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01.
arXiv (CS.AI) 2026-06-16

Localizing Credit at the Divergence: Path-Conditioned Self-Distillation for LLM Reasoning

arXiv:2606.15576v1 Announce Type: cross Abstract: Reinforcement learning from verifiable rewards assigns a single scalar to each rollout, leaving token-level credit assignment underspecified in long reasoning traces. On-policy self-distillation addresses this by letting the same model act as a teacher conditioned on privileged information, producing a dense per-token signal. But the common choice of a ground-truth answer is only an endpoint cue: on terse-answer tasks, the teacher falls silent at the intermediate positions where path-level guidance matters most. We propose Hindsight Self-Distillation (HSD), which conditions the teacher on a successful peer rollout drawn from the current training group. Such a peer is an exact sample from the success-conditioned policy, requiring no additional sampled rollouts. By providing a full successful continuation rather than only the final answer, the resulting credit signal concentrates at the divergence position between a failed rollout and a successful peer. Across Qwen3-8B and Qwen3-32B on math and code benchmarks, HSD obtains the best result against GRPO variants and on-policy distillation baselines, with the largest gains on terse-answer tasks such as AIME.

02.
arXiv (CS.AI) 2026-06-16

WorkflowPerturb: Calibrated Stress Tests for Evaluating Multi-Agent Workflow Metrics

arXiv:2602.17990v2 Announce Type: replace Abstract: Multi-agent LLM systems that generate structured workflows from natural-language requests are now deployed in production across cloud automation, DevOps, and enterprise process orchestration. Operating such systems exposes a recurring change-management problem. Routine updates, such as re-running the same input, swapping the underlying LLM, or refactoring an agent's prompt or orchestration code, frequently produce workflows that differ substantially from previously validated references. Engineers are then left without a principled way to decide whether a change is safe to ship. Automatic workflow evaluation is the natural tool for answering this question. In practice, however, metric scores are poorly calibrated, and a numeric change rarely communicates the severity of the underlying degradation. We introduce WorkflowPerturb, a controlled benchmark for studying workflow evaluation metrics by applying realistic, graded perturbations to golden workflows. WorkflowPerturb contains 4,973 golden workflows and 44,757 perturbed variants across three perturbation types (Missing Steps, Compressed Steps, and Description Changes), each applied at severity levels of 10%, 30%, and 50%. We benchmark multiple metric families and analyze their sensitivity and calibration using expected score trajectories and residuals. Our results characterize systematic differences across metric families and support severity-aware interpretation of workflow evaluation scores in change-management settings. Our dataset will be released upon acceptance.

03.
arXiv (CS.CV) 2026-06-25

Toward Low-Latency Vision-Language Models with Doubly-Correct Predictions in Egocentric Visual Understanding

The rapid rise of Vision-Language Models (VLMs) in egocentric visual understanding has made low-latency inference in human-robot collaborative (HRC) tasks increasingly critical. Weight pruning techniques developed for VLMs to shrink model size and computation can be readily applied to satisfy the efficiency demands of on-board processing and real-time interactive robotics. Moreover, safe human-robot interaction demands pruning strategies that preserve doubly-correct predictions; outputs must be both accurate and evidentially grounded to mitigate risks and ensure user trust. In this paper, we present a new study of VLM pruning through the lens of doubly-correct prediction. Our experiments surprisingly show that existing pruning methods often preserve the right evidence localization but undermine correct prediction. To address this, we propose a rationale-informed pruning strategy that better aligns evidence with decisions. Benchmark results on egocentric video datasets demonstrate that our method not only achieves the highest prediction accuracy but also outperforms existing approaches in attaining doubly-correct predictions. We aim to stimulate research on efficient and reliable VLMs, ensuring accuracy-driven advances align with the transparency, auditability, and safety required for responsible human-robot interaction and embodied intelligence.

