24042v1 Announce Type: new Abstract: Recommender systems often induce filter bubbles and semantic homogenization by monolithically optimizing for immediate user engagement. Standard single-objective models, including traditional Deep Q-Networks, are ill-equipped to navigate the trade-offs between platform retention and critical societal values like information diversity and provider fairness. To address these limitations, we introduce a multi-objective reinforcement learning framework that formalizes recommendation as a semantic multi-objective Markov decision process. By integrating high-fidelity semantic embeddings with a Pareto-DQN agent, our architecture treats engagement, diversity, and fairness as distinct, non-aggregable reward signals, avoiding the pitfalls of static reward scalarization. Empirical evaluations on the MovieLens small dataset shows that our hypervolume based action selection disrupts the feedback loops responsible for semantic collapse. By sustaining high state-trajectory variance, the Pareto-DQN effectively maps the Pareto frontier, achieving gains in auxiliary societal objectives with only marginal impacts on engagement. This work provides a path toward intrinsically aligned, responsible recommender systems.

03.
medRxiv (Medicine) 2026-06-22

Burden of Cardiovascular Disease in Brazil, 1996-2023: A Retrospective Descriptive Study of the Epidemiology and Impact on Public Healthcare with Emphasis on Acute Myocardial Infarction

Background Cardiovascular diseases (CVD) are the leading cause of death worldwide, and their epidemiology is correlated with genetic predisposition, exposure to risk factors, sex, age, access to medical care, and other sociodemographic characteristics. Brazil is a developing country with a vast territory, which leads to structural inequalities. Estimates of CVD in Brazil, in its regions, and in its population are poorly evaluated and analysed. Methods We obtained CVD-related data from the Brazilian Unified Health System (SUS) and analysed mortality and morbidity from 1996 to 2023 by sex, race/ethnicity, age, and region. We calculated the risk of death from the most prevalent diseases, the average length of hospital stay, and the costs associated with heart transplantation. Findings In Brazil, acute myocardial infarction was the pathology that led to the highest number of deaths across all variables analysed during the evaluated period. Other CVD were also related to causes of death and morbidity, such as hypertensive diseases and heart failure. Interpretation Brazil presents a serious challenge to the public health system due to the high number of deaths and the progressive mortality rate. This study represents a fundamental contribution to the basis for formulating public health policies aimed at reducing the growing impact associated with these diseases. Funding CNPq, CAPES, FAPEMIG, INCT

04.
arXiv (CS.AI) 2026-06-15

Design Methodology and Performance Trade-offs Management for Distributed and Compound AI Systems

arXiv:2606.14350v1 Announce Type: cross Abstract: Artificial Intelligence (AI) systems must typically satisfy service-level objectives including accuracy, latency, and cost. The prevailing model-centric approaches select a monolithic model at design time and apply identical computation regardless of input difficulty, cannot decompose tasks across specialized components, and have knowledge that is fixed at training time. During runtime, this can lead to performance degradation and increasing costs. Because the model is the main design variable, it determines the majority of system behavior, coupling operational objectives to a single design-time choice. Addressing these limitations requires shifting from model-centric to system-centric design. Compound AI systems realize this shift by orchestrating multiple models, algorithms, and tools as distributed AI systems through explicit control logic. The performance of such systems depends on their workflow topology, the models assigned to each task, and the parameters governing runtime behavior. We present a design methodology that organizes this space along two dimensions, workflow topology and configuration selection, and identifies eight design patterns, each consolidating techniques to address a specific limitation of monolithic deployment. We validate our methodology through three case studies. Across our case studies, Compound AI configurations approach accuracy of monolithic models within 2.5 to 4 percentage points while reducing latency by up to 60% and cost by up to 71%. We show that model selection and parameter configuration jointly determine system performance, but the resulting design space grows combinatorially, as workflows compose more patterns and components. Thus, we identify five open challenges that define a roadmap from manually configured prototypes towards systems that automatically discover and maintain SLO-compliance in Compound and Distributed AI systems.

