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01.
arXiv (CS.CL) 2026-06-12

Operads for compositional reasoning in LLMs

Question decomposition, i.e. breaking a complex query into simpler sub-queries whose answers are composed to produce a final answer, is a widely used strategy for improving LLM reasoning, yet it currently lacks a rigorous mathematical foundation. In this paper, we propose operads, mathematical structures that model many-in, one-out operations and compositions thereof, as a natural framework for describing question decomposition. We define the questions operad $Q$, in which operations correspond to question templates and composition corresponds to substitution of sub-answers, and show how QA models can be interpreted as algebras over $Q$. Beyond reframing existing practice, this operadic perspective points toward new methods, in particular a notion of operadic consistency, which measures whether a QA model's answers agree across the partial collapses of a question decomposition tree. Empirical evaluation of operadic consistency is reported in our companion paper (Bottman, Liu, and Richardson, 2026), which finds it strongly correlated with accuracy across twelve LLMs and four multi-hop QA datasets and outperforming standard temperature-based self-consistency baselines. We argue that operads are the natural mathematical home for question decomposition, and that invariants such as operadic consistency open new directions for analyzing and improving the reliability of multi-step reasoning.

02.
arXiv (CS.AI) 2026-06-11

GPO: Learning from Critical Steps to Improve LLM Reasoning

arXiv:2509.16456v3 Announce Type: replace Abstract: Large language models (LLMs) are increasingly used in various domains, showing impressive potential on different tasks. Recently, reasoning LLMs have been proposed to improve the reasoning or thinking capabilities of LLMs to solve complex problems. Despite the promising results of reasoning LLMs, enhancing the multi-step reasoning capabilities of LLMs still remains a significant challenge. While existing optimization methods have advanced the LLM reasoning capabilities, they often treat reasoning trajectories as a whole, without considering the underlying critical steps within the trajectory. In this paper, we introduce Guided Pivotal Optimization (GPO), a novel fine-tuning strategy that dives into the reasoning process to enable more effective improvements. GPO first identifies the `critical step' within a reasoning trajectory - a point that the model must carefully proceed to succeed at the problem. We locate the critical step by estimating the advantage function. GPO then resets the policy to the critical step, samples the new rollout and prioritizes the learning process on those rollouts. This focus allows the model to learn more effectively from pivotal moments within the reasoning process to improve the reasoning performance. We demonstrate that GPO is a general strategy that can be integrated with various optimization methods to improve reasoning performance. Besides theoretical analysis, our experiments across challenging reasoning benchmarks show that GPO can consistently and significantly enhance the performance of existing optimization methods, showcasing its effectiveness and generalizability in improving LLM reasoning by concentrating on pivotal moments within the generation process.

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

NEST3D: A High-Resolution Multimodal Dataset of Sociable Weaver Tree Nests

Sociable weaver nests function as complex ecological structures offering thermoregulatory microhabitats and sustaining diverse species; however, datasets used in prior studies lack fine-grained 3D structural detail. Producing usable and accurate 3D weaver nest data is challenging due to their irregular geometry and integration with complex host vegetation. We bridge this gap with an open-access, 1.4 TB multimodal drone dataset of 104 nest-bearing trees, comprising 27,945 RGB images, 111,780 multispectral images, approximately 781 million 3D points, and expert-annotated semantic segmentation labels. We benchmark semantic segmentation using KPConv, RandLA-Net, and Point Transformer V3, with PT-v3 achieving an mIoU of 86.35% on the test set. While the results demonstrate strong performance for transformer-based and point-wise methods, they also highlight architecture-dependent challenges, particularly for convolution-based approaches such as KPConv. By uniquely combining spectral, spatial, and structural information, the presented dataset advances 3D reconstruction, segmentation, and classification algorithms, enabling ecological applications from nest volume estimation to species conservation, and serves as a demanding benchmark that exposes architecture-dependent performance under extreme class imbalance.

04.
Nature Biotechnology 2026-06-05

Structural motif search across the protein universe with Folddisco

Authors:

Detecting similar protein structural motifs in large structure collections is computationally expensive. We developed Folddisco, a fast structural motif search tool that uses an index of position-independent geometric features, including side-chain orientation, combined with a rarity-based scoring system. Folddisco is 20-fold faster in querying and fourfold more storage-efficient than existing methods while improving accuracy. Folddisco is freely available online ( https://folddisco.foldseek.com ), along with a webserver ( https://search.foldseek.com/folddisco ). Folddisco enables protein structural motif search in million scale databases.

