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

Distributed General-Purpose Agent Networks: Architecture, Key Mechanisms, and Prototypes

arXiv:2606.17368v1 Announce Type: new Abstract: Large language models have accelerated the transition from passive conversational assistants to autonomous agents that can understand goals, plan actions, invoke tools, and execute multi-step tasks. Yet the capability of a single agent remains constrained by its local data, tool permissions, runtime environment, and governance boundary. This paper studies distributed general-purpose agent networks: open peer-to-peer networks in which heterogeneous agents deployed on personal devices, edge nodes, or autonomous computing environments can discover one another, establish trust, negotiate cooperation rules, and execute open-ended tasks. We argue that such networks cannot be obtained by simply combining existing peer-to-peer overlays with conventional multi-agent systems. Unlike traditional P2P networks, agent networks must propagate semantic declarations about intentions, capabilities, states, and cooperation constraints. We therefore propose a layered architecture centered on a protocol adaptation layer that connects upper-level task semantics with lower-level network operations. Based on this architecture, the paper identifies three core mechanism problems: semantic announcement propagation for collaborator discovery, verifiable identity and multi-topic reputation for cooperation governance, and semantic-gradient mechanism design for open task execution. For each problem, we present a technical route, including bodyless gossip with sequential logs, BAID-based identity binding with MG-EigenTrust reputation, and a Stackelberg-style mechanism-generation loop driven by semantic attribution feedback. We further report prototype overhead results for BAID-style tiered verification and mechanism-level simulations of MG-EigenTrust under cross-topic disguise-collusion attacks. The resulting framework provides a system-level foundation for open, trustworthy, and scalable agent collaboration.

02.
Nature Medicine 2026-06-17

General-purpose chatbots outperform clinical AI tools on physicians’ real-world questions

Authors: Unknown Author

Specialized clinical AI tools are entering medical practice with little independent testing. In a head-to-head evaluation across two public benchmarks and real questions from physicians, three general-purpose frontier large language models outperformed two leading clinical AI tools, which performed no better than Google search AI overview.

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

LoSoNA: A Benchmark for Local Social Norm Adaptation in Group Conversations

Online group chats are social spaces with local conversational norms that are rarely stated explicitly. The ability and willingness of LLM-based agents to recognize and adapt to these norms remains mostly unexplored. We introduce LoSoNA, a benchmark for local social norm adaptation in multi-party chat. Each scenario gives a subject model a curated group-chat transcript in which non-subject participants demonstrate a hidden local norm, followed by a final elicitor turn that forces a response revealing whether the subject has inferred that norm. We evaluate eight frontier and open-weight models under four prompting conditions that vary how explicitly the model is told to treat the prior conversation as evidence for how it should answer. Naive prompting remains limited for most models; explicit norm-aware prompting helps unevenly, with Gemini 3.1 Pro reaching $84.2\%$ and Claude Fable 5 reaching $81.6\%$, while several other models show small gains or regressions. LoSoNA contributes to recent calls for evaluating LLM social capabilities by testing whether models can infer local conversational norms from precedent and use them in a one-turn group-chat response.

04.
Nature Medicine 2026-06-10

Brain Health for Economic Resilience: a data-driven framework for the brain-positive economic transition

Announced in this Comment and in collaboration with Nature Medicine is the convening of the Brain Health for Economic Resilience Commission, a global, transdisciplinary effort to define, measure and operationalize brain health and cognitive capacity as foundational drivers of economic resilience.

05.
arXiv (CS.CL) 2026-06-15

Detecting undisclosed LLM-generated content in parliamentary texts

In this paper, we evaluate the extent of undisclosed LLM-generated content in texts from the parliaments of the United Kingdom and Sweden. In many areas, such as in journalism or in academic writing, there are often requirements to clearly disclose whether AI tools, such as LLMs, have been used. In the case of parliamentary texts, the guidelines on disclosure of AI use are more vague. However, in order to maintain transparency and retain public trust, it is generally recommended that parliamentarians should state whether or not they have used AI when writing texts, such as parliamentary motions. Here, we train an interpretable (glass-box) text classifier using pre-LLM parliamentary texts and LLM-generated versions of such texts. We then apply the classifier to a test set containing recent parliamentary texts, finding a steady increase in undisclosed LLM use, in both parliaments, from 2022 onwards.