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

Million-scale multimodal pollen microscopy with expert-guided foundation models

Automated pollen identification from microscopy remains a bottleneck in aerobiology, palaeoecology and biodiversity monitoring, because scalable systems must generalise across specimen preparation, scanner settings and geographic origins while retaining palynological interpretability. To address this gap, we present a million-scale multimodal pollen microscopy resource, Pollen AI Atlas, assembled from pure-species whole-slide bright-field images spanning four geographic origins, four scanner settings and 46 taxon labels across 31 botanical families. Seeded by one manually selected exemplar per source slide, token-level mining and filtering produced 1,511,390 released grain detections with 99.6\% proposal precision in expert-curated test regions. Each detection was paired with machine-generated grain-level morphological captions from five open-weight vision-language models, guided by expert-verified palynological anchors, yielding structured descriptions of aperture systems, wall ornamentation, shape and size. Among the evaluated models, Gemma4 provided the most controlled primary caption set, combining tight length control, no leakage and the strongest text-retrieval performance. Baseline benchmarks with frozen visual features reached 88.16\% top-1 accuracy, while cross-regional retrieval showed that caption-derived text embeddings remained robust when image similarity degraded (mAP@20 0.811 versus 0.262). Released data, annotations, captions, splits, code, and weights provide a benchmark for pollen recognition, cross-regional domain adaptation and domain-specific multimodal microscopy learning.

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

No One-Size-Fits-All Neurons: Task-based Neurons for Artificial Neural Networks

arXiv:2405.02369v2 Announce Type: replace-cross Abstract: In the past decade, many successful networks are on novel architectures, which almost exclusively use the same type of neurons. Recently, more and more deep learning studies have been inspired by the idea of NeuroAI and the neuronal diversity observed in human brains, leading to the proposal of novel artificial neuron designs. Designing well-performing neurons represents a new dimension relative to designing well-performing neural architectures. Biologically, the brain does not rely on a single type of neuron that universally functions in all aspects. Instead, in our brain, neurons are often task-based. In this study, we address the following question: since the human brain is a task-based neuron user, can the artificial network design go from the task-based architecture design to the task-based neuron design? Since methodologically there are no one-size-fits-all neurons, given the same structure, task-based neurons can enhance the feature representation ability relative to the existing universal neurons due to the intrinsic inductive bias for the task. Specifically, we propose a two-step framework for prototyping task-based neurons. As the initial step, we evaluate the proposed framework using polynomials as base functions. Empirically, systematic experimental results on synthetic data, classic benchmarks, and real-world applications show that the proposed task-based neuron design is not only feasible but also delivers competitive performance over other state-of-the-art models.

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

ChronoID: Infusing Explicit Temporal Signals into Semantic IDs for Generative Recommendation

arXiv:2606.14260v1 Announce Type: cross Abstract: Semantic IDs are crucial in generative recommendation, but with a fundamental limitation: temporal information is not well incorporated into semantic IDs. Instead, time influences recommendation only implicitly (e.g., through session construction heuristics, preference alignment, or sequence order), while existing semantic ID learning remains entirely time-agnostic. This design conflates interactions occurring under distinct temporal contexts into identical semantic representations, implicitly assuming that item semantics and user intent are temporally stationary. Such an assumption is misaligned with real-world recommendation scenarios, where evolving interaction rhythms play a central role. In this work, we investigate where and how the explicit time should be incorporated into semantic ID for generative recommendation. First, we systematically characterize the design space along three orthogonal dimensions of temporal signals and present a unified framework, ChronoID, for time-aware semantic ID learning. Then, by contributing a new time-explicit generation recommendation benchmark, ChronoID answers the questions: what is the effective way of infusing time, how to design the architecture, and where does the gain come from.