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

IntSeqBERT: Learning Arithmetic Structure in OEIS via Modulo-Spectrum Embeddings

arXiv:2603.05556v2 Announce Type: replace Abstract: Integer sequences in the OEIS span values from single-digit constants to astronomical factorials and exponentials, making prediction challenging for standard tokenised models that cannot handle out-of-vocabulary values or exploit periodic arithmetic structure. We present IntSeqBERT, a dual-stream Transformer encoder for masked integer-sequence modelling on OEIS. Each sequence element is encoded along two complementary axes: a continuous log-scale magnitude embedding and sin/cos modulo embeddings for 100 residues (moduli $2$–$101$), fused via FiLM. Three prediction heads (magnitude regression, sign classification, and modulo prediction for 100 moduli) are trained jointly on 274,705 OEIS sequences. At the Large scale (91.5M parameters), IntSeqBERT achieves 95.85% magnitude accuracy and 50.38% Mean Modulo Accuracy (MMA) on the test set, outperforming a standard tokenised Transformer baseline by $+8.9$ pt and $+4.5$ pt, respectively. An ablation removing the modulo stream confirms it accounts for $+15.2$ pt of the MMA gain and contributes an additional $+6.2$ pt to magnitude accuracy. A probabilistic Chinese Remainder Theorem (CRT)-based Solver converts the model's predictions into concrete integers, yielding a 7.4-fold improvement in next-term prediction over the tokenised-Transformer baseline (Top-1: 19.09% vs. 2.59%). Modulo spectrum analysis reveals a strong negative correlation between Normalised Information Gain (NIG) and Euler's totient ratio $\varphi(m)/m$ ($r = -0.851$, $p < 10^{-28}$), providing empirical evidence that composite moduli capture OEIS arithmetic structure more efficiently via CRT aggregation.

06.
Nature (Science) 2026-06-10

A first-in-class pulsatile FXR agonist for bile-acid-related liver diseases

Authors:

Nuclear receptors are central regulators of metabolism1, yet therapeutic strategies that enforce continuous receptor activation frequently lead to reduced efficacy and unacceptable toxicity. Here we report a first-principles drug design strategy that aligns pharmacokinetics with physiological signalling cycles. We developed linafexor, a potent non-bile-acid agonist of the farnesoid X receptor (FXR)2; it is engineered for rapid systemic clearance, which enables pulsatile receptor activation that mirrors endogenous bile acid dynamics3–5. Linafexor has robust efficacy across multiple preclinical models of metabolic dysfunction-associated steatohepatitis6, liver fibrosis7, primary biliary cholangitis and primary sclerosing cholangitis8,9. Transcriptomic analyses reveal that, unlike long-acting FXR agonists10,11, linafexor preserves cyclic FXR signalling, avoids receptor downregulation and prevents broad transcriptional dysregulation. Direct manipulation of delivery patterns demonstrates that sustained FXR activation—independent of compound identity—induces severe toxicity, establishing activation duration as a determinant of therapeutic index. In phase 1 clinical studies (ClinicalTrials.gov; NCT05082779), linafexor administered once daily produces transient FXR pathway engagement, marked by (1) induction of FGF1912–14, a key endocrine mediator of bile acid feedback regulation; and (2) suppression of C415, an intermediate reflecting hepatic bile acid synthesis, with no treatment-related adverse events. Together, these findings identify pulsatile FXR activation as a mechanistically grounded and clinically translatable strategy, and establish linafexor as a first-in-class therapeutic for bile acid–related liver diseases. Linafexor is a rapidly cleared FXR agonist designed to mimic natural bile acid signalling, achieving transient receptor activation with strong efficacy and reduced toxicity in preclinical and early clinical studies.

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

Machine Unlearning for the XGBoost Model with Network Intrusion Datasets

arXiv:2606.19220v1 Announce Type: cross Abstract: Machine Unlearning (MU) has emerged as an important technique for removing specific data points from trained models without requiring full retraining. However, most existing MU research focuses on deep learning and image data, leaving a gap in the domain of network intrusion detection, which relies heavily on tabular data. This work introduces XGBoost-Forget, an unlearning approach for the XGBoost model, to address this gap. The approach is evaluated on two tabular Network Intrusion (NI) datasets, IoT-23 and GeNIS, using multiple metrics to assess model performance, unlearning efficiency, and forgetting quality. The results show that XGBoost-Forget maintains predictive performance close to the original model while providing significantly faster unlearning, demonstrating its potential for MU in tabular NI settings.