04.
arXiv (CS.CV) 2026-06-16

LLM-Based Visual Explanation Evaluation Framework for Assessing the Explainability of Facial Skin Disease Classification Models

Authors:

This study proposes a domain-specific LLM-based Visual Explanation Evaluation Framework for assessing Grad-CAM explanations in facial skin disease diagnosis models. While previous studies have primarily focused on improving classification performance through data augmentation techniques, relatively few studies have systematically examined whether model explanations are grounded in clinically relevant lesion regions. In this study, geometric augmentation, color-based augmentation, and mixed augmentation strategies were applied to facial skin disease classification models based on EfficientNet-B0, MobileNetV3, and ResNet18. Grad-CAM was employed to generate visual explanations representing the models' decision-making processes. Furthermore, an LLM-as-a-Judge evaluation framework was designed using GPT-5.5, Gemini 3.5 Flash, and Claude Sonnet 4.6 to assess Grad-CAM explanations from the perspectives of lesion localization and explanation trustworthiness. To improve evaluation consistency and clinical grounding, a progressive prompt engineering strategy was introduced, incorporating evaluation rubrics, clinical knowledge, penalty rules, and structured output formats.

05.
arXiv (CS.AI) 2026-06-24

Tractable Reasoning and Conjunctive Query Answering for Defeasible DL-Lite under Rational Closure

arXiv:2606.24279v1 Announce Type: new Abstract: In Description Logics (DLs), reasoning under Rational Closure (RC) is a well-known and widely accepted non-monotonic formalism to handle defeasible knowledge. In this paper, we study the application of RC to the core and horn variants of the DL-Lite family of lightweight description logics. We analyze both entitlement (instance checking) and Conjunctive Query (CQ) answering under RC. Our main contribution is providing a plug-in architecture that builds upon existing standard classical reasoners, establishing that reasoning and CQ answering under RC for DL-Lite can be done efficiently with minimal computational overhead.

06.
medRxiv (Medicine) 2026-06-22

Level of Physical Activity and ApoE Status - Effects on Alzheimer's Disease and on Mortality

Background: Alzheimer's disease and related dementias (ADRD) affect over 7.2 million Americans aged 65 and older, with the APOE-4 allele representing the strongest known genetic risk factor. Physical activity (PA) has been associated with reduced dementia risk, but its interaction with APOE genotype remains poorly characterized in large, genomically informed cohorts. Methods: We conducted a retrospective cohort analysis using linked genomic, survey, and longitudinal electronic health record data from the VA Million Veteran Program (MVP). Veterans aged

07.
arXiv (CS.AI) 2026-06-24

Ensemble Distributionally Robust Bayesian Optimisation with Continuous Context

arXiv:2605.07565v2 Announce Type: replace-cross Abstract: We study Bayesian Optimisation (BO) in settings where the objective function is influenced by uncontrollable environmental contexts governed by an unknown probability distribution. In practice, the contextual distribution must be estimated from empirical data, a process that inherently introduces distributional mismatch, producing sub-optimal results. While Distributionally Robust Optimisation (DRO) provides a framework to mitigate these risks, existing robust BO methods frequently suffer from high computational complexity, rely on discretisation of continuous context spaces, or impose restrictive assumptions on the structure of the ambiguity set. To overcome these limitations, we propose Ensemble Distributionally Robust Bayesian Optimisation (EDRBO). Our framework leverages the expressive power of ensemble surrogate models to approximate the black-box function while simultaneously accounting for contextual uncertainty. By utilising Wasserstein ball as ambiguity sets, EDRBO provides a robustified acquisition function that remains computationally tractable and natively handles continuous context spaces. We establish a rigorous theoretical foundation for our approach by proving sublinear cumulative regret guarantees of order $\mathcal{O}(\gamma_T \sqrt{T})$, where $\gamma_T$ represents the maximum information gain within the ensemble. Finally, we provide extensive empirical evaluations that corroborate our theory and demonstrate the state-of-the-art performance of EDRBO.