08.
arXiv (quant-ph) 2026-06-25

Benchmarking Dark Matter Search using a Parity-Check Protocol with Machine-Learning Optimized Pulses

arXiv:2606.25795v1 Announce Type: new Abstract: We report on an improved microwave detection protocol for dark matter candidates such as the axion and the dark photon. We employ a superconducting transmon qubit dispersively coupled to a double-cavity system, enabling quantum non-demolition measurements of the photon occupation in a relatively short-lived storage cavity. To reduce the experimental cycle time and enhance sensitivity for axion and dark-photon searches, we operate this detector in a regime of increased qubit-cavity coupling, resulting in Stark shifts of 4.6 MHz. In this regime, conventional control pulses suffer from strong frequency-detuning sensitivity and photon-number-dependent errors. We address this limitation by implementing frequency-detuning-robust $\pi/2$ pulses (obtained by machine-learning optimization) that preserve high-fidelity qubit control over a bandwidth of approximately 20 MHz. We experimentally validate this protocol and demonstrate single-photon detection performance comparable to previous implementations, despite significantly reduced qubit coherence times and storage-cavity lifetimes. Using parity-based measurement sequences combined with a Hidden Markov Model (HMM) analysis, we achieve background rates on the order of $\mathcal{O}(20)$ Hz. In the absence of a magnetic field, we derive exclusion limits on the dark photon model for dark matter, reaching a sensitivity to the kinetic mixing angle of $\epsilon_{95\%} \sim 1\times10^{-14}$ at 5.051 GHz. These results establish machine-learning robust control as a key enabler for faster, more scalable microwave quantum sensors for dark-matter searches.

09.
arXiv (quant-ph) 2026-06-11

Handbook of Error-Correcting Codes

arXiv:2606.11484v1 Announce Type: new Abstract: Barcode scans, clear phone calls, reliable data storage, satellite communication, and large-scale quantum computation are all made possible by error correction. We present a handbook version of The Error Correction Zoo, a curated reference of methods for protecting classical or quantum information from errors during storage and transmission. The handbook includes descriptions of these error-correcting codes and a classification according to the symbols they use. It also catalogues relations among codes and related objects such as sphere packings, lattices, designs, groups, and classical and quantum phases of matter. The collection is intended both as a rigorous reference and as a practical aid for tracing the web of code relationships and uncovering new connections.

10.
arXiv (CS.CL) 2026-06-15

QIAS 2026: Overview of the Shared Task on Islamic Inheritance Reasoning

This paper presents a comprehensive overview of the QIAS 2026 shared task, organized as part of the OSACT7 Workshop and co-located with LREC 2026. The shared task was designed to evaluate the ability of large language models to perform complex reasoning in the religious and legal domain of Islamic inheritance. Unlike conventional question-answering benchmarks, QIAS 2026 focuses on end-to-end reasoning from natural language cases, requiring systems to perform the full inheritance calculation process, from identifying the eligible heirs to assigning the correct share to each beneficiary. To support this evaluation, the task was based on the MAWARITH benchmark, a dataset of $12{,}500$ Arabic inheritance cases annotated with intermediate reasoning steps and final answers. System submissions were evaluated using MIR-E, a multi-step metric that measures performance across the main stages of inheritance reasoning. A total of $16$ teams participated in the shared task, investigating a range of approaches, including prompting-based methods, retrieval-augmented generation, and fine-tuning strategies. The results show that Islamic inheritance remains a highly challenging benchmark for current language models, especially in stages that require precise legal interpretation and structured numerical reasoning. This overview summarizes the task design, dataset, evaluation framework, participating systems, and main results.

11.
arXiv (CS.CL) 2026-06-25

Cross-Modal Robustness Transfer (CMRT): Training Robust Speech Translation Models Using Adversarial Text

End-to-End Speech Translation (E2E-ST) has seen significant advancements, yet current models are primarily benchmarked on curated, "clean" datasets. This overlooks critical real-world challenges, such as morphological robustness to inflectional variations common in non-native or dialectal speech. In this work, we adapt a text-based adversarial attack targeting inflectional morphology to the speech domain and demonstrate that state-of-the-art E2E-ST models are highly vulnerable it. While adversarial training effectively mitigates such risks in text-based tasks, generating high-quality adversarial speech data remains computationally expensive and technically challenging. To address this, we propose Cross-Modal Robustness Transfer (CMRT), a framework that transfers adversarial robustness from the text modality to the speech modality. Our method eliminates the requirement for adversarial speech data during training. Extensive experiments across four language pairs demonstrate that CMRT improves adversarial robustness by an average of more than 3 BLEU points, establishing a new baseline for robust E2E-ST without the overhead of generating adversarial speech.