08.
medRxiv (Medicine) 2026-06-16

Reporting patterns of adverse drug withdrawal events using individual case safety reports in United States and European databases

Introduction: Adverse drug withdrawal events (ADWEs) are a key safety concern with deprescribing but are infrequently reported in trials. Although pharmacovigilance systems have advanced our understanding of medication-related harms, it is unclear how extensively these systems have been used for ADWEs. Objectives: To examine the reporting patterns of ADWEs for all drugs recorded in United States and European pharmacovigilance databases between 2004 and 2023. Methods: A retrospective study was conducted using two pharmacovigilance databases, the publicly available FDA-FAERS dataset and EMA-EV Level 2A (individual-level) dataset. ADWE cases were identified using relevant MedDRA preferred terms. Data on patient characteristics, reporter type, drugs, indication, ADWE outcomes, dechallenge/rechallenge, seriousness criteria, time to onset, duration, and causality were summarised. Results: A total of 158,505 ADWE reports were analysed (FDA-FAERS: 145,514; EMA-EV: 12,987), with mean ages of 46.1 (FDA; 55.3% female) and 45.5 years (EMA; 57.1% female). The frequently reported drug classes were opioids (FDA: oxycodone, 29.8%; EMA: buprenorphine, 19%), antidepressants (FDA: duloxetine, 32%; EMA: venlafaxine, 25.9%) and gabapentinoids (FDA: pregabalin, 6.7%; EMA: pregabalin, 6.0%). The most common adverse outcomes were other serious medical conditions (FDA=63.9%; EMA=46.0%), hospitalisation (FDA=15.9%; EMA=28.3%), and disability (FDA=13.3%; EMA=6.2%) and these outcomes varied significantly based on sex and age group (p

09.
arXiv (CS.CL) 2026-06-19

PerceptionDLM: Parallel Region Perception with Multimodal Diffusion Language Models

Multimodal large language models (MLLMs) have achieved remarkable progress in visual understanding tasks. However, most existing MLLMs rely on autoregressive generation, which limits their efficiency for perception tasks that require captioning multiple regions. In this work, we propose PerceptionDLM, a multimodal diffusion language model optimized for efficient parallel region perception. Built upon PerceptionDLM-Base, a strong foundational baseline that achieves state-of-the-art performance among open-source diffusion MLLMs, our architecture fully leverages the parallel decoding nature of DLMs. Specifically, we introduce efficient prompting and structured attention masking to enable simultaneous perception of multiple masked regions, allowing the model to generate region descriptions in parallel at both the sequence and token levels. This design significantly improves inference efficiency compared with existing approaches that process regions sequentially. To systematically evaluate the parallelism property of visual perception capability for DLMs, we construct a new Parallel Detailed Localized Captioning Benchmark (ParaDLC-Bench) by scaling the DLC-Bench to include multiple region masks per image, enabling joint evaluation of both caption quality and inference efficiency. Experiments demonstrate that PerceptionDLM maintains competitive performance in region captioning while achieving substantial speed improvements for multi-region perception tasks. Our results highlight the potential of multimodal diffusion language models for efficient, parallel visual perception. To the best of our knowledge, we are the first to achieve parallel region caption and perception by leveraging the advantages of diffusion language models. Code, models, and datasets are released.

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

Multi-Task Bayesian In-Context Learning

arXiv:2606.20538v1 Announce Type: new Abstract: Bayesian predictive inference provides a principled framework for uncertainty quantification, data efficiency, and robust generalization. However, exact inference is often intractable, and scalable approximations may remain computationally expensive or require restrictive modeling assumptions that degrade predictive performance. Prior-Data Fitted and in-context models have recently emerged as an amortized alternative by learning to map datasets directly to predictive distributions, but existing approaches are tightly coupled to the support of the training prior and lack explicit mechanisms for adapting to new priors at test time, resulting in limited robustness under distribution shift. We introduce a multi-task in-context learning framework for amortized hierarchical Bayesian predictive inference that explicitly represents prior information as a prefix of in-context datasets. A transformer trained on sequences of prior and target tasks learns to adapt its predictions across families of priors. On a suite of evaluations with increasing difficulty, including out-of-meta-distribution priors and priors with high-dimensional latent structures, our method matches oracle Bayesian predictors while being orders of magnitude faster. We further demonstrate its practical relevance on a real-world spatiotemporal temperature prediction benchmark. Code is available at https://github.com/martianmartina/multi-task-bayesian-icl/.