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

SceneMiner: Identity-Preserving Multi-Task Fine-Tuning for Unified BEV Scene Mining

Mining hard, safety-critical scenes from driving logs is bottlenecked by the absence of difficulty labels, and no single proxy, collision risk, trajectory ambiguity, or semantic rarity suffices to find such scenes on its own. We present SceneMiner, a unified, camera-only bird's-eye-view pipeline that emits complementary mining signals from a frozen vision-language backbone in a single forward pass, with no LiDAR or radar: a retrieval embedding for text-prompted scenario search, a multi-label scene-tag distribution, and a continuous physics-based risk score (a motion forecast is a byproduct, not a contribution). Building such a multi-head model exposes our central finding, a failure mode we term cross-task interference: adding or upgrading one head shifts a shared activation stream and degrades weight-frozen sibling heads, so freezing parameters alone is insufficient. Our contribution, identity-preserving multi-task fine-tuning, removes this interference by zero-initializing every new sub-module and freezing every parameter that feeds the shared stream. The mining heads are thereby preserved bit-identically while training only ~102k parameters. The tagging head reaches mAP 0.4614 (micro-F1 0.5557) on 20 scene tags by pooling each scene into 32 visual tokens, and the embedding head supports text-prompted retrieval, validated qualitatively. Code is available at: https://anonymous.4open.science/r/sceneminer_anonymous-64E5

07.
arXiv (quant-ph) 2026-06-19

Matrix Product Operator Encodings of the Magnus Expansion and Dyson Series

arXiv:2605.21597v2 Announce Type: replace Abstract: We introduce a matrix product operator (MPO) encoding of the Magnus expansion and the Dyson series for one-dimensional quantum lattice models with time-dependent Hamiltonians. The MPO construction can be made accurate up to arbitrary order in the time step, it can be applied to both finite and infinite systems, and it can handle long-range interactions. The resulting MPO can be combined with state-of-the-art time evolution algorithms based on matrix product states, allowing for drastic improvements in simulating evolution under time-dependent Hamiltonians. Our MPO construction can also be used for the optimization of quantum circuits in the context of quantum simulation of time-dependent Hamiltonians.

08.
medRxiv (Medicine) 2026-06-17

Deep learning for interactive and automated inner retinal layer segmentation in OCT images of patients with retinitis pigmentosa using limited training data

Purpose: New therapeutic strategies such as optogenetics have created a need for accurate tracking of inner retina degeneration in Retinitis pigmentosa (RP) patients. We introduce two tailored deep learning models to segment the RNFL (retinal nerve fibre layer), GCIPL (ganglion cell inner plexiform layer), INL (inner nuclear layer), CFT (central foveal thickness) and RPE (retinal pigment epithelium) in RP: The first is based on a Segment Anything Model (SAM), the second on nnU-Net. To our knowledge, SAM has not yet been applied to retinal layers in OCT data. Methods: SD-OCT images of a retrospective cohort of 37 RP patients were included. Data for four training cycles were prepared semi-automatically in MATLAB, then assessed and corrected by three expert graders. 1,700 segmented B-Scans from two open datasets were used for pretraining. For post-processing, semantic retinal boundary detection was developed. The final models, OCT-SAM and nnU-Net, were trained on 228 annotated RP scans. Detected layer thicknesses were validated against manual segmentation at 90 random points in 30 OCT B-Scans. Finally, OCT-SAM was tested on three RP cases with retrospective, longitudinal OCT data. Results: nnU-Net achieved a precision, recall and F-1 score of 0.96 while OCT-SAM performance resulted in slightly lower values of 0.93, 0.8 and 0.85, respectively. OCT-SAM measurements had low bias and good agreement with manual annotations, confirming reliability. Conclusions: OCT-SAM enabled fast data annotation and tool integration, whereas nnU-Net provided the best segmentation performance. OCT-SAM demonstrated longitudinal reproducibility and detected RP-characteristic pathologies and degenerative changes. Future work will extend OCT-SAM to 3D OCT segmentation.

