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01.
medRxiv (Medicine) 2026-06-22

Pump-Free Patient-Derived Human Proximal Tubule Microphysiological System for Modeling Flow-Dependent Epithelial Maturation and Cisplatin Injury

Recent initiatives by the U.S. Food and Drug Administration and the National Institutes of Health to reduce animal testing in drug development have highlighted the need for in vitro platforms that better recapitulate human biology for preclinical safety assessment. Drug-induced nephrotoxicity remains a major cause of drug attrition, underscoring the need for human-relevant kidney models. To address this, a pump-free human patient-derived proximal tubule microphysiological system was developed by integrating human renal proximal tubular epithelial cells (hRPTECs), isolated from non-tumorous nephrectomy cortex, with a porous membrane-based microfluidic device. Expanded hRPTECs were cultured for 10 days under static conditions or rocker-driven shear stress approximating physiological proximal tubular flow. Shear stress increased epithelial density, enhanced proximal tubule marker expression (Na+/K+-ATPase and aquaporin-1), and improved Zonula occludens-1 and occludin localization. Bulk RNA sequencing demonstrated transcriptomic changes associated with enhanced apical maturation and epithelial signature. In cisplatin-induced injury assays, shear-conditioned epithelia exhibited reduced cell density and increased {gamma}H2AX staining, indicating greater sensitivity to nephrotoxicity. These findings demonstrate that rocker-driven shear stress promotes epithelial maturation in patient-derived hRPTECs. The pump-free human patient-derived proximal tubule microphysiological system offers a practical, scalable, and physiologically relevant platform for modeling flow-dependent proximal tubule biology and assessing human-relevant nephrotoxicity.

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

Taming Curvature: Architecture Warm-Up for Stable Transformer Training

arXiv:2606.16768v1 Announce Type: new Abstract: Training billion-parameter Transformers is often brittle, with transient loss spikes and divergence that waste compute. Even though the recently developed Edge of Stability (EoS) theory provides a powerful tool to understand and control the stability of optimization methods via the (preconditioned) curvature, these curvature-controlling methods are not popular in large-scale Transformer training due to the complexity of curvature estimation. To this end, we first introduce a fast online estimator of the largest (preconditioned) Hessian eigenvalue (i.e., curvature) based on a warm-started variant for power iteration with Hessian-vector products. We show theoretically, and verify empirically, that the proposed method makes per-iteration curvature tracking feasible at billion parameter scale while being more accurate. Using this tool, we find that training instabilities coincide with surges in preconditioned curvature and that curvature grows with depth. Motivated by these observations, we propose architecture warm-up: progressively growing network depth to carefully control the preconditioned Hessian and stabilize training. Experiments on large Transformers validate that our approach enables efficient curvature tracking and reduces instabilities compared to existing state-of-the-art stabilization techniques without slowing down convergence.

03.
arXiv (CS.CL) 2026-06-16

AdaMame: A Training Recipe for Adaptive Multilingual Reasoning

While Large Reasoning Models (LRMs) show strong performance in English, they often fail to reason in the language of the query, a phenomenon known as language collapse. Existing RL-based fixes typically add a binary language fidelity reward to the accuracy objective, yet still incur trade-off in accuracy, mid-trace code-switching, and excessive token usage. In this work, we propose AdaMame, a two-stage training recipe for multilingual mathematical reasoning that addresses these limitations by adaptively aligning the reasoning language to the query language without compromising accuracy. The first SFT stage fine-tunes on naturally occurring reasoning traces across five languages to establish multilingual reasoning capability. In the subsequent RL stage, we introduce AdaMame-GRPO, an adaptation of Group Relative Policy Optimization (GRPO) in which a query-conditioned alignment factor grows progressively during training, guiding the model to first explore diverse reasoning languages before exploiting reasoning in the query language. Evaluated across two benchmarks, two LRMs, and 12 languages, AdaMame-GRPO achieves Pareto-optimal performance across reasoning accuracy, language fidelity, and token efficiency over all baselines, with the strongest gains on out-of-domain, lower-resource languages.