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

High-Frequency Pricing at Scale for E-Commerce

arXiv:2606.13741v1 Announce Type: new Abstract: This paper presents the design, development, and implementation of a specialized forecast-then-optimize algorithmic pricing tool for sales campaigns in fashion e-commerce. Sales events present unique challenges for pricing including volatile demand patterns, rapid pricing decisions, and the need to balance short-term revenue with long-term profitability. We describe our approach combining daily-resolution demand forecasting using gradient-boosted trees with a multi-objective optimization framework that maximizes both long-term profit and net merchandise value for more than 5 million articles. Our solution addresses key limitations of existing weekly-granularity systems by implementing a forecast-then-optimize architecture that reduces pricing decision time from hours to minutes. We validate our approach through 23 A/B tests across 12 markets during 2023-2024 sales campaigns at Zalando, one of Europe's leading online fashion retailers. Experimental results demonstrate that the new pricing system achieves approximately 6% higher profit while maintaining equivalent performance on sales and revenue compared to the previous manual-algorithmic hybrid approach. Based on these results, the algorithm was successfully deployed to production and now handles the majority of algorithmic pricing decisions for sales campaigns at the company.

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

Robust State-Conditional Feature-Weighted Jump Models for Temporal Clustering

arXiv:2606.13146v1 Announce Type: cross Abstract: We propose a robust feature-weighted jump model for time-dependent clustering. A penalty is used to encourage smoothness of transitions over time, while robustness is achieved through the use of a Tukey's biweight loss function. An additional parameter controls the variability of feature weights across states, allowing the model to assign state-specific relevance to each feature. We illustrate in simulation how the method accurately recovers the true cluster sequence and reliably identifies relevant features, outperforming competing approaches, particularly in the presence of outliers. We conclude with two empirical applications, one on the number of conflict-related homicides in Kosovo in the period 1998-2000, and another on macroeconomic performance of twelve European countries in the period 1949-2024.

13.
arXiv (CS.CV) 2026-06-11

How Auxiliary Reasoning Unleashes GUI Grounding in VLMs

Graphical user interface (GUI) grounding is a fundamental task for building GUI agents. However, general vision-language models (VLMs) struggle with this task due to a lack of specific optimization. We identify a key gap in this paper: while VLMs exhibit significant latent grounding potential, as demonstrated by their performance measured by Pointing Game, they underperform when tasked with outputting explicit coordinates. To address this discrepancy and bypass the high data and annotation costs of current fine-tuning approaches, we propose three zero-shot auxiliary reasoning methods. By providing explicit spatial cues such as axes, grids and labeled intersections as part of the input image, these methods enable VLMs to better articulate their implicit spatial understanding capabilities. We evaluate these methods on four GUI grounding benchmarks across seven open-source and proprietary VLMs. Experimental results show substantial gains from auxiliary reasoning. Mark-Grid Scaffold boosts Gemini-3.1-Pro from 11.72\% under direct inference to 95.20\% on ScreenSpot-v2, achieves state-of-the-art performance on ScreenSpot, and approaches the strongest fine-tuned methods on ScreenSpot-v2 and UI-I2E-Bench. Our code is available at https://github.com/liweim/AuxiliaryReasoning.

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

Notation Matters: A Benchmark Study of Token-Optimized Formats in Agentic AI Systems

Large language models in Agentic AI systems consume tool schemas and execution results and emit tool invocations as structured data. The default language for that exchange, JSON, was designed for application-to-application interchange rather than token efficiency, so its structural elements impose substantial token overhead. Recent work proposes token-optimized alternatives such as TOON (Token-Oriented Object Notation) and TRON (Token Reduced Object Notation) as more compact replacements, but these formats have been evaluated only on isolated comprehension or generation tasks. Whether their token reductions hold inside end-to-end agentic loops therefore remains an open question. We evaluate TOON and TRON on four agentic benchmarks (BFCL, MCPToolBenchPP, MCP-Universe, StableToolBench) and five open-weight LLMs, decoupling input compression from output compression to measure comprehension and generation independently. TRON reduces tokens by up to 27% with accuracy within 14pp of the JSON baseline. TOON achieves up to 18% reduction at a similar 9pp accuracy cost, but additionally cascades on multi-turn parsing failures and collapses parallel tool-call output for most models. The code is available at: https://github.com/lkutschka/notation-matters