09.
arXiv (CS.CL) 2026-06-11

Organize then Retrieve: Hierarchical Memory Navigation for Efficient Agents

Large language model (LLM) agents struggle with long-horizon tasks due to their inherent statelessness, requiring all task-relevant information to be encoded in growing input contexts. The resulting degraded reasoning quality, increased inference cost, and higher latency necessitate efficient working memory mechanisms. However, existing approaches either rely on lossy compression or similarity-based retrieval, which often fail to capture temporal structure and causal dependencies required for multi-step agentic tasks. In this work, we present HORMA, a Hierarchical Organize-and-Retrieve Memory Agent that organizes experience into a file-system-like hierarchical structure, where summarized entities are linked to the corresponding raw trajectories, enabling efficient access without losing detailed information. HORMA decomposes working memory into two stages: structured memory construction and navigation-based retrieval. The construction module iteratively refines how experiences are structured by distinguishing between failures caused by missing information and those caused by misleading or overloaded context. The navigation module retrieves task-relevant context by traversing the hierarchy using a lightweight agent trained with reinforcement learning to select minimal yet sufficient context, thereby reducing latency along the critical execution path. Across ALFWorld, LoCoMo, and LongMemEval, HORMA improves task performance under constrained context budgets while requiring at most 22.17% of the baseline token usage in long conversation tasks. Compared to existing methods, it consistently achieves better efficiency-performance trade-offs and generalizes effectively to unseen tasks.

10.
arXiv (CS.CL) 2026-06-19

Code-Switching Reveals Language Anchoring in Multilingual LLMs

Multilingual Large Language Models (MLLMs) are increasingly expected to handle Code-Switched (CS) inputs, yet mixing languages frequently degrades performance relative to source- or target-language monolingual counterparts. To understand this degradation, we use grammar-forced CS as a controlled diagnostic setting for locating CS representations relative to their source and target counterparts. We introduce Anchor Bias, a geometric measure that quantifies language anchoring, whether a CS hidden state aligns closer to its source or target language counterpart. Across diverse MLLMs, Anchor Bias reveals a consistent grammar-frame effect: source-framed CS stays source-anchored, whereas target-framed CS shifts target-ward and shows larger Question Answering (QA) degradation. Motivated by this representational pattern, we propose CANVAS (Contextual Anchor-based Neural Vector Alignment Steering), an inference-time intervention that extracts a source-side canvas from the input and softly steers target-language hidden states toward the source anchor during prefill. CANVAS consistently recovers QA F1 across MLLMs and CS conditions, showing that internal anchoring signals provide an actionable target for mitigating CS inference failures.

11.
arXiv (CS.LG) 2026-06-12

Graphical Causal Reasoning for Root Cause Analysis in Cloud Networks

arXiv:2606.13532v1 Announce Type: cross Abstract: Cloud-computing relies on large-scale networks which are inherently complex systems. In this paper, we present a novel approach to root cause analysis (RCA) of cloud network incidents, leveraging graph-based causal discovery techniques. Our method addresses the limitations of rule-based automation by introducing a spatiotemporal grouping strategy and an automation ontology to reduce the dimensionality of the problem. We construct a causal graph from binary time series data using bivariate Granger causality and conditional independence tests. For inference, we introduce a probabilistic method that assigns edge-specific conditional probabilities as a function of time lag, allowing for interpretable, time-aware root cause scoring via causal graph traversal. We evaluated the system using a labeled dataset of 35 production incidents from a major cloud provider. The model successfully recalled the correct root cause in 85.7% of incidents and produced an exact match in 74.3%. In production, the deployed system has been used in over 800 real-world incidents, with positive qualitative feedback from network engineers. These results highlight the practicality of a data-driven, causal approach to RCA in dynamic and large-scale operational environments.

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

Dealing with Annotator Disagreement in Hate Speech Classification

Hate speech detection is a crucial task, especially on social media where harmful content can spread quickly. Collecting social media content (tweets etc.) to train machine learning models is easy, but detecting and categorizing hate speech can be difficult due to the inherently subjective nature. This subjectivity leads to frequent disagreement among annotators, particularly for subtle or borderline content. Traditional approaches either discard non-consensus samples or force a ''gold standard'' through expert adjudication, ignoring valuable information about uncertainty and diverse human perspectives. We examine the largely overlooked problem of annotator disagreement in hate speech classification and evaluate a range of aggregation methods, including majority voting, ordinal strategies (minimum, maximum, and mean), and analyze their impact across binary, 4-class, and 6-class classification tasks. In addition, we leverage annotators' perceived hate speech strength scores to explore regression-based and hybrid modeling approaches. Among others, we show that filtering non-consensus samples results in over-optimistic results and that the perceived strength provides a complementary signal that enhance classification performance. Finally, we establish new state-of-the-art results for hate speech detection in Turkish tweets, and demonstrate that annotator disagreement, when properly modeled, is a valuable resource for building more robust and reliable systems.

