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01.
medRxiv (Medicine) 2026-06-19

The Impact of Pregnant Womens Dietary Behavior on the Physiological Adaptation Paradox and Maternal-Fetal Resource Conflict in Conflict Settings: A Predictive Analytical Study

This scientific study aims to assess the level of awareness, nutritional knowledge, and actual behavioral practices among pregnant women in the Capital District of Sanaa, Republic of Yemen, and to determine their impact on the health and clinical indicators of the mother and fetus under complex conflict conditions. The study employed a descriptive-analytical approach based on a simple random sample of 200 pregnant women attending government-run hospitals and specialized medical centers in the Capital District. Field data were collected during December 2025 using a structured and validated questionnaire consisting of 42 items measuring demographic variables, awareness, practices, barriers, and health outcomes. The results of the statistical analysis using SPSS software showed a high level of nutritional awareness (87%) and healthy dietary practices (80%) among the sample participants. Simple and multiple linear regression tests revealed a statistically significant effect of awareness and practices in explaining 20.2% of the variance in the health status of the mother and fetus (R{superscript 2}= 0.204, p < 0.001). The study demonstrated that actual behavioral practices have greater predictive power ({beta}=0.316, p=0.001) compared to theoretical cognitive awareness ({beta}=0.232, p=0.005) in determining clinical outcomes for the mother and fetus, highlighting the widening gap between knowledge and behavior under structural pressures. "Morning sickness" (80%) and the deterioration of "family economic status" (71%) emerged as the greatest physiological and material barriers to proper nutrition. With their inferential impact established as an extension of the maternal-fetal resource allocation conflict in a physiologically and economically challenging environment, the study also identified significant differences in nutritional behavior and health outcomes in favor of housewives and mothers who are more educated and have higher incomes, while no significant differences were recorded attributable to obstetric variables such as stage or order of pregnancy. The study offers a unique theoretical and practical contribution by formulating an integrated causal model that demonstrates that the fetus acts as a biological drain on the mothers cellular and mineral reserves in a war environment, which necessitates directing antenatal care and support programs toward effective behavioral empowerment and nutritional support to overcome the structural and material barriers faced by pregnant women.

02.
medRxiv (Medicine) 2026-06-17

Menopausal symptoms in peri- and postmenopausal women: systematic review and meta-analysis of prevalence, incidence, comorbidities, and clinical outcomes

Introduction: The global epidemiology of menopausal symptoms among middle-aged and elderly women remains unclear. Methods: Data on prevalence, comorbidities, incidence and outcomes of menopausal symptoms published up until March 1st 2019 were searched in PubMed, Embase and Cochrane databases. We used a random-effects model to compute point estimates of prevalence for 24 types of menopausal symptoms. We narratively summarized the patterns of the comorbidities, incidence and outcomes of menopausal symptoms due to limited data. Results: A total of 239 studies (n{approx}2.5 million middle-aged and elderly women) from 56 countries and regions were included in the analysis. The global pooled prevalence analysis revealed that hot flashes (48%) and night sweats (30%) were highly prevalent, alongside psychological symptoms like insomnia (47%), irritability (46%), anxiety (39%), and depression (30%). Physical symptoms including joint aches/pain (50%), backache (47%), and tiredness (61%) were also commonly reported. Heat intolerance showed the highest prevalence (76%), while symptoms like urinary incontinence (24%) and poor appetite (8%) were less frequent. These findings highlight the diverse and widespread impact of menopause on women globally, with significant variations across symptom types. Africa showed the highest pooled prevalence across a series of symptoms, compared with other continents. We observed high prevalence in developing countries, especially for psychological and physical symptoms; significant intra-Asian variation in vasomotor symptoms; hypertension and obesity as the most common comorbidities; joint pain, urinary incontinence, and vasomotor symptoms as the most incident complaints; and positive associations with cardiovascular disease in the psychological (depression and insomnia) and physical (joint pain) domains. Conclusion: This study highlights the global burden of menopausal symptoms, with significant differences across continents. The findings call for more inclusive research on underrepresented groups (particularly in Africa) and further investigation into drivers of this marked global heterogeneity in prevalence of menopausal symptoms and their comorbidities, incidence and outcomes.