15.
arXiv (CS.LG) 2026-06-19

Semantic-Anchored Evidential Fusion for Domain-Robust Whole-Slide Survival Analysis

arXiv:2606.19966v1 Announce Type: cross Abstract: Whole-slide images (WSIs) are widely used for computational cancer prognosis. However, most existing methods primarily focus on in-domain performance and fail to generalize across clinical centers. This limitation stems from their reliance on pixel-derived representations that are highly susceptible to domain-specific artifacts caused by staining protocols and scanner hardware. We hypothesize that high-level pathology semantics, such as tumor grade and micro-environmental architecture, provide a domain-invariant semantic representation that mirrors the robust diagnostic logic of human pathologists. Therefore, we propose a Semantic-Anchored Evidential Fusion Survival (SAEFS) framework, where SAEFS derives semantic anchors from WSIs via Visual Question Answering (VQA), employs a dual-stream WSI evidence extraction architecture, uses Dirichlet-based Subjective Logic to model uncertainty, and fuses semantic and visual evidence through a cautious conjunction rule to avoid overconfident fusion from correlated sources. Trained exclusively on one source domain and evaluated zero-shot across four unseen domains, SAEFS consistently outperforms state-of-the-art models both in prediction accuracy and reliability, improving the average C-index by 10.2%. Quantitative analyses further show that VQA-derived semantic features exhibit significantly lower cross-center divergence than pixel-derived features, highlighting their robustness for cross-center clinical applications.

16.
medRxiv (Medicine) 2026-06-22

Body composition subphenotypes, cardiometabolic risk and incident outcomes: validation in the population-based NAKO and UK Biobank imaging cohorts

Background Anthropometric measures do not adequately capture heterogeneity in body fat distribution and corresponding cardiometabolic risk, whereas magnetic resonance imaging (MRI) enables precise differentiation and quantification of adipose tissue compartments and ectopic fat. We aimed to validate previously derived MRI-based body composition subphenotypes and their cardiometabolic risk profiles in two independent European cohorts. Methods Using deep learning-based image analysis, we quantified bone marrow, visceral, subcutaneous, cardiac, renal sinus, hepatic, skeletal muscle, and pancreatic fat in the imaging substudies of two population-based cohorts: the German National Cohort (NAKO, N=29,314, age range 19-74 years) and the UK Biobank (N=36,109, age range 40-69 years). Body composition subphenotypes, previously identified by k-means clustering, were evaluated using a rigorous statistical cluster validation framework with method-based and results-based approaches. In NAKO, cross-sectional associations between subphenotypes and estimated cardiovascular disease risk scores were examined using linear regression. In UK Biobank, longitudinal associations between subphenotypes and incident cardiometabolic outcomes, ascertained through hospital record linkage, were analysed using Cox regression. Findings All five body composition subphenotypes were robustly validated across both cohorts, and showed distinct fat distribution patterns and cardiometabolic risk profiles: I "lean", II "average adiposity", III "bone and muscle adiposity", IV "hepato-abdominal adiposity", and V "general and pancreatic adiposity". Subphenotypes I-III showed progressive adipose tissue remodelling patterns likely reflecting ageing trajectories. The "hepato-abdominal adiposity" subphenotype showed highest risk of incident diabetes, whereas the "general and pancreatic adiposity" subphenotype showed highest overall cardiovascular disease burden and metabolic impairment. Interpretation MRI-derived body composition subphenotypes represent distinct fat distribution patterns that reflect ageing- and disease-related processes, which supports the potential of body composition phenotyping for improved cardiometabolic risk stratification and targeted prevention.

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

CEVAR: Centerline Embedding Extraction for Endovascular Aneurysm Repair

Long-term mortality rates after endovascular aneurysm repair (EVAR) remain elevated due to post-EVAR rupture caused by loss of seal in stent graft sealing zones. Structured CT review using centerline measurements improves detection, but current workflows require manual centerline editing and expert operators. We propose a transformer framework for automated, protocol-driven sealing zone assessment that combines 3D centerline tracking with embedding-based geometric prediction. Two state-of-the-art image-to-graph models are evaluated for aorto-iliac centerline extraction from follow-up CT and for measurement of stent position, vessel diameters, and seal lengths according to EVAR4C protocol. Across the full test set and a challenging no-contrast subset, the proposed fully automatic method outperforms the commercial semi-automatic workflow.