12.
medRxiv (Medicine) 2026-06-17

Identifying anaphylaxis using weakly-supervised prediction models and natural language processing

Objectives Scalable computable phenotyping algorithms are critical for conducting high-throughput disease-outcome research in large, distributed-data electronic health record (EHR) and claims data settings. We developed and evaluated a claims- and EHR-based computable phenotyping algorithm for anaphylaxis, a rare acute condition that is challenging to accurately identify using claims data alone. Materials and Methods Potential anaphylaxis events came from two healthcare systems (Kaiser Permanente Washington [KPWA] and Vanderbilt University Medical Center [VUMC]). We engineered features from clinical text using automated natural language processing (NLP) methods. We then developed a phenotyping algorithm using four NLP- and diagnosis code-based silver labels (proxies for the gold-standard labels). Gold-standard abstracted outcomes were used to evaluate algorithm performance. Results The largest area under the receiver operating characteristic curve (AUC) was 0.931 for an NLP-based silver-label model at KPWA. Depending on the model and healthcare system site, positive predictive value (PPV) and sensitivity at the threshold of predicted probability that maximized F1 score ranged from 0.52 to 0.77 (PPV) and 0.78 to 1 (sensitivity). Discussion NLP-based silver-label models had large AUC at KPWA but not at VUMC. This may be because clinical text at KPWA is only available for outpatient encounters and secure messaging. High sensitivity for identifying anaphylaxis can be obtained using our best-performing models. Conclusion The best-performing models had better PPV and sensitivity tradeoffs than prior bespoke anaphylaxis models with costly, manually curated features. The simplicity of the approach compared to traditional phenotyping methods allows it to be deployed easily at multiple health care systems.

13.
arXiv (CS.LG) 2026-06-18

Ultrafast On-chip Online Learning via Spline Locality in Kolmogorov-Arnold Networks

arXiv:2602.02056v3 Announce Type: replace-cross Abstract: Ultrafast online learning is essential for high-frequency systems, such as controls for quantum computing and nuclear fusion, where adaptation must occur on sub-microsecond timescales. Meeting these requirements demands low-latency, fixed-precision computation under strict memory constraints, a regime in which conventional Multi-Layer Perceptrons (MLPs) are both inefficient and numerically unstable. We identify key properties of Kolmogorov-Arnold Networks (KANs) that align with these constraints. Specifically, we show that: (i) KAN updates exploiting B-spline locality are sparse, enabling superior on-chip resource scaling, and (ii) KANs are inherently robust to fixed-point quantization. By implementing fixed-point online training on Field-Programmable Gate Arrays (FPGAs), a representative platform for on-chip computation, we demonstrate that KAN-based online learners are significantly more efficient and expressive than MLPs across a range of low-latency and resource-constrained tasks. To our knowledge, this work is the first to demonstrate model-free online learning at sub-microsecond latencies.

14.
arXiv (CS.LG) 2026-06-18

Optimal scenario design for climate emulation

arXiv:2606.19302v1 Announce Type: cross Abstract: As deep learning for physical systems continues to grow in popularity, efforts to improve generalizability have primarily focused on designing architectures that embed physical constraints. However, for machine-learning surrogate climate models (emulators), we show that the low structural diversity in existing scenarios commonly used to generate training data places a ceiling on predictive skill. Here, we examine whether training datasets themselves can be optimized to improve generalization. We introduce a method to create datasets that produce emulators capable of generalizing to new, structurally different scenarios absent from the training data. We use a differentiable Simple Climate Model (SCM) to calculate the sensitivity of emulator loss to perturbations in the training data, iteratively updating the training data to maximize emulator skill. For an SCM, training on one scenario optimized in this fashion outperforms an emulator trained on six standard ScenarioMIP pathways. We achieve this higher predictive skill despite training on a smaller dataset, finding that our emulator successfully isolates distinct physical behaviors of different climate forcing agents (e.g., greenhouse gases vs. aerosols) without single-forcing runs. We then demonstrate that scenarios optimized using an SCM, when used to drive an intermediate-complexity climate model, produce a training dataset that yields a more skillful emulator than training on ScenarioMIP outputs. Our results suggest that, in the compute-constrained environment of running full-scale climate models, generating a small number of dynamically rich scenarios provides greater marginal value for emulation and characterizing system responses than expanding the suite of traditional emissions pathways.