03.
arXiv (quant-ph) 2026-06-16

Long-range nonstabilizerness of topologically encoded states from mutual information

arXiv:2605.22424v2 Announce Type: replace Abstract: We study long-range nonstabilizerness (LRN), namely the obstruction to remove nonstabilizerness with shallow-depth local quantum circuits. In one-dimensional settings, the mutual information between disconnected spatial regions has proven to be a powerful tool to diagnose LRN. In this work, we focus on encoded states of two-dimensional topologically-ordered systems, and explore the ability of the mutual information to serve as a diagnostic of LRN. Focusing on the concrete setting of lattice models defined on a torus, we show that information about LRN can be gained from the analysis of the mutual information between non-overlapping regions containing non-contractible loops, and of the change of such mutual information under modular real-space transformations. We exemplify this idea in the toric code and the non-abelian string-net model with doubled Fibonacci topological order. In the former case, we show that the mutual information provides a full classification, certifying LRN for all encoded non-stabilizer states. In the latter case, instead, our approach does not lead to a full classification, as it detects LRN for all states except from a finite subset with special transformation properties under the modular group. Finally, we discuss how our results on LRN constrain the logical gates that can be implemented fault-tolerantly on the torus.

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

Possibilistic Predictive Uncertainty for Deep Learning

Deep neural networks achieve impressive results across diverse applications, yet their overconfidence on unseen inputs necessitates reliable epistemic uncertainty modeling. Existing methods for uncertainty modeling face a fundamental dilemma: Bayesian approaches provide principled estimates but remain computationally prohibitive, while efficient second-order predictors lack rigorous connections between their specific objectives and epistemic uncertainty quantification. To resolve this dilemma, we introduce Dirichlet-approximated possibilistic posterior predictions (DAPPr), a principled framework grounded in possibility theory. We define a possibilistic posterior over parameters, project it to the prediction space via supremum operators, and approximate the projected posterior using learnable Dirichlet possibility functions. This projection-and-approximation strategy yields a simple training objective with closed-form solutions. Despite its simplicity, extensive experiments across diverse benchmarks show that DAPPr achieves competitive or superior uncertainty quantification performance over state-of-the-art second-order predictors while maintaining both principled derivation and computational efficiency. Code is available at https://github.com/MaxwellYaoNi/DAPPr.

05.
arXiv (CS.AI) 2026-06-18

Large-Scale OD Matrix Estimation with A Deep Learning Method

arXiv:2310.05753v2 Announce Type: replace Abstract: The estimation of origin-destination (OD) matrices is a crucial aspect of Intelligent Transport Systems (ITS). It involves adjusting an initial OD matrix by regressing the current observations like traffic counts of road sections (e.g., using least squares). However, the OD estimation problem lacks sufficient constraints and is mathematically underdetermined. To alleviate this problem, some researchers incorporate a prior OD matrix as a target in the regression to provide more structural constraints. However, this approach is highly dependent on the existing prior matrix, which may be outdated. Others add structural constraints through sensor data, such as vehicle trajectory and speed, which can reflect more current structural constraints in real-time. Our proposed method integrates deep learning and numerical optimization algorithms to infer matrix structure and guide numerical optimization. This approach combines the advantages of both deep learning and numerical optimization algorithms. The neural network(NN) learns to infer structural constraints from probe traffic flows, eliminating dependence on prior information and providing real-time performance. Additionally, due to the generalization capability of NN, this method is economical in engineering. We conducted tests to demonstrate the good generalization performance of our method on a large-scale synthetic dataset. Subsequently, we verified the stability of our method on real traffic data. Our experiments provided confirmation of the benefits of combining NN and numerical optimization.

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

Enhancing Decision-Making with Large Language Models through Multi-Agent Fictitious Play

Large language model (LLM)-based multi-agent systems (MAS) have demonstrated great potential in solving tasks with execution complexity, by distributing subtasks across cooperative agents. However, this divide-and-conquer paradigm falls short on decision-making tasks that are also prevalent in the real world. These tasks require simultaneous reasoning from the stances of all involved stakeholders whose decisions are mutually dependent and thus cannot be solved in isolation. We characterize this challenge as stance entanglement, a form of decision complexity distinct from execution complexity. To address it, we propose Multi-Agent Fictitious Play (MAFP), a novel MAS paradigm that represents stakeholder stances as agents and formulates decision-making as an equilibrium-seeking process. Built on the game-theoretic principle of fictitious play, MAFP iteratively updates each agent's decision by best responding to the empirical mixture of other agents' past decisions. This enables agents to expose and address one another's weaknesses, progressively improving decision quality and robustness. We evaluate MAFP on challenging decision-making tasks that test the capability of deciding strategies for competitive scenarios prior to acting. MAFP outperforms both single-round and multi-round baselines on two complementary metrics, tournament strength and robustness, demonstrating its effectiveness in addressing stance entanglement.