13.
arXiv (CS.LG) 2026-06-16

Sharp analysis of linear ensemble sampling

arXiv:2602.08026v2 Announce Type: replace Abstract: We analyse linear ensemble sampling (ES) with standard Gaussian perturbations in stochastic linear bandits. We show that for ensemble size $m=\Theta(d\log n)$, ES attains $\tilde O(d^{3/2}\sqrt n)$ high-probability regret, closing the gap to the Thompson sampling benchmark while keeping computation comparable. The proof brings a new perspective on randomized exploration in linear bandits by reducing the analysis to a time-uniform exceedance problem for $m$ independent Brownian motions. This continuous-time lens appears particularly natural here: it yields an exact representation of the relevant discrete-time processes, and we do not know another route to a sharp ES bound.

14.
PLOS Medicine 2026-06-12

Comparison of count-based and clustering definitions of multimorbidity and their association with prevalence of multimorbidity, health profiles, and mortality: A cohort study of UK Biobank participants

by Gabriella C. Silva, Aurore Fayosse, Louis Jacob, Séverine Sabia, Archana Singh-Manoux, Benjamin Landré Background Multimorbidity, the presence of several chronic conditions, is linked to higher mortality and healthcare use and thus poses a major challenge for aging populations. While most studies rely on simple counts of conditions, clustering approaches have been proposed to describe patterns of co-occurring diseases. We aimed to evaluate the extent to which these methodological choices influence prevalence and association with health profiles and mortality. Methods and findings Using UK Biobank baseline data (n = 474,397), collected between 2006 and 2010, we compared six count-based definitions of multimorbidity based on different condition lists (extended, most prevalent, or body systems) and thresholds (≥2 versus ≥3 conditions). We also applied a clustering analysis to characterize subtypes of multimorbidity among participants with at least two chronic conditions. We compared prevalence and associations with concurrent health outcomes (polypharmacy, self-rated health, frailty, falls, surgery, chronic pain), blood-based measures (C-reactive protein, Cystatin-C, HDL, LDL Cholesterol, IGF-1), and 3- and 10-year mortality risks. Analyses were undertaken separately in men and women using multivariable regression models adjusted for sociodemographic characteristics and body mass index. Multimorbidity prevalence ranged from 1.0% (cluster-based) to 35.3% (count-based). Count-based definitions using lists with more conditions yielded higher prevalence. Higher thresholds identified more severe health profiles on all measured health outcomes, blood-based measures, but not higher mortality risks. Associations with blood-based measures were more pronounced using clustering, with the highest differences from the standard definition distributed across clusters. Odds ratios for 3-year mortality ranged from 1.44 [1.26; 1.64] to 4.60 [3.73; 5.62] for men and 1.35 [1.07; 1.69] to 3.83 [2.78; 5.14] for women. For 10-year mortality, they ranged from 1.42 [1.34; 1.50] to 3.86 [3.46; 4.30] in men and 1.29 [1.21; 1.39] to 3.33 [2.93; 3.77] for women, with clustering identifying groups with low prevalence and high mortality risks. Findings should be interpreted in light of the selected nature of the UK Biobank cohort and the cross-sectional assessment of several health indicators. Conclusion Operational definitions of multimorbidity substantially influence prevalence estimates, while associations with mortality appear more robust across count-based approaches. Clustering analyses provide complementary insights into heterogeneity within multimorbid populations. Future translational studies are warranted to determine how multimorbidity definitions can be optimized to ultimately improve clinical management and health outcomes in practice.

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

Curiosity-Critic: Cumulative Prediction Error Improvement as a Tractable Intrinsic Reward for World Model Training

arXiv:2604.18701v3 Announce Type: replace-cross Abstract: Local prediction-error-based curiosity rewards focus on the current transition without considering the world model's cumulative prediction error across all visited transitions. We introduce Curiosity-Critic, which grounds its intrinsic reward in the improvement of this cumulative objective, and show that it admits a tractable per-step surrogate: the difference between the current prediction error and the asymptotic error baseline of the current state transition. We estimate this error baseline online with a learned critic co-trained alongside the world model; since the critic only has to learn how hard a transition is to predict, its estimate of the irreducible noise floor converges well before the world model saturates, redirecting exploration toward learnable transitions. The reward is higher for learnable transitions and collapses toward zero for stochastic ones, thereby separating epistemic (reducible) from aleatoric (irreducible) prediction error online. Prior prediction-error curiosity formulations, from Schmidhuber (1991) to learned-feature-space variants, emerge as special cases corresponding to specific approximations of this error baseline. Experiments on a stochastic grid world show that Curiosity-Critic outperforms prediction-error, visitation-count, and Random Network Distillation methods in training speed and final world model accuracy.