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

Evaluating Prompting-Based Defenses Against Domain-Camouflaged Injection Attacks

Authors:

Domain-camouflaged injection attacks embed malicious instructions in retrieved content using domain-appropriate vocabulary, evading standard detectors that rely on syntactic injection markers. When detection fails, practitioners need to know which defense architectures reduce attack success. We evaluate five prompting-based defenses (spotlighting, paraphrasing, prompt sandwiching, and two combinations) against domain-camouflaged injection across three model families (Claude Haiku, Llama 3.1 8B, Gemini 2.0 Flash) and three deployment domains (financial, legal, general) using 3,510 trials. Paraphrasing retrieved content before agent processing is the most consistently effective defense in this benchmark, reducing camouflage attack success rate by 55-84\% depending on model, and achieves lower attack success rates than our Llama Guard 4 configuration on every model tested. Defense effectiveness is strongly model-dependent: spotlighting halves attack success on Claude Haiku but provides no benefit on Llama 3.1 8B. Financial domain deployments face the highest residual risk at 26-33\% baseline attack success rate, with no prompting-based defense fully eliminating the threat on weaker models. These results provide the first systematic evaluation of prompting-based defenses specifically against camouflage-class injection attacks and establish benchmark-based recommendations for practitioners. All tasks use synthetically constructed professional documents; whether these benchmark rankings generalize to real enterprise documents remains an open question.

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

Agentic World Modeling: Foundations, Capabilities, Laws, and Beyond

arXiv:2604.22748v3 Announce Type: replace Abstract: As AI systems move from generating text to accomplishing goals through sustained interaction, the ability to model environment dynamics becomes a central bottleneck. Agents that manipulate objects, navigate software, coordinate with others, or design experiments require predictive environment models, yet the term world model carries different meanings across research communities. We introduce a "levels x laws" taxonomy organized along two axes. The first defines three capability levels: L1 Predictor, which learns one-step local transition operators; L2 Simulator, which composes them into multi-step, action-conditioned rollouts that respect domain laws; and L3 Evolver, which autonomously revises its own model when predictions fail against new evidence. The second identifies four governing-law regimes: physical, digital, social, and scientific. These regimes determine what constraints a world model must satisfy and where it is most likely to fail. Using this framework, we synthesize over 400 works and summarize more than 100 representative systems spanning model-based reinforcement learning, video generation, web and GUI agents, multi-agent social simulation, and AI-driven scientific discovery. We analyze methods, failure modes, and evaluation practices across level-regime pairs, propose decision-centric evaluation principles and a minimal reproducible evaluation package, and outline architectural guidance, open problems, and governance challenges. The resulting roadmap connects previously isolated communities and charts a path from passive next-step prediction toward world models that can simulate, and ultimately reshape, the environments in which agents operate. Code and resources are available at: https://github.com/matrix-agent/awesome-agentic-world-modeling.

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

HG-Bench: A Benchmark for Multi-Page Handwritten Answer-Region Grounding in Automated Homework Assessment

Automated homework assessment depends not only on recognizing student answers, but also on accurately locating where each answer and each intermediate reasoning step appears in noisy, multi-page handwritten work. This paper addresses the missing evaluation setting of page-aware, two-level answer-region grounding: given a sequence of homework page images, a model must localize complete answer regions and their ordered step-level subregions. We introduce HG-Bench, a benchmark of 500 human-annotated K-12 homework samples curated from a 1,489,278-image source pool, with question-level and step-level boxes linked by a hierarchical containment constraint. HG-Bench is paired with a page-aware evaluation protocol that separately measures complete-answer localization (FA) and step-level decomposition (FSm), revealing whether models truly ground the spatial structure of student reasoning rather than merely parse visible text. Across frontier closed-source APIs and competitive open-weight VLMs, no zero-shot system exceeds 55.22% on FA or 48.22% on FSm, while a GLM-4.6V 9B reference model fine-tuned on ~10k in-domain examples reaches 74.97/72.26. These results identify step-level handwritten grounding as a concrete capability gap and provide a reproducible benchmark, evaluation protocol, and trained reference point for future work on automated homework assessment.