07.
arXiv (CS.CL) 2026-06-18

TW-LegalBench: Measuring Taiwanese Legal Understanding

Large language models (LLMs) have shown impressive capabilities across diverse tasks, yet their performance on jurisdiction-specific legal reasoning remains underexplored. We present TW-LegalBench that utilizes Taiwanese legal system's rich official corpus open to the public to fill the gap in evaluating LLMs on Taiwanese law, among common-law benchmarks that focus on English sources and civil-law benchmarks focusing on sources of Simplified Chinese. TW-LegalBench comprises three task types: (1) over 16,000 multiple-choice questions (MCQs) across five years of official examinations in 18 professional domains; (2) 117 open-ended essay questions (OEQs) from examinations for legal professionals with official scoring rubrics; and (3) more than 14,000 legal judgment prediction (LJP) instances covering hundreds of crime categories. We evaluate 13 LLMs using accuracy for MCQs, a decomposed LLM-as-Judge framework based on the scoring rubric points for OEQs, and metrics for sentencing accuracy and statute citation for LJP. Our results reveal that top-performing models exceed the passing threshold for qualified lawyers (passing rate: 11%) but fall short of that for judges and prosecutors (passing rate: 1~2%). For LJP, while models demonstrate reasonable verdict type accuracy and sentence prediction capability, they struggle to cite exact legal articles. These findings highlight that reliable legal text generation remains challenging for LLMs, even though their performance on qualification examinations approaches human level.

08.
arXiv (CS.LG) 2026-06-18

Knockoffs-based False Discovery Rate Control and Simplification for Deep Neural Networks

arXiv:2606.04404v2 Announce Type: replace-cross Abstract: The deep neural network is a widely used framework in machine learning that has been widely applied in various fields. However, deep neural networks often involve a large number of parameters and inputs, many of which may be irrelevant to the goal or true output. These parameters and input variables not only increase computational complexity, but also contribute to additional computational cost. One solution to this problem is knockoff methods, which have proven successful in controlling false discovery rates in high-dimensional regression. Building on the knockoff methods and using the regularised neural network, this paper proposes three variable screening methods under the condition of controlling false discovery rates: one layer filter, multiple layers filter, and variable weight aggregation filter. In comparison with existing algorithms, we find that our algorithms show satisfactory performance.

09.
arXiv (CS.LG) 2026-06-16

SILAGE: Memory-Efficient, Full-Gradient-Free Nonconvex Optimization for Nested Finite Sums

arXiv:2606.15832v1 Announce Type: new Abstract: Empirical risk minimization on massive datasets naturally exhibits a nested double finite-sum structure, where $N=nm$ total samples are logically or physically partitioned into $n$ blocks of size $m$ (e.g., in pooled data silos, out-of-core learning, or deliberate stratification). While variance-reduced methods achieve optimal oracle complexities for nonconvex objectives, they suffer from severe scaling bottlenecks in this centralized regime. Recursive estimators, such as PAGE, require periodic global full-gradient refreshes over all $nm$ samples, which are computationally expensive. Conversely, single-loop methods, such as SILVER, avoid such refreshes but require an impractical $\mathcal{O}(nm)$ memory footprint to store a control variate for every sample. In this paper, we propose SILAGE, a variance-reduced algorithm that addresses this trade-off. By actively exploiting the double-sum structure, SILAGE eliminates periodic global full-gradient refreshes over all $nm$ components (evaluating at most one local group gradient per iteration) while requiring only $\mathcal{O}(n)$ memory. Furthermore, we provide a tight convergence analysis that avoids pessimistic worst-case Lipschitz constants. Instead, SILAGE's complexity natively adapts to the underlying data geometry via nested functional similarities: across-group ($\delta_1$) and within-group ($\delta_2$) heterogeneity. Our results improve existing state-of-the-art bounds in several practically relevant regimes.