08.
arXiv (quant-ph) 2026-06-24

Mode-selective nonlinear interference for high-brightness and high-purity fiber-coupled SPDC sources

arXiv:2606.23836v1 Announce Type: new Abstract: Single-mode-fiber-coupled spontaneous parametric down-conversion (SPDC) sources are a key resource for photonic quantum technologies, but in single-crystal geometries brightness, heralding efficiency, and spectral purity remain constrained by intrinsic trade-offs. Here, we show how nonlinear interference in a cascaded two-crystal type-II SPDC source can be used to engineer the modal structure of SPDC emission, improving the brightness–heralding-efficiency trade-off by more than one order of magnitude beyond the single-crystal limit. We further demonstrate two routes to near-unity spectral purity while retaining high brightness and/or heralding efficiency, even with standard periodically poled crystals, and study the additional advantages of aperiodic poling with Gaussian phase matching. Using a spectrally resolved Laguerre–Gauss modal decomposition, we show that these improvements arise from mode-selective interference of spatial-spectral SPDC modes within the nonlinear interferometer. We experimentally validate the model through sum-frequency-generation measurements of the spatial-spectral state.

09.
arXiv (CS.AI) 2026-06-15

Selective Agentic Recovery for UAV Autonomy with a Persistent Mission Runtime

arXiv:2606.14219v1 Announce Type: cross Abstract: Agentic AI can support unmanned aerial vehicle (UAV) autonomy by providing high-level recovery reasoning when local waypoint- or setpoint-based execution encounters blocked passages, repeated no-progress behavior, or mission-level ambiguity. On physical UAVs, however, remote reasoning is most useful when it is invoked selectively, since each call introduces latency, resource cost, backend uncertainty, and a need to validate the returned decision. This paper presents Persistent Mission Runtime (PMR), a UAV recovery framework that keeps the mission loop and safety-critical execution local while using an external agentic reasoner only as an on-demand recovery module. The reasoner selects from predefined recovery skills, and each returned decision is parsed, verified, safety-filtered, and mapped to local executor actions before it can affect flight. PMR introduces learned Cognitive Value of Invocation (learned-CVI), a compact admission gate that estimates when remote agentic reasoning is likely to improve near-term mission progress enough to justify its operational cost. Across a fixed 400-run Gazebo/PX4 benchmark with eight scenarios, learned-CVI raises hard/ambiguous-regime success from 5.0% under local-only autonomy to 95.0%, outperforms one-shot and periodic reasoning baselines by 20.0 and 32.5 percentage points, and reduces remote-agent calls by 16.7% and logged tokens by 29.2% relative to a manually tuned rule-based invocation baseline.

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

Mitigating Simplicity Bias in OOD Detection through Object Co-occurrence Analysis

arXiv:2605.07821v2 Announce Type: replace-cross Abstract: Out-of-distribution (OOD) detection is crucial for ensuring the reliability of deep learning models. Existing methods mostly focus on regular entangled representations to discriminate in-distribution (ID) and OOD data, neglecting the rich contextual information within images. This issue is particularly challenging for detecting near-OOD, as models with simplicity bias struggle to learn discriminative features in disentangled representations. The human visual system can use the co-occurrence of objects in the natural environment to facilitate scene understanding. Inspired by this, we propose an Object-Centric OOD detection framework that learns to capture Object CO-occurrence (OCO) patterns within images. The proposed method introduces a new OOD detection paradigm that understands object co-occurrence within an image by predicting disentangled representations for the test sample, then adaptively divides patterns into three scenarios based on object co-occurrence patterns observed in ID training data, and finally performs OOD detection in a divide-and-conquer manner. By doing so, OCO can distinguish near-OOD by considering the semantic contextual relationships present in their images, avoiding the tendency to focus solely on simple, easily learnable regions. We evaluate OCO through experiments across challenging and full-spectrum OOD settings, demonstrating competitive results and confirming its ability to address both semantic and covariate shifts. Code is released at https://github.com/Michael-McQueen/OCO.