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

GauS: Differentiable Scheduling Optimization via Gaussian Reparameterization

arXiv:2602.20427v2 Announce Type: replace Abstract: Efficient operator scheduling is a fundamental challenge in software compilation and hardware synthesis. While recent differentiable approaches have sought to replace traditional ones like exact solvers or heuristics with gradient-based search, they typically rely on categorical distributions that fail to capture the ordinal nature of time and suffer from a parameter space that scales poorly. In this paper, we propose a novel differentiable framework, GauS, that models operator scheduling as a stochastic relaxation using Gaussian distributions, which fully utilize modern parallel computing devices like GPUs. By representing schedules as continuous Gaussian variables, we successfully capture the ordinal nature of time and reduce the optimization space by orders of magnitude. Our method is highly flexible to represent various objectives and constraints, which provides the first differentiable formulation for the complex pipelined scheduling problem. We evaluate our method on a range of benchmarks, demonstrating that Gaus achieves Pareto-optimal results.

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

TreeGRNG: Binary Tree Gaussian Random Number Generator for Efficient Probabilistic AI Hardware

arXiv:2606.16599v1 Announce Type: cross Abstract: Bayesian Neural Networks (BNNs) offer opportunities for greatly enhancing the trustworthiness of conventional neural networks by monitoring the uncertainties in decision-making. A significant drawback for BNN inference at the extreme edge, however, is the imperative need to incorporate Gaussian Random Number Generators (GRNG) within each neuron. State-of-the-art GRNG algorithms heavily depend on multiple arithmetic operations and the use of extensive look-up tables, posing significant implementation challenges for ultra-low power hardware implementations. To overcome this, this paper presents an innovative binary tree random number generator (TreeGRNG) allowing the use of ultra-low-cost constant comparators instead of arithmetic units. We further enhance the TreeGRNG proposal with a set of hardware-aware optimizations exploiting the Gaussian properties. The optimized TreeGRNG surpasses the State-of-the-Art (SoTA) in terms of distribution accuracy while achieving a 3.7$\times$ reduction in energy per sample and boosting the throughput per unit area by 5.8$\times$. Moreover, our TreeGRNG proposal possesses a distinct advantage over the current SoTA in terms of flexibility, as it easily enables designers to adjust the shape of the sampled probability distribution, extending beyond the capabilities of traditional GRNGs, opening the horizon towards future probabilistic AI designs. The TreeGRNG design is available open-source in the link

18.
arXiv (CS.AI) 2026-06-16

RECTOR: Masked Region-Channel-Temporal Modeling for Affective and Cognitive Representation Learning

arXiv:2606.15278v1 Announce Type: cross Abstract: Affective and cognitive disorders manifest as distributed, time-varying brain network dynamics across regions, channels, and time, challenging robust representation learning from EEG/sEEG for clinical diagnosis. We propose RECTOR (Masked Region-Channel-Temporal Modeling), an end-to-end self-supervised framework that unifies joint region-channel-temporal representation learning beyond fixed anatomical priors. At its core, RECTOR-SA is a hierarchical, block-sparse self-attention induced by Adaptive Functional Partitioning that evolves region structures from static anatomical definitions to adaptive functional regions. The self-supervision is driven by Masked Topology and Representation Learning, which jointly optimizes three complementary objectives: Masked Predictive Modeling, Topological Structure Modeling, and Cross-View Consistency. Across diverse benchmarks, RECTOR sets a new state-of-the-art in EEG emotion recognition and sEEG task-engagement classification. Crucially, its strong robustness to missing channels and cross-montage generalization underscores its potential for large-scale pre-training on heterogeneous EEG/sEEG, providing interpretable insights at both region and channel levels.