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

EurekAgent: Agent Environment Engineering is All You Need For Autonomous Scientific Discovery

LLM-based agents have shown increasing potential in automating scientific discovery. Given an optimizable metric and an execution environment, they can propose, validate, and iterate scientific solutions, and have produced results that outperform human-designed approaches. As model capabilities continue to improve, we argue that the bottleneck for autonomous scientific discovery is shifting from prescribing agent workflows to designing agent environments: the resources, constraints, and interfaces that shape agent behavior. We frame this as environment engineering: building environments that amplify productive behaviors, such as open-ended exploration, systematic artifact management, and inter-agent collaboration, while suppressing harmful behaviors, such as reward hacking and high-friction human oversight. We present EurekAgent, an environment-engineered agent system for metric-driven autonomous scientific discovery. EurekAgent engineers the environment along four dimensions: permissions engineering for bounded agent execution and isolated evaluation; artifact engineering for filesystem and Git-based collaboration; budget engineering for budget-aware exploration; and human-in-the-loop engineering for easy human supervision and intervention. EurekAgent sets new state-of-the-art results on multiple mathematics, kernel engineering, and machine learning tasks, including new state-of-the-art 26-circle packing results discovered with less than $11 in total API cost. We open-source our code and results, and call for environment engineering as a core research direction for developing reliable autonomous research agents.

11.
arXiv (CS.AI) 2026-06-18

AI-Driven Assessment of Human Tutors: Linking Training Performance to Real-Life Practice

arXiv:2606.18617v1 Announce Type: cross Abstract: There exist numerous tutor training platforms. However, few provide AI-driven training and evaluation for human tutors based on real-life performance. We present an AI-driven system that assesses both open responses during training and authentic real-life tutoring. Unlike platforms that only assess learning through online training or simulations, our system utilizes Generative AI (Gemini-2.5-pro) to analyze transcriptions of authentic tutoring, measuring the transfer of tutor skills to real-life application. Human tutors instructing students remotely in math (N=86) completed six scenario-based lessons, averaging a significant 7.4% learning gain. Using mixed-effects models across 405 session-to-lesson pairs, we found that training performance significantly predicted real-life transcript scores with an effect size of 0.25 SD. Model comparison (AIC/BIC) indicated averaging open response and multiple choice performance during training predicted real-life tutor performance best, although open responses were comparatively more predictive. Exploratory analysis showed that after training, tutors were significantly more likely to encounter pedagogical opportunities to apply their skills (61.1% to 68.9%) and demonstrated higher execution quality within those opportunities (65.5% to 68.1%). Interrupted time series analysis suggested that these tutor improvements were part of a gradual trend over time rather than an immediate intervention effect of training. We illustrate an AI-driven method to link tutor training with real-life assessment. In doing so, we contribute open datasets, AI prompts, and scoring rubrics to support transparency and reproducibility.

12.
medRxiv (Medicine) 2026-06-10

Cortical activity during narrative discourse production in individuals with post-stroke aphasia and controls measured via functional near-infrared spectroscopy

Introduction: Aphasia is an acquired language disorder with a significant negative functional impact. Much of the research on aphasia has focused on word-level language comprehension and production. Further evaluation of discourse-level tasks, both at behavioral and neural levels, will allow for an ecologically valid understanding of the functional implications of language impairment in this population. Method: This study evaluated bilateral frontal, temporal, and parietal cortical activity during computer-based narrative production in 14 young neurotypical individuals, 17 individuals with post-stroke aphasia, and 15 age-matched neurotypical participants using functional near-infrared spectroscopy (fNIRS). Oxygenated hemoglobin (HbO) was measured during narrative production following short video clips and compared to HbO during counting aloud. In addition, behavioral measures quantifying in-task performance were correlated with averaged HbO values. Results: Young neurotypical individuals showed greater cortical activity in bilateral language regions for narrative production compared to counting aloud. In contrast, people with aphasia showed positive condition-related effects in the right frontal ROI and the age-matched group showed positive condition-related effects in the left frontal and right precentral ROIs. Each group showed different patterns in relationships between cortical activity and discourse performance measures. Conclusion: Overall, young participants showing more consistent condition-related effects for narrative discourse production than individuals with aphasia and age-matched controls. This study shows the potential for fNIRS to evaluate cortical activity for ecologically valid language tasks in individuals with post-stroke aphasia.