18.
arXiv (quant-ph) 2026-06-11

Measurement incompatibility and quantum steering via linear programming

arXiv:2506.03045v3 Announce Type: replace Abstract: The problem of deciding whether a set of quantum measurements is jointly measurable is known to be equivalent to determining whether a quantum assemblage is unsteerable. This problem can be formulated as a semidefinite program (SDP). However, the number of variables and constraints in such a formulation grows exponentially with the number of measurements, rendering it intractable for large measurement sets. In this work, we circumvent this problem by transforming the SDP into a hierarchy of linear programs that compute upper and lower bounds on the incompatibility robustness with a complexity that grows polynomially in the number of measurements. The hierarchy is guaranteed to converge and it can be applied to arbitrary measurements – including non-projective POVMs (Positive Operator-Valued Measures) – in arbitrary dimensions. While convergence becomes impractical in high dimensions, in the case of qubits our method reliably provides accurate upper and lower bounds for the incompatibility robustness of sets with several hundred measurements in a short time using a standard laptop. We also apply our methods to qutrits, obtaining non-trivial upper and lower bounds in scenarios that are otherwise intractable using the standard SDP approach, although such bounds are significantly looser than the ones obtained in the qubit case. Finally, we show how our methods can be used to construct local hidden state models for states (i.e., to prove that a state cannot lead to steering under any possible local measurements), or conversely, to certify that a given state exhibits steering; for two-qubit quantum states, our approach is comparable to, and in some cases outperforms, the current best methods.

19.
Nature Medicine 2026-06-15

Activity-dependent adaptive deep brain stimulation improves gait in Parkinson’s disease

Authors:

Parkinson’s disease leads to a spectrum of locomotor deficits that vary in severity with the nature of daily activities and the fluctuating physiology of patients. Many of these deficits remain inadequately addressed by existing deep brain stimulation therapies that rely on activity-agnostic parameters optimized for cardinal motor symptoms. By contrast, therapies embedding activity-specific parameters have the potential to better address the entire range of symptoms. Here we expose physiological principles that enable real-time decoding of ongoing locomotor activities across motor fluctuations from the neural dynamics of the subthalamic nucleus. This decoding steered activity-dependent adaptations of deep brain stimulation therapies that improved locomotor deficits while preserving efficacy for cardinal motor symptoms across activities of daily living. Our activity-dependent framework provides a blueprint for next-generation neuromodulation therapies that continuously select parameters optimized to the behavioral context and fluctuating physiology of each patient. ClinicalTrials.gov registration NCT06791902 . Neural decoding algorithms that leverage physiological principles of locomotor encoding support activity-dependent deep brain stimulation therapies that improve locomotor deficits in people with Parkinson’s disease.

20.
arXiv (CS.AI) 2026-06-16

Trust Between AI Agents: Measuring Formation, Breakage, and Recovery, with Implications for Governing Multi-Agent Systems

Authors:

arXiv:2606.14923v1 Announce Type: new Abstract: As language-model agents increasingly work in teams, each agent must decide how much to trust its teammates. Yet we lack a standard way to measure trust between AI agents. We propose a behavioral measure based on costly verification. In a cooperative survival game, checking a teammate's work consumes resources, while trusting a wrong answer can be fatal. Relative to a memoryless version of the same model, reduced verification provides an observable measure of trust. Using this framework, we study trust formation, breakage, and recovery across six frontier model snapshots. When paired with a consistently reliable teammate, four snapshots (Claude Opus 4.6, Claude Sonnet 4.6, GPT-5.1, and Gemini 3.1 Pro) reduce verification by roughly 60-85%, whereas two smaller snapshots show little or no such adjustment. Failures reverse this discount, but models differ in how they respond. Some concentrate renewed scrutiny on the culprit, while others become more cautious toward the entire team. Recovery is slower than formation, and clustered failures sustain suspicion far longer than the same number of failures spread apart. These differences have practical consequences. Models that form trust verify less, decide more quickly, and achieve higher payoffs in our environment. By contrast, persistent over-verification is associated with indecision rather than safety. Our results show that trust dispositions can be measured before deployment and suggest that calibration, rather than maximal suspicion, should be the central concern in the governance of multi-agent AI systems.