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

Atlas H&E-TME: Scalable AI-Based Tissue Profiling at Expert Pathologist-Level Accuracy

Hematoxylin and eosin (H&E) staining is the cornerstone of histopathology, yet scalable, quantitative analysis of H&E whole-slide images (WSIs) remains a central challenge in computational pathology. We present Atlas H&E-TME, an AI-based system built on the Atlas family of pathology foundation models that predicts tissue quality, tissue region, and cell type labels across multiple cancer types, yielding over 4,500 quantitative readouts per slide at cell-level resolution. A key challenge to validating such systems is overcoming morphological ambiguity inherent to H&E-only ground truth and the limited scalability of more informed references drawing on modalities such as immunohistochemistry (IHC). We address this with a dual validation framework combining biologically grounded depth with technical and morphological breadth. For depth, we propose an IHC-informed multi-pathologist consensus protocol that substantially improves inter-rater agreement over conventional H&E-only annotation. This yields a molecularly grounded reference against which we compare Atlas H&E-TME and pathologists working from H&E alone. For breadth, we benchmark Atlas H&E-TME on over 200,000 high-confidence H&E-only pathologist annotations across 1,500+ cases spanning eight cancer types and their most common metastatic sites, with subtypes covering >90% of clinical cases per cancer type, drawn from 25+ sources and 8+ scanner models. Benchmarked against the IHC-informed consensus, Atlas H&E-TME matches or exceeds pathologist H&E-only performance and generalizes consistently and robustly across this broad morphological and technical scope. In doing so, Atlas H&E-TME turns the H&E slide – the most ubiquitous data in pathology – into a scalable, quantitative window into the tumor and its microenvironment, laying a foundation for the next generation of tissue-based biomarkers in translational and clinical research.

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

LESS Is More: Mutual-Stability Sampling for Diffusion Language Models

Diffusion large language models (dLLMs) offer a promising alternative to autoregressive decoding by iteratively refining masked sequences, enabling parallel token updates and bidirectional conditioning. Their practical efficiency, however, is limited by sampling procedures that execute a fixed number of reverse denoising steps selected before decoding, spending computation on already-stable positions and sometimes committing unstable ones too early. We present \textsc{LESS}, a training-free, model-agnostic adaptive sampler that treats token commitment as an online stopping problem. \textsc{LESS} implements mutual-stability sampling through a joint stability rule that makes a masked position eligible for unmasking only when its top-1 prediction has high confidence, its top-1 token persists across recent reverse steps, and its predictive distribution is stable under top-$K$ inter-step Jensen–Shannon divergence. We evaluate \textsc{LESS} on Dream-7B, LLaDA-8B, and LLaDA-1.5-8B, covering full-sequence diffusion and semi-autoregressive blockwise sampling regimes, across seven benchmarks spanning general knowledge, math, and code. \textsc{LESS} improves average accuracy over strong training-free adaptive samplers while using $72.1\%$ fewer reverse steps than fixed-budget decoding. Since each reverse step requires a Transformer forward pass, these step-count reductions translate into fewer forward evaluations, lower measured wall-clock latency, and lower estimated inference compute.

20.
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.

22.
arXiv (CS.LG) 2026-06-12

Analog Quantum Asynchronous Event-Based Graph Neural Network

arXiv:2606.11000v1 Announce Type: cross Abstract: Asynchronous, event-based graph neural networks (AEGNNs) have recently emerged as an efficient paradigm for processing the sparse and high-temporal-resolution data from event cameras. In this paper, we propose quantum analog AEGNNs (QA-AEGNNs), a novel framework to implement an AEGNN on a neutral-atom quantum computer. Neutral-atom quantum processors offer a programmable analog quantum computing platform based on controllable Rydberg-atom interactions. To this end, we map the streaming event data to an array of trapped neutral atoms, where each atom represents a graph node (event) and is positioned such that geometric proximity reflects the spatio-temporal neighborhood of events. The native Rydberg Hamiltonian of the quantum processor is programmed to mirror the message-passing computations of the AEGNN, with atomic qubit states serving as node feature embeddings and inter-atom interactions realizing graph edges. Furthermore, we propose a hybrid quantum-classical training scheme in which the analog Hamiltonian parameters (e.g., laser pulse amplitudes and detunings) are optimized using classical feedback to learn the quantum AEGNN model from data. Our approach leverages the continuous Hamiltonian dynamics and massive parallelism of neutral-atom quantum systems to natively execute event-based graph computations with potential accuracy improvements