11.
arXiv (CS.LG) 2026-06-24

Generating adversarial inputs for a graph neural network model of AC power flow

Authors:

arXiv:2602.17975v2 Announce Type: replace Abstract: This work formulates and solves optimization problems to generate input points that yield high errors between a neural network's predicted AC power flow solution and solutions to the AC power flow equations. We demonstrate this capability on an instance of the CANOS-PF graph neural network model, as implemented by the PF$\Delta$ benchmark library, operating on a 14-bus test grid. Generated adversarial points yield errors as large as 3.7 per-unit in reactive power and 0.08 per-unit in voltage magnitude. When minimizing the perturbation from a training point necessary to satisfy adversarial constraints, we find that the constraints can be met with as little as an 0.04 per-unit perturbation in voltage magnitude on a single bus. This work motivates the development of rigorous verification and robust training methods for neural network surrogate models of AC power flow.

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

Reinforcement Learning for Accelerated Aerodynamic Shape Optimisation

arXiv:2507.17786v2 Announce Type: replace Abstract: We introduce a reinforcement learning (RL) based adaptive optimization algorithm for aerodynamic shape optimization focused on dimensionality reduction. The form in which RL is applied here is that of a surrogate-based, actor-critic policy evaluation MCMC approach allowing for temporal 'freezing' of some of the parameters to be optimized. The goals are to minimize computational effort, and to use the observed optimization results for interpretation of the discovered extrema in terms of their role in achieving the desired flow-field. By a sequence of local optimized parameter changes around intermediate CFD simulations acting as ground truth, it is possible to speed up the global optimization if (a) the local neighbourhoods of the parameters in which the changed parameters must reside are sufficiently large to compete with the grid-sized steps and its large number of simulations, and (b) the estimates of the rewards and costs on these neighbourhoods necessary for a good step-wise parameter adaption are sufficiently accurate. We give an example of a simple fluid-dynamical problem on which the method allows interpretation in the sense of a feature importance scoring.

14.
arXiv (CS.AI) 2026-06-24

CrossPool: Efficient Multi-LLM Serving for Cold MoE Models through KV-Cache and Weight Disaggregation

arXiv:2606.24506v1 Announce Type: cross Abstract: Emerging LLM services increasingly host many sparse MoE models, yet most models receive sparse requests and remain cold. This creates a GPU memory problem: model weights are stable and model-determined, while KV-cache is transient and demand-determined. Because cold models rarely reach peak KV-cache demand at the same time, reserving worst-case KV capacity per model wastes memory; a shared KV-cache pool can instead provision aggregate active demand. However, KV-cache sharing is not sufficient when weights and KV-cache remain in a monolithic GPU memory pool. Static weights compete with dynamic KV-cache, and KV-head-limited attention under cold, low-concurrency traffic exposes only a fraction of replicated KV capacity, leading to low GPU memory utilization and weak long-context support. We present CrossPool, a serving engine for cold MoE models that separates FFN weights and KV-cache into two GPU memory pools: a weights pool that consolidates FFN weights across cold models, and a KV-cache pool that dynamically serves active requests while keeping attention local to KV-cache. CrossPool combines a KV-cache planner and virtualizer, a layer-wise pipeline scheduler that hides hidden-state transfers, and persistent kernels with control lowering to reduce CPU-GPU control overhead. With efficient GPU memory pooling, CrossPool underpins bursty long-context requests and outperforms the state-of-the-art kvcached-based multi-LLM serving system, reducing P99 TBT by up to $10.4\times$.

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

SPADE: Split-and-Delay Embeddings for Autoregressive High-Granularity Calorimeter Simulation

arXiv:2606.11304v1 Announce Type: cross Abstract: We introduce SPADE (SPlit And Delay Embeddings), an autoregressive transformer for sequences whose tokens carry multiple features. Rather than embedding these features jointly, SPADE embeds them independently. Delaying each feature stream relative to the previous one allows intra-token correlations to be learned by the standard self-attention mechanism. Applied to point-cloud calorimeter shower generation in the highly granular ILD detector, SPADE is competitive with the state of the art AllShowers model on photon showers, and substantially outperforms its VQ-VAE-based predecessor OmniJet-$\alpha_C$. The mechanism is applicable to any generative task with multi-feature tokens, enabling LLM-style pretraining workflows for higher-dimensional data.