13.
medRxiv (Medicine) 2026-06-24

Association Between Intermittent Water Supply and Helicobacter pylori Prevalence: A Global Ecological Study

Background: Helicobacter pylori is a major global pathogen with recognized potential for waterborne transmission. Intermittent water supply affects over one billion worldwide and may promote H. pylori contamination of municipal sources. Whether water supply discontinuity contributes to population-level H. pylori burden has not been examined globally. Materials and Methods: We conducted a cross-sectional ecological analysis of 79 countries with matched utility-level water infrastructure data and country-level H. pylori prevalence estimates from a published global meta-analysis. The primary exposure was continuity of water supply (hours/day). Secondary exposures included non-revenue water percentage (NRW %), pipe breaks per utility, and operating cost coverage ratio. Unadjusted and adjusted linear regression models with heteroscedasticity-consistent standard errors were estimated, controlling for basic sanitation coverage and log-transformed population density. A sensitivity analysis used a population-based measure of water availability on demand. Results: Greater water supply continuity was independently associated with lower H. pylori prevalence in both unadjusted ({beta} = -0.987, 95% CI -1.669 to -0.305, p = 0.005) and adjusted models ({beta} = -1.125, 95% CI -1.876 to -0.375, p = 0.004). Higher NRW % and lower operating cost coverage were each associated with higher H. pylori prevalence after adjustment. Pipe breaks were not significant in regression models though the Spearman correlation was in the expected direction. Sensitivity analysis produced consistent findings. Conclusion: IWS and broader water infrastructure deterioration are associated with higher H. pylori prevalence at the country level. These findings implicate water supply continuity as a potentially relevant environmental determinant of H. pylori transmission and suggest a role for water system investment within long-term gastric cancer prevention strategies.

14.
arXiv (math.PR) 2026-06-18

A simple approach to the L{\o}kka-Zervos dichotomy for absolutely continuous dividend strategies

arXiv:2604.13302v3 Announce Type: replace-cross Abstract: We revisit the optimization problem solved in L{\o}kka & Zervos (2008), i.e., the maximization of dividends, in a Brownian risk model, with the possibility (not the obligation) of making capital injections. Following the approach introduced in Alvarez & Shepp (1998), Renaud & Simard (2021), Renaud et al. (2023), we consider instead absolutely continuous (AC) dividend strategies with an affine bound on the payment rates, while singular capital injections are still allowed. In addition, we incorporate a parameter for the cost of ruin or, said differently, a penalty at ruin in the performance function. We show that the solution is a so-called L{\o}kka-Zervos dichotomy: the surplus is never ruined by making bail-out payments, or no capital is injected and bankruptcy can occur; in either case, dividends are paid at full rate when the surplus is above a threshold. Our framework allows us to provide explicit conditions to express the dichotomy, either using the cost of capital injections or the cost of ruin as a criterion, which also exposes the underlying structure of the solution. In particular, for some values of the parameters, we show that it is optimal to liquidate. Moreover, we perform a numerical analysis highlighting the range of values generated under this AC affine-bound structure.

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

Uncertainty Estimation for Molecular Diffusion Models

arXiv:2606.13451v1 Announce Type: new Abstract: Diffusion models have seen wide adoption for 3D molecular generation, yet they offer no principled signal of when a generated molecule is likely to be of low quality. We propose a post-hoc method for estimating per-sample uncertainty in pretrained molecular diffusion models. Building on a Laplace approximation of the denoising network, we measure the variability of the noise prediction across the generation trajectory. Empirically, we show that the resulting uncertainty score is informative of sample quality, exhibiting a negative correlation with established sample-level quality metrics. We further study how the proposed uncertainty score can be used to filter generated samples, improving model performance via test-time scaling.