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

Gen-VCoT: Generative Visual Chain-of-Thought Reasoning via Diffusion-Based RGB Intermediate Representations

Multimodal large language models (MLLMs) excel at visual reasoning but rely on text-based chain-of-thought (CoT), lacking interpretable visual intermediates. Existing methods use opaque tokens or external tools, missing key properties. We propose Gen-VCoT, a framework using expert vision models to generate RGB images as reasoning intermediates. It has three stages: visual grounding (SAM segmentation), geometric reasoning (Marigold depth maps), and semantic reasoning (Qwen2-VL integration). An adaptive router selects reasoning depth. Evaluations show Gen-VCoT improves spatial (25% better) and depth (50% better) questions, but may hurt simple factual queries. Text CoT outperforms visual intermediates on CLEVR (91.2% vs 62.5%), showing task-dependent optimal representations. Gen-VCoT establishes a new paradigm for interpretable multimodal reasoning.

24.
arXiv (quant-ph) 2026-06-19

Applications of quantum annealing to magnetic dipole hyperfine structure constants: First results beyond energies for atoms

arXiv:2606.20166v1 Announce Type: new Abstract: We report the first results of the magnetic dipole hyperfine structure (HFS) constants of neutral $\mathrm{Li}$, Li-like $\mathrm{Be}$, neutral $\mathrm{Na}$, and Na-like $\mathrm{Mg}$ using a modified version of the Quantum Annealer Eigensolver (QAE) algorithm on D-Wave's quantum hardware. The results are benchmarked against relativistic configuration interaction with multiconfiguration Dirac Hartree-Fock (MCDHF) calculations using the General-purpose Relativistic Atomic Structure Package (GRASP), and simulated annealing. In our modified QAE, a zooming-and-sigma-annealing approach with a floating-point encoding scheme is adopted to estimate the ground-state eigenvalue and eigenvector of the relativistic Dirac-Coulomb Hamiltonian matrices ($H_{\mathrm{DC}}$) constructed from 11 or fewer configuration state functions (CSFs). For calculations with extended correlation orbital sets, we applied a CSF truncation scheme, retaining only CSFs (up to 12) that make significant contributions to the ground-state wavefunction. Our modified QAE precision is kept limited to three decimal places (up to 10 qubits). Hardware demonstrations on the D-Wave quantum processing unit (QPU) yielded results that were completely consistent with GRASP (at the chosen precision) in determining the magnetic dipole HFS constants, with accuracy varying across systems and $H_{\mathrm{DC}}$ matrix dimensions.

25.
arXiv (quant-ph) 2026-06-19

On the significance of Wigner's Friend in contexts beyond quantum foundations

arXiv:2402.08727v3 Announce Type: replace Abstract: There has been a surge of recent interest in the Wigner's Friend paradox, sparking several novel thought experiments and no-go theorems. The main narrative has been that Wigner's Friend highlights a counterintuitive feature that is unique to quantum theory, and which is closely related to the quantum measurement problem. Here, we challenge this view. We argue that the gist of the Wigner's Friend paradox can be reproduced without assuming quantum physics, and that it underlies a much broader class of enigmas in the foundations of physics and philosophy. To show this, we first consider several recently proposed Extended Wigner's Friend scenarios, and demonstrate that some of their implications for the absoluteness of observations can be reproduced by classical thought experiments that involve the duplication of agents. Crucially, some of these classical scenarios are technologically much easier to implement than their quantum counterparts. Then, we argue that the essential structural ingredient of all these scenarios is a feature that we call "Restriction A": that a physical theory cannot give us a probabilistic description of the observations of all agents. Finally, we argue that this difficulty is at the core of other puzzles in the foundations of physics and philosophy, and demonstrate this explicitly for cosmology's Boltzmann brain problem. Our analysis suggests that Wigner's Friend should be studied in a larger context, addressing a frontier of human knowledge beyond quantum foundations: to obtain reliable predictions for experiments in which these predictions can be privately but not intersubjectively verified.