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

Lifecycle-Aware Dynamic Analysis for Secure ML Model Execution

arXiv:2606.19023v1 Announce Type: cross Abstract: The growing reliance on pre-trained Machine Learning (ML) models has introduced new attack surfaces. Recent vulnerabilities demonstrate that malicious behavior can be embedded within model artifacts, often bypassing existing defenses. Current model-scanning solutions primarily rely on static, format-specific rules or known attack signatures, which limit their ability to generalize across frameworks and to detect novel exploitation paths. In contrast, we propose a solution that focuses on the effects an attack has on the host system executing the model and builds on foundational intuitions about ML model execution. In particular, we observe that ML models operate within well-defined lifecycle phases and that, within each phase, interactions with the host system are highly structured and predictable. We translate these intuitions into Moat, a dynamic lifecycle-aware approach for securing ML model execution, and instantiate this design in Re-Moat, our reference implementation. We evaluate Re-Moat across multiple ML frameworks using 77,974 real-world model artifacts from the Hugging Face Hub, 31 Proofs-of-Concept (PoCs) from CVEs, and 334 models from a state-of-the-art dataset, and compare it against state-of-the-art model-scanning solutions. Our results show that our approach detects all evaluated attack classes while maintaining a close-to-zero false-positive rate, validating our intuitions and motivating dynamic analysis for securing ML model execution.

20.
arXiv (CS.LG) 2026-06-24

Bridging Mechanistic Interpretability and Prompt Engineering with Gradient Ascent for Interpretable Persona Control

arXiv:2601.02896v3 Announce Type: replace Abstract: Controlling emergent behavioral personas (e.g., sycophancy, hallucination) in Large Language Models (LLMs) is critical for AI safety, yet remains a persistent challenge. Existing solutions face a dilemma: manual prompt engineering is intuitive but unscalable and imprecise, while automatic optimization methods are effective but operate as "black boxes" with no interpretable connection to model internals. We propose a novel framework that adapts gradient ascent to LLMs, enabling targeted prompt discovery. In specific, we propose two methods, RESGA and SAEGA, that both optimize randomly initialized prompts to achieve better aligned representation with an identified persona direction. We introduce fluent gradient ascent to control the fluency of discovered persona steering prompts. We demonstrate RESGA and SAEGA's effectiveness across Llama 3.1, Qwen 2.5, and Gemma 3 for steering three different personas, sycophancy, hallucination, and myopic reward. Crucially, on sycophancy, our automatically discovered prompts achieve significant improvement (49.90% compared with 79.24%). By grounding prompt discovery in mechanistically meaningful features, our method offers a new paradigm for controllable and interpretable behavior modification. We release our scripts for RESGA and SAEGA in this github repo: https://github.com/HarshSaini10/RESGA_SAEGA.

21.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

22.
PLOS Medicine 2026-06-23

Parental body mass index and offspring childhood body size and eating behaviour: A structural equation modelling analysis in the Norwegian Mother, Father and Child Cohort Study

Authors:

by Tom A. Bond, Tom A. McAdams, Nicole M. Warrington, Laurie J. Hannigan, Espen Moen Eilertsen, Ziada Ayorech, Fartein A. Torvik, George Davey Smith, Deborah A. Lawlor, Eivind Ystrom, Alexandra Havdahl, David M. Evans Background The intergenerational transmission of obesity-related traits could propagate an accelerating cycle of obesity, if parental adiposity causally influences offspring adiposity. The extent to which intergenerational obesity associations are due to such causal effects, as opposed to genetic confounding (inheritance), is unclear. We aimed to establish whether associations between parental peri-pregnancy body mass index (BMI) and offspring birth weight (BW), BMI until 8 years of age, and 8-year-old eating behaviour are due to genetic confounding. Methods and findings Data were from the Norwegian Mother, Father and Child Cohort Study, a prospective population-based birth cohort born between 1999 and 2009 at 50 out of 52 hospital maternity units in Norway. We compared the strength of the associations of maternal pre-pregnancy BMI versus paternal BMI during pregnancy, with offspring outcomes including birth weight and BMI assessed between age 6 months and 8 years of age, and appetite-related eating behaviour traits assessed at age 8 years via the Child Eating Behaviour Questionnaire (CEBQ), adjusting for potential confounders including parity, parental/grandparental language group and parental age, smoking, education and income). We then used an extended children of twins structural equation model (SEM) to quantify the extent to which associations were due to genetic confounding. Up to 85,866 children (51.3% male) were included in linear regression models, whereas SEM models included up to 50,999 children. Maternal BMI was more strongly associated than paternal BMI with offspring BW, but the maternal-paternal difference decreased for offspring BMI after birth. Greater parental BMI was associated with obesity-related offspring eating behaviours. SEM results indicated that genetic confounding did not explain the association between parental BMI and offspring BW, but explained the majority of the association with offspring BMI from 6 months onwards. For 8-year BMI, genetic confounding explained 79% (95% CI [62, 95]; p = 1.9 × 10−12) of the covariance with maternal BMI and 94% (95% CI [72, 113]; p = 2.7 × 10−14) of the covariance with paternal BMI. Limitations of this study include selective recruitment and attrition, potential bias due to parental assortative mating, and that findings may not generalise beyond high-income country settings with high obesity prevalence. Conclusions We found strong evidence that parent–child BMI associations may primarily be due to genetic confounding. When considered alongside prior evidence, this finding may argue against a strong causal effect of maternal or paternal adiposity on childhood adiposity via intrauterine or periconceptional mechanisms.