21.
arXiv (CS.CV) 2026-06-17

Predicting Immune Biomarkers with MultiModal Mixture-of-Expert Pathology Foundation Models Empowers Precision Oncology

Predicting immune biomarkers associated with the tumor immune microenvironment (TIME) is critical for advancing precision oncology, yet existing approaches are largely limited to single image modalities and suffer from insufficient resolution and incomplete utilization of complementary clinical and biological information. Here we introduce MixTIME, a multimodal foundation model that leverages a mixture-of-experts (MoE) architecture to integrate pathology foundation models trained across distinct modalities: image only (UNIv2), image text (CONCHv1.5), and image transcriptomic (STPath) representations for pixel-level and slide-level prediction of multiplex immunofluorescence (mIF) protein expression from hematoxylin and eosin (HE) whole-slide images. MixTIME employs a learnable router to dynamically weight expert contributions and is trained with a distribution- and tendency-aware loss function. Benchmarked on two datasets of different scales, MixTIME achieves state-of-the-art performance across 17 protein markers as measured by correlation metrics. The predicted mIF profiles substantially enhance downstream tasks, including spatial domain identification, survival prediction, and AI-assisted pathology report generation validated by expert pathologists from multiple institutes across the world. Furthermore, MixTIME enables longitudinal tracking of protein expression dynamics across clinical time points and reveals protein gene interaction patterns linked to drug resistance and immune suppression in tumor microenvironments. Collectively, MixTIME provides a scalable framework for multimodal biomarker discovery and clinical translation in computational pathology.

22.
medRxiv (Medicine) 2026-06-12

Opportunistic CKD Screening in Hospitalized Patients

Background. Chronic kidney disease (CKD) affects 10-13% of adults worldwide but remains largely undiagnosed until advanced stages. Hospitalization provides an opportunity for early detection through opportunistic urine albumin-to-creatinine ratio (UACR) measurement. Methods. We conducted a prospective three-arm study of opportunistic CKD screening in general internal medicine wards at Hadassah Mt. Scopus (MS), Hadassah Ein Kerem (EK), and Shaare Zedek Medical Center (SZMC) in Jerusalem (Protocol HMO-23-0300). Adult inpatients without known CKD or recent UACR were enrolled. Pathological UACR was defined as [≥]30 mg/g. Confirmed CKD required two pathological measurements [≥]90 days apart (KDIGO-compatible). eGFR was computed using the 2021 CKD-EPI race-free equation. Pooled proportions were estimated by fixed-effects logit meta-analysis; odds ratios by DerSimonian-Laird random-effects models. Results. A total of 158 patients were enrolled (MS n=50, EK n=57, SZMC n=51). Pathological first UACR was identified in 43/158 patients (27.2%; 95% CI 21.3-34.1%; I2=0% across centers). Of 24 patients with a second UACR available, 14 (58%) confirmed CKD, yielding a pooled confirmed-CKD rate of 8.9% of all screened patients. In-hospital mortality was significantly higher among patients with pathological UACR (9.3% vs ~2%; Fisher's exact p=0.012). In per-center multivariate logistic regression, three predictors reached pooled significance: BUN (OR 1.10 per mg/dL, 95% CI 1.04-1.17, p=0.002, I2=0%), heart failure (OR 3.21, 95% CI 1.34-7.70, p=0.009, I2=0%), and diabetes mellitus (OR 2.54, 95% CI 1.11-5.82, p=0.028, I2=17%). Cardiac/vascular admissions had the highest pathological UACR rate (~42%); GI/hepatic admissions had 0%. Conclusions. Opportunistic inpatient UACR screening identifies previously unrecognized CKD in approximately 9% of general internal medicine patients, with consistent results across three independent centers. BUN elevation, heart failure, and diabetes are the strongest independent predictors. Pathological UACR carries significant short-term mortality risk, supporting integration of routine screening into inpatient care pathways.