16.
arXiv (quant-ph) 2026-06-25

Quantum Detectability in Invisibility Cloaks

arXiv:2606.25666v1 Announce Type: new Abstract: Classical invisibility cloaks are designed to suppress selected scattering signatures and thereby make an object appear absent to external electromagnetic probes. However, the suppression of a classical scattering observable does not, by itself, establish that all information about the concealed object has been removed from the detected quantum state of light. Here we formulate the detectability of classically cloaked objects as a quantum-state distinguishability problem. Treating a linear passive cloak as an effective Gaussian quantum channel acting on the accessible detected modes, we show that local quantum undetectability requires the detected first and second moments to be independent of the hidden-object parameter. In this framework, quantum Fisher information provides an operational criterion for whether the concealed parameter remains estimable from the detected output state. We derive displacement- and covariance-level detectability conditions and show that a nonzero parameter imprint surviving in the detected Gaussian state leads to a nonzero accessible quantum Fisher information. To connect the criterion with a physical cloaking model, we analyze a regularized cylindrical transformation-optical cloak in the Born limit and compare the scaling of the classical scattering response with the derivative-based quantum sensitivity. The analysis shows that reducing a scattering amplitude is not equivalent to eliminating local quantum-state sensitivity. Loss, environmental noise, and finite numerical aperture degrade the accessible information, but quantum undetectability is reached only when the parameter imprint is removed from the detected state or projected entirely outside the accessible subspace. These results provide a Gaussian-channel framework for assessing when classical cloaking does, and does not, imply quantum-state undetectability.

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

MVEB: Massive Video Embedding Benchmark

We introduce the Massive Video Embedding Benchmark (MVEB), a 23-task benchmark for video embeddings spanning classification, zero-shot classification, clustering, pair classification, retrieval, and video-centric question answering. We evaluate 33 models and find that no single model dominates: MLLM-based embeddings lead on classification, clustering, pair classification, and QA; multimodal binding leads on retrieval and zero-shot classification; generative MLLMs without contrastive adaptation collapse on cross-modal tasks. Paired video-only vs. audio+video evaluations show that audio's contribution depends on dataset annotation provenance: audio helps when labels were produced from both modalities and hurts when they were produced from visuals alone, a six-point gap consistent across model families. MVEB is derived from MVEB+, a 184-task pool, and is designed to maintain task diversity while reducing evaluation cost. It integrates into the MTEB ecosystem for unified evaluation across text, image, audio, and video. We release MVEB and all 184 tasks along with code and a leaderboard at https://github.com/embeddings-benchmark/mteb.

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

An AI Security Agent for Banking: Multi-Vector Fraud and AML Detection Across Retail and Corporate Accounts

arXiv:2606.17555v1 Announce Type: cross Abstract: Banks simultaneously face signature-based fraud (card-not-present attacks, account takeover, ATM cloning) and behavioural financial crime (structuring, layering, mule networks, business email compromise) – two threat families with fundamentally different detection requirements. Static rule engines that reliably catch brute-force and high-velocity events are structurally blind to business-email-compromise (BEC) payment redirection, session hijacking, and money-laundering layering, which are engineered to appear indistinguishable from legitimate activity at the individual transaction or session level. This paper presents an AI security agent for retail and corporate banking that addresses this gap through a three-component fusion architecture operating on two parallel event streams: a transaction stream (card fraud, ACH/wire fraud, AML categories) and a session stream (account takeover, session hijacking, SIM-swap, insider abuse). Each stream combines an LSTM sequence model capturing per-account behavioural history, a statistical velocity/threshold monitor, and a graph/network module capturing account-counterparty relationship patterns (fan-in, fan-out, pass-through ratio) for money-laundering detection. Experiments on a synthetic event log of 237,669 transactions and 113,508 sessions across 13 threat categories and 3,470 simulated accounts demonstrate overall F1 of 0.787 (transaction stream) and 0.867 (session stream) for the proposed model, versus 0.562/0.733 for a rule-based baseline and 0.655/0.713 for an LSTM-only baseline. The agent includes a customer-facing transaction-verification chatbot (96.6% identity verification accuracy, 86.8% mass-reset attack detection) and an analyst case-summary assistant (99.3% action-recommendation F1), with Critical-tier automated response latency under 0.43 ms at the 95th percentile.