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

Learning Dynamics Reveal a Hierarchy of Weight-Induced Layerwise Gram Metrics

arXiv:2606.09744v3 Announce Type: replace Abstract: We study feed-forward ReLU networks with fixed readout and quadratic loss. The aim is to rewrite gradient descent not primarily as a dynamics in weight space, but as a collective dynamics closed in terms of fields defined on the training-set space. For a single hidden layer, the weight variables can be eliminated from the activation dynamics, yielding a closed equation for the residuals governed by a collective kernel that factorizes into an input-geometric matrix and a dynamical co-activation matrix. For deeper networks, the residual dynamics retains a clean layer-wise kernel structure. However, from depth three onward, closure requires a hierarchy of weight-induced Gram operators that mediate information transport across layers. Moreover, the conjugate-field dynamics is governed by operators satisfying a backward pullback recursion, of which the weight-induced Gram operators are the first nontrivial instances.

17.
arXiv (CS.CV) 2026-06-11

ARGUS: Stacked Multi-View Identity Mosaic Injection for Subject-Preserving Video Generation

Subject-preserving video generation is not solved by frontal-face similarity alone: a generated person must remain recognizable across motion, large viewpoint changes, expression shifts, occlusion, scale variation, and conflicts among text, first-frame, and identity references. We argue that the central bottleneck is the point-reference paradigm, which collapses identity into a single static observation entangled with pose, accessories, lighting, background, and camera statistics. We introduce Argus, a Wan-based framework centered on Stacked Multi-View Identity Mosaic Injection (SMII). SMII converts MLLM-selected image/video identity evidence into a 3*3 stacked mosaic, synchronizes the mosaic with the current diffusion time, and injects it as negative-time read-only memory in Wan's native token space. This turns identity from an external clean adapter or a single reference image into a compact dynamic distribution. Around SMII, an MLLM Identity Director selects informative identity moments and resolves condition conflicts, while no-cross-pair counterfactual training, Temporal Identity Annealing, and Adaptive Self-Likeness Guidance improve robustness without paired subject-video supervision. We further release HardID-Celeb, a public-figure identity-stress benchmark, and introduce YawScore and OccScore to probe large-yaw and first-frame-occlusion robustness. Argus achieves state-of-the-art results on OpenS2V-Eval Human-Domain, reaching 64.38 Total Score, 71.86 FaceSim, 51.62 NexusScore, and 79.14 NaturalScore. On HardID-Celeb, Argus obtains 76.80 FaceSim and improves YawScore and OccScore by 12.60 and 15.10 points over the strongest baselines, demonstrating that dynamic identity memory and large-scale counterfactual self-supervision are highly effective for subject-preserving video generation.

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

RGFVR: Reference-Guided Face Video Restoration with Flow Matching

Face video restoration from degraded observations is challenging, as it requires simultaneously recovering visual fidelity, temporal consistency, and subject identity. Existing approaches are often either reference-free, which can lead to identity loss when person-specific facial details are lost, or subject-specific, which limits generalization to unseen identities. We propose a subject-agnostic, reference-guided framework for identity-preserving face video restoration. Our method introduces bimodal perceptual-descriptive identity conditioning into a pretrained flow-based text-to-video generator and employs a two-stage training strategy to strengthen identity guidance during restoration. Experiments show that our approach improves restoration fidelity, temporal consistency, and identity preservation, achieving superior performance under challenging video degradations, including downsampling, blur, noise, and compression artifacts. The code is available under: https://github.com/batuhanntosun/RG-FVR.

19.
Nature (Science) 2026-06-17

Towards autonomous medical artificial intelligence agents

Authors:

Large language models (LLMs) show great potential for clinical decision-making, yet most applications remain narrow, task-specific chat tools rather than systems integrated into clinical workflows1,2. However, building physician copilots will require models that operate within the electronic health record (EHR), with governed access to patient data and the ability to initiate permitted EHR actions within defined safety constraints. Yet it remains unproven whether such a system can manage patient cases with physician-level performance. Here we show that MIRA (Medical Intelligence for Reasoning and Action), an autonomous artificial intelligence agent operating in a sandboxed EHR environment, can navigate a large clinical action space to obtain patient histories; order and interpret laboratory, imaging and microbiology tests; generate differential diagnoses; and formulate treatment plans such as prescribing medications, scheduling surgical procedures and planning admissions. In simulations on real patient cases spanning multiple diagnoses, MIRA outperformed physicians in diagnostic accuracy and made guideline-concordant, medication-safe and appropriate admission decisions. Compared with previous LLM applications that addressed isolated subtasks or provided free-text advice, these results suggest that an EHR-integrated artificial intelligence agent can turn clinical intent into structured, actionable EHR operations, possibly making it a more effective decision-support partner for physicians. Further work is needed to establish generalization, safety and governance through prospective, real-world studies. A large language model artificial intelligence agent operating in a sandboxed electronic health record system can autonomously&nbsp;take patient histories, order tests, interpret findings, diagnose conditions and propose treatments, outperforming experienced clinicians while adhering to safety standards and clinical guidelines.