23.
arXiv (CS.CL) 2026-06-17

PACE-RAG: Patient-Aware Contextual and Evidence-Constrained RAG for Clinical Drug Recommendation

Drug recommendation requires a deep understanding of individual patient context, especially for complex conditions like Parkinson's disease. While LLMs possess broad medical knowledge, they fail to capture the subtle nuances of actual prescribing patterns. Existing RAG methods also struggle with these complexities because guideline-based retrieval remains too generic and similar-patient retrieval often replicates majority patterns without accounting for the unique clinical nuances of individual patients. To bridge this gap, we propose PACE-RAG (Patient-Aware Contextual and Evidence-Constrained RAG). Rather than directly copying frequent medications from retrieved patients, PACE-RAG personalizes recommendations by first extracting patient-specific clinical features, retrieving cases around these features, and then refining the final prescription using the patient's current symptoms, active medication history, and focus-specific prescribing tendencies. By analyzing treatment patterns tailored to specific clinical features, PACE-RAG generates patient-specific medication recommendations along with an explainable clinical summary. Evaluated on a Parkinson's cohort and the MIMIC-IV benchmark using Llama-3.1-8B and Qwen3-8B, PACE-RAG achieved state-of-the-art performance, reaching F1 scores of 80.84% and 47.22%, respectively. These results suggest that PACE-RAG is a robust and clinically grounded framework for personalized decision support. Our code is available at: https://github.com/ChaeYoungHuh/PACE-RAG.

24.
Nature (Science) 2026-06-24

Small-molecule modulation of β-arrestins

β-Arrestins are multifunctional regulators of G-protein-coupled receptor (GPCR) signalling and orchestrate diverse downstream signalling events and physiological responses across the GPCR superfamily1–3. Although GPCR pharmacology has advanced to target orthosteric and allosteric sites, as well as G proteins and GPCR kinases, direct chemical tools to modulate β-arrestin activities have remained conspicuously absent. Here we report the identification of small-molecule inhibitors that selectively target β-arrestins and delineate their mechanism of action through integrated pharmacological, biochemical, biophysical and structural analyses. These inhibitors disrupt β-arrestin engagement with agonist-activated GPCRs, impairing desensitization, internalization and β-arrestin-dependent physiological functions while sparing G protein–receptor coupling. Cryo-electron microscopy, molecular dynamics simulations and structure-guided mutagenesis reveal that one modulator, Cmpd-5, engages a pocket within the central crest of β-arrestin1 formed by the middle, C and lariat loops, a critical receptor-binding interface, stabilizing a distinct conformation that is incompatible with full β-arrestin–receptor engagement. Together, these findings establish a mechanistic framework for β-arrestin modulation, reveal a novel allosteric site for structure-based drug design, and open new avenues for transducer-targeted, pathway-specific GPCR therapeutic agents. Integrated pharmacological, biochemical, biophysical and structural analyses of small-molecule β-arrestin inhibitors show how they block β-arrestin engagement with activated GPCRs, revealing their mechanism of action and uncovering a previously unrecognized allosteric regulatory site.

25.
arXiv (CS.CL) 2026-06-19

Learning to Prompt: Improving Student Engagement with Adaptive LLM-based High-School Tutoring

LLMs can personalize education, although current static-prompt tutoring systems struggle to adapt to diverse academic disciplines. We develop and test a system with subject-aware prompting, based on 14 pedagogical features (e.g., tutor scaffolding, student understanding) extracted from raw transcripts. We first train a prompt routing model in a simulation environment, and then deploy it for online adaptation with actual high-school students. The simulation benchmark shows the router outperforming two static baselines ($0.694$ vs. $0.647$ and $0.64$, $p