20.
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.

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

ERTS: Adversarial Robustness Testing of Ethical AI via Semantic Perturbation in a Bounded Consequence Space

arXiv:2606.13282v1 Announce Type: new Abstract: As AI systems are deployed in high-stakes ethical contexts such as healthcare triage, autonomous vehicle control, and employment screening, formal methods for evaluating their robustness against adversarial manipulation of ethical reasoning remain underdeveloped. This paper introduces the Ethical Robustness Testing System (ERTS), a closed-pipeline framework that: (1) encodes ethical dilemmas into a 22-dimensional Ethical Consequence Space (ECS) grounded in established ethical theory; (2) applies 17 semantic perturbation functions subject to 6 validity constraint classes including a novel semantic coherence constraint; (3) measures decision deviation via a 4-component Ethical Instability Index (EII); and (4) produces domain-adaptive pre-deployment robustness assessment verdicts. We evaluate 4 structured baseline models and 2 production LLMs (Gemini 2.0 Flash and Llama 3.2) across 50 ethical scenarios spanning 8 deployment domains, generating 1,500 adversarial test cases. Results demonstrate that only 33% of models achieve assessment clearance, with the local Llama-3.2 model proving particularly vulnerable to fairness corruption and information degradation attacks (ERS = 0.737). To the best of our knowledge, no existing framework combines a bounded ethical consequence space, semantic coherence constraints, and domain-adaptive assessment in a single adversarial testing pipeline.

22.
arXiv (CS.LG) 2026-06-16

OptEMA: Adaptive Exponential Moving Average for Stochastic Optimization with Zero-Noise Optimality

Authors:

arXiv:2603.09923v4 Announce Type: replace Abstract: Exponential moving averages (EMAs) are a central component of widely used adaptive optimizers such as Adam. However, existing analyses of Adam-style methods often yield suboptimal guarantees in the zero-noise regime, rely on open-loop parameter schedules, or require prior knowledge of smoothness constants. Motivated by these limitations, we introduce OptEMA and analyze two complementary variants: OptEMA-M, which applies an adaptive, decreasing EMA coefficient to the first moment with a fixed second-moment decay, and OptEMA-V, which swaps these roles. At the heart of these variants is a Corrected AdaGrad-Norm coefficient schedule. This formulation renders OptEMA algorithmically closed-loop and Lipschitz-free, meaning its effective stepsizes are trajectory-dependent and require no parameterization via the Lipschitz constant. Under lower-boundedness, unbiasedness, bounded variance, average smoothness, and a bounded stochastic-gradient condition used to control the adaptive normalizers, we prove that both variants achieve the unified noise-adaptive rate $\tilde{\mathcal{O}} \left(T^{-1/2}+\sigma^{1/2}T^{-1/4}\right)$ for the averaged gradient norm. In the zero-noise regime, these bounds automatically reduce to the nearly optimal deterministic rate $\widetilde{\mathcal{O}}(T^{-1/2})$ without manual hyperparameter retuning.

23.
medRxiv (Medicine) 2026-06-12

Heterogeneity of Treatment Effect of Aspirin and Clinically Significant Bleeding in Older Adults