20.
PLOS Medicine 2026-06-24

Cardiovascular outcomes and safety associated with statin therapy for primary prevention in older adults with type 2 diabetes: A target trial emulation study

Authors:

by Linda Chan, Wanchun Xu, Esther W. Y. Chan, Eric Yuk Fai Wan Background There is limited evidence on the use of statins for primary prevention of cardiovascular disease (CVD) in older adults with type 2 diabetes due to underrepresentation of this population in randomized controlled trials (RCTs). We aimed to determine the effectiveness and safety of statin therapy for primary CVD prevention among type 2 diabetes patients aged ≥75 years. Methods and findings In this cohort study, territory-wide electronic health records (EHRs) from the Hospital Authority Clinical Management System in Hong Kong were used to emulate a sequence of nested target trials. Eligible patients were included in a rolling basis in each calendar month from January 2009 to December 2015, and thus we emulated 84 ‘nested monthly trials’. In each monthly trial, all type 2 diabetes patients aged ≥60 years with elevated low-density lipoprotein cholesterol (≥2.6 mmol/L) in the baseline calendar month were included; patients with a history of type 1 diabetes, CVDs, cancers, muscle-related disorders, or liver dysfunction were excluded from analysis. Eligible individuals were classified into statin initiators or noninitiators based on whether they initiated statin therapy at the time of enrollment. They were categorized into various age groups (60–74, 75–84, ≥85 years) for analysis, with those aged 60–74 years forming a benchmark group to test the validity of the emulated target trial. Patients were followed up until the outcome of interest, death, or the administrative end (December 2018), whichever occurred first. We estimated hazard ratios (HRs) comparing statin use versus nonuse for CVDs, all-cause mortality, muscle-related adverse events (AEs), and liver dysfunction using pooled logistic models, with inverse probability weighting to adjust for time-varying confounders related to treatment adherence, under the assumption of no unmeasured confounding. Propensity score matching was performed on eligible person-trials at baseline, incorporating demographic characteristics, clinical and laboratory parameters, comorbidities, medication history, and healthcare utilization as matching variables. Among 30,804 matched person-trials aged 75–84 years, a significant reduction in the incidence of CVDs (HR 0.69 (95% CI [0.65, 0.75]; p 

21.
arXiv (CS.AI) 2026-06-12

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

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

22.
bioRxiv (Bioinfo) 2026-06-11

A multi-agent system for spine MRI report generation from multi-sequence imaging

Spinal pathology is a leading cause of pain and disability worldwide. Spine magnetic resonance imaging (MRI) is central to clinical evaluation, yet its interpretation remains complex and time-consuming, requiring integration of information across multiple imaging sequences and anatomical regions. Despite recent advances in automated MRI analysis, effectively combining multi-sequence data while preserving sequence-specific diagnostic information remains an open challenge. Here we present SpineAgent, a multi-agent framework for spine MRI report generation built upon a multi-sequence foundation model trained on routine clinical data from 32,047 patients and 453,683 MRI series, comprising a total of 13,441,191 MRI slices. To accommodate diverse modalities of sequences, we first pre-train two DINOv3-based encoders separately on T1- and T2-weighted sequences. We then introduce a continual training strategy that learns a synthesizer to embed images of other sequences using the T1 and T2 encoders, producing patient-level embedding that integrates various signals across MRI sequences. Using these embeddings, SpineAgent achieves state-of-the-art performance, with mean 10.8% AUROC improvement across 17 spinal condition-prediction tasks compared to the best competing method, and demonstrates strong generalizability under cross-manufacturer and cross-cohort evaluation. Beyond classification, SpineAgent enables pathology localization by identifying findings-relevant slices and segmenting pathological regions. It also supports multimodal image-report retrieval, providing a solid foundation for scalable and explainable MRI report generation. We further integrate these validated capabilities of SpineAgent into 37 specialized agents for condition diagnosis, pathological-region localization, and clinically-similar-cases retrieval. Finally, we incorporate their outputs as structured tokens within a Medical Report Agent trained end-to-end for report generation. Through both automated metrics and expert evaluation by five radiologists, SpineAgent achieves leading performance in spine MRI report generation. Together, SpineAgent introduces a continual training approach for multi-sequence spine MRI understanding. By decomposing report generation into clinically grounded subtasks addressed by specialized agents, the SpineAgent framework enables accurate, interpretable and generalizable spine MRI reporting across diverse imaging sequences and anatomical regions.