24.
medRxiv (Medicine) 2026-06-17

Clinical Study Protocol of the 'Biomarkers of Severity of COVID-19 Patients' (BIOMARCOVID) Project

Introduction The coronavirus disease 2019 (COVID-19) pandemic has challenged health care systems worldwide, in certain areas exceeding hospital capacities and human resources. This has underscored the importance of having better tools to predict the outcome of potentially severe respiratory infections such as SARS-CoV-2. Predicting COVID-19 severity may allow physicians to better manage ICU beds and increase the chances of patient survival through appropriate management. During the toughest months of the pandemic, most physicians tried to identify patients that might develop severe forms based primarily on clinical features on admission (e.g., BMI, age). In this context, significant research has focused on identifying comorbidities, clinical manifestations, and routine blood biomarkers to predict disease severity. However, despite the demonstrated value of untargeted metabolomics in assessing severity, limited data exist on its use for identifying novel metabolite biomarkers that could improve both the sensitivity and specificity of outcome prediction. Our goal is to identify metabolite biomarkers that could enhance the predictive accuracy of standard medical biology data and clinical parameters. Methods and analysis This is a retrospective, observational, monocentric cohort study conducted at the Centre Hospitalier Universitaire Grenoble Alpes (CHUGA). The maximum number of eligible patients admitted for PCR-confirmed COVID-19 between March and December 2020 will be included. Severity outcome is defined using the WHO 10-category ordinal scale (mild: categories 4-5; severe: >5). Blood samples were collected within 48 hours of admission and analyzed for 62 routine blood tests and untargeted multiplatform LC-MS/MS metabolomics across four national platforms. Statistical analysis will include logistic regression with variable selection for the primary aim, and multi-block chemometric integration of clinical, biological, and metabolomics data as a secondary aim. Ethics and dissemination A study steering committee has been formed to ensure the accuracy of the collected data by thoroughly reviewing it prior to the data lock. All aspects of the study comply with ethical standards, including approval by the CHUGA institutional review board and adherence to CNIL Reference Methodology MR004 for the protection of participants' rights, privacy, and confidentiality. This study is registered on the French Health Data Hub (number F20210218154851). Results will be disseminated through peer-reviewed publications, presentations at national and international scientific and clinical conferences, and reports shared with key healthcare system stakeholders.

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

InternVideo3: Agentify Foundation Models with Multimodal Contextual Reasoning

Recent progress in foundation models has shifted toward agentic behavior involving multi-step reasoning and tool use. However, open-source efforts largely focus on text-dominant settings, leaving long-horizon multimodal tasks underexplored. This gap is evident in video tasks requiring sustained temporal understanding and iterative interaction. We present InternVideo3, a framework enhancing these capabilities via Multimodal Contextual Reasoning (MCR). MCR treats understanding as a closed-loop process over a shared, evolving context containing observations, instructions, reasoning, tool actions, and memory. This frames long-video understanding as evidence accumulation and verification. To ensure efficiency, we introduce Multimodal Multi-head Latent Attention (M^2LA), a token-preserving reparameterization compressing KV-cache states while retaining the full token stream. Our staged training includes continued pretraining, short-to-long supervised fine-tuning, rule-based reinforcement learning, and on-policy distillation. Experiments show InternVideo3 achieves strong performance on benchmarks like Video-MME, MLVU, and EgoSchema. We further instantiate the model as a video agent with retrieval tools, demonstrating robust evidence-grounded behavior. Our results suggest that efficient context handling and closed-loop reasoning are vital for adapting open multimodal models toward long-horizon visually grounded agency.