Aim: The global population of older adults is growing, and older age is linked to higher bleeding risk. Although guidelines discourage aspirin for primary prevention in healthy older adults due to bleeding harms outweighing benefits, many continue taking it without a clear indication. It remains unclear whether all older adults face uniform aspirin-related bleeding risk or if certain subgroups are more vulnerable. Methods: We analyzed data from 19,114 ASPREE trial participants to develop machine learning models using 116 baseline variables. Random forest (RF) and random survival forest (RSF) models predicted 5-year bleeding risk, and participants were stratified into low, intermediate, and high-risk groups based on the 20th and 80th percentiles of predicted risk. We assessed heterogeneity of treatment effect (HTE) by testing treatment-by-risk group interactions on the relative scale using Fine-Gray models, and on the absolute scale using observed 5-year cumulative incidence rates. Results: Over a median follow-up of 4.7 years, 626 major bleeding events occurred. The RF model had moderate discrimination (AUC = 0.65, 95% CI: 0.63-0.67) and good calibration (Brier = 0.032, 95% CI: 0.029-0.034). Statistically significant HTE was observed on the relative scale, with the greatest relative increase in bleeding risk seen in the low-risk group (subdistribution hazard ratio = 2.26, 95% CI: 1.27-4.01). On the absolute scale, low-risk participants experienced higher bleeding with aspirin (absolute risk difference (ARD) = 1.17%, 95% CI: 0.37-1.95), but heterogeneity in ARDs was not statistically significant (Cochran's Q p > 0.45). Similar findings were observed when using the RSF model. Conclusion: Participants at lowest baseline bleeding risk experienced the greatest relative increase in bleeding risk with aspirin therapy. We found statistically significant heterogeneity in treatment effects on the relative but not absolute scale. These findings support an individualized, risk-based approach to aspirin therapy decision-making in older adults.

24.
medRxiv (Medicine) 2026-06-18

Hard to Halt: Automation Bias in Agent-Driven Sequencing Prior Authorization Workflows

Purpose: Prior authorization (PA) for exome or genome sequencing is a time-consuming process that impedes timely rare disease diagnosis. Large language model-based browser agents offer potential for automating these workflows, but their clinical reliability remain uncharacterized. Methods: We developed a sandbox compromising a simulated ES/GS PA submission payer portal and a synthetic EHR containing 836 patient records spanning compliant profiles and deficient profiles with different types of issues. Gemini 3 Pro, Gemini 3 Flash, and Claude Opus 4.5 were evaluated on task completion rate, form completion accuracy, and appropriate withholding for deficient profiles. Results: Larger models achieved much higher task completion rates (Gemini 3 Pro 95.45%, Claude Opus 4.5 93.67%) compared to Gemini 3 Flash (56.05%), but nearly universally failed to withhold submission for deficient profiles whereas Gemini 3 Flash ironically demonstrated superior withholding performance (17.33%). In a non-agentic setting, Gemini 3 Pro correctly identified 91% of the issues in deficient profiles, indicating that withholding failure is attributable to the browser interaction rather than the model's reasoning limitations. Conclusion: Current LLM-based browser agents exhibit a systematic bias towards form submission that poses risks in PA workflows. A modular, multi-agent architecture with human supervision is necessary for a safe clinical deployment.

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

MIMFlow: Integrating Masked Image Modeling with Normalizing Flows for End-to-End Image Generation

Normalizing Flows (NFs) are powerful generative models capable of exact density estimation and sampling. However, their strict invertibility often forces the model to exhaust its capacity on low-level pixel details, hindering the capture of high-level semantic structures. While Masked Image Modeling (MIM) has excelled in representation learning, its integration into generative pipelines has remained largely modular and disjointed. In this paper, we propose MIMFlow, a unified end-to-end framework that jointly optimizes latent semantics, pixel reconstruction, and generative flow. By employing a VAE encoder to infer semantic latent from masked images, MIMFlow achieves a principled decoupling of the generative task: the Normalizing Flow focuses on modeling a simplified, low-frequency semantic manifold, while a specialized decoder handles high-frequency synthesis. This design effectively resolves the inherent capacity bottleneck of NFs, allowing the model to prioritize global structural coherence over redundant noise. Empirical results on ImageNet 256$\times$256 show that MIMFlow-L reaches 71.3\% linear probing accuracy and an FID of 2.50. Despite using only 128 tokens (50\% fewer than standard models), it yields a 32.8\% performance gain over similar-scale NF baselines. Our code is available at https://github.com/MCG-NJU/MIMFlow.