23.
arXiv (CS.LG) 2026-06-25

ROAD-VLA: Robust Online Adaptation via Self-Distillation for Vision-Language-Action Models

arXiv:2606.25800v1 Announce Type: new Abstract: Effective online adaptation of vision-language-action (VLA) models remains challenging, as sparse rewards provide weak supervision for high-dimensional autoregressive action policies. Although self-distillation can in principle provide denser training signals, we find that text-based privileged teachers conditioned on demonstrations, retrieved experiences, or high-level plans are ineffective for VLA adaptation, exposing a modality gap between symbolic guidance and low-level robot actions. We propose ROAD-VLA, an advantage-guided self-distillation framework that constructs a proximal teacher directly in action space by perturbing action-token logits with calibrated advantage estimates. This converts sparse rewards into dense token-level supervision while keeping the teacher close to the current policy. We further derive a policy-improvement lower bound under calibrated advantages and accurate teacher matching. Across seven robotic manipulation environments with in-distribution and out-of-distribution shifts, ROADVLA outperforms PPO in nearly all settings, demonstrating robust online VLA adaptation.

24.
arXiv (CS.AI) 2026-06-19

Denoising Implicit Feedback for Cold-start Recommendation

arXiv:2606.19658v1 Announce Type: new Abstract: Implicit feedback is widely used in recommender systems due to its accessibility and generality, yet it usually presents noisy samples (e.g., clickbait, position bias). Meanwhile, recommenders inevitably face the item cold-start problem due to the continuous influx of new items. We identify that cold items are more prone to noisy samples due to the aforementioned factors, and researchers often overlook the significance of denoising implicit feedback for cold items. Previous denoising studies usually identify noisy samples based on heuristic patterns, such as higher loss values, and mitigate noise through sample selection or re-weighting. However, these methods have limited adaptability and are ineffective in cold-start scenarios. To achieve denoising implicit feedback for cold-start recommendation, we propose a model-agnostic denoising method called DIF. First, user preferences for content remain stable, which allows us to infer pseudo-labels indicating whether a user is interested in a cold item through content-similar warm items. Furthermore, to improve pseudo-label accuracy, we model the confidence of pseudo-labels based on the content similarity between the cold item and warm items, and then aggregate multiple pseudo-labels for each sample. Finally, we explicitly estimate the uncertainty of the noisy sample label by considering its relative entropy and the cold-start status of the item, which adaptively guides the role of pseudo-labels to correct the noisy labels at the sample level. DIF's superiority is supported by both theoretical justification and extensive experiments on real-world datasets. The method has been deployed on a billion-user scale short video application Kuaishou and has significantly improved various commercial metrics within cold-start scenarios.

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arXiv (CS.CL) 2026-06-17

RooseBERT: A New Deal For Political Language Modelling

The increasing amount of political debates and politics-related discussions calls for the definition of novel computational methods to automatically analyse such content with the final goal of lightening up political deliberation to citizens. However, the specificity of the political language and the argumentative form of these debates (employing hidden communication strategies and leveraging implicit arguments) make this task very challenging, even for current general-purpose pre-trained Language Models (LMs). To address this, we introduce a novel pre-trained LM for political discourse language called RooseBERT. Pre-training a LM on a specialised domain presents different technical and linguistic challenges, requiring extensive computational resources and large-scale data. RooseBERT has been trained on large political debate and speech corpora (11GB) in English. To evaluate its performances, we fine-tuned it on multiple downstream tasks related to political debate analysis, i.e., stance detection, sentiment analysis, argument component detection and classification, argument relation prediction and classification, policy classification, named entity recognition (NER). Our results show improvements over general-purpose LMs on the majority of these tasks, highlighting how domain-specific pre-training enhances performance in political debate analysis. We release RooseBERT for the research community.