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

Efficient Reinforcement Learning by Guiding World Models with Non-Curated Data

arXiv:2502.19544v3 Announce Type: replace Abstract: Leveraging offline data is a promising way to improve the sample efficiency of online reinforcement learning (RL). This paper expands the pool of usable data for offline-to-online RL by leveraging abundant non-curated data that is reward-free, of mixed quality, and collected across multiple embodiments. Although learning a world model appears promising for utilizing such data, we find that naive fine-tuning fails to accelerate RL training on many tasks. Through careful investigation, we attribute this failure to the distributional shift between offline and online data during fine-tuning. To address this issue and effectively use the offline data, we propose two techniques: i) experience rehearsal and ii) execution guidance. With these modifications, the non-curated offline data substantially improves RL's sample efficiency. Under limited sample budgets, our method achieves nearly twice the aggregate score of learning-from-scratch baselines across 72 visuomotor tasks spanning 6 embodiments. On challenging tasks such as locomotion and robotic manipulation, it outperforms prior methods that utilize offline data by a decent margin.

05.
medRxiv (Medicine) 2026-06-15

An epidemiological scenario for Mass Events During the World Cup

This brief work discusses potential superspreading events that may occur during the World Cup in Mexico. The study is particularly focused on the city of Guadalajara due to a large recent outbreak in January and February and insufficient vaccine coverage prior to 2026. Keywords: Superspreading; measles outbreak; branching process; individual reproduction number; World Cup

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

GraphInfer-Bench: Benchmarking LLM's Inference Capability on Graphs

Graph analysis underlies many applications whose answers cannot be looked up in a single record or retrieved along a path: laundering rings, drug repurposing, user preference, and scientific theme are all inferred from a node together with its neighbourhood. We introduce GraphInfer-Bench, a benchmark for whether LLMs can perform this graph inference: producing an open-ended answer that no single node supports and no path retrieves. Existing graph-QA protocols cannot test this capability: algorithm simulation, node classification, single-node description, KG-QA, and GraphRAG all admit answers retrievable from one node or along a path. GraphInfer-Bench defines five tasks along Description (what a region is) and Comparison (how regions differ), each constructed so the ground truth lives in no single node. The release contains 42,000 samples across six real-world graphs, produced automatically and screened by a four-layer quality-control protocol. We evaluate four method families against the same tasks: graph-token alignment models, zero-shot frontier closed-source LLMs, Graph2Text supervised fine-tuning, and plain GNNs as a structural reference. No method family closes the gap. Graph-token alignment partially handles description tasks (relational, theme) but collapses on comparison tasks. Frontier LLMs lead on outlier detection and community partition among LLM-based methods but lag on masked-node prediction. Graph2Text SFT is the strongest LLM-based method on the description side yet falls behind frontier LLMs on comparison. Across every task, plain GNNs match or beat the strongest LLM-based row, with the largest margin on community detection. GraphInfer-Bench surfaces graph inference as an open capability gap rather than a property of any one architecture.

07.
arXiv (CS.CL) 2026-06-17

Zone of Proximal Policy Optimization: Teacher in Prompts, Not Gradients

Knowledge distillation transfers a teacher's competence to a small student but is brittle in the small-student regime: forcing the student to imitate logits from a much larger teacher concentrates it on the teacher's sharpest modes, hurting generalization on benchmark families beyond the training corpus. Reinforcement learning (RL) avoids logit imitation by training on the student's own rollouts. However, on questions where every rollout fails-yielding zero advantage and being silently discarded-injecting a stronger teacher's response into the policy gradient breaks the on-policy assumption and induces drift. We introduce Zone of Proximal Policy Optimization (ZPPO), inspired by Vygotsky's zone of proximal development, which keeps the teacher inside the prompt rather than the policy gradient. On hard questions, ZPPO constructs two reformulated prompts: a Binary Candidate-included Question (BCQ) pairs one correct teacher response with one incorrect student response as anonymized candidates the student must discriminate, and a Negative Candidate-included Question (NCQ) aggregates the student's wrong rollouts into a single prompt to surface their shared failure modes. A prompt replay buffer recirculates each hard question until it either graduates-the student's mean rollout accuracy on it reaches half- or is FIFO-evicted under finite capacity, amplifying BCQ and NCQ inside the student's current zone of proximal development. On the Qwen3.5 family at four student scales (0.8B-9B) with a 27B teacher, post-trained as vision-language models and evaluated on a 31-benchmark suite (16 VLM, 10 LLM, 5 Video), ZPPO outperforms off/on-policy distillation and GRPO, with the largest gains at the smallest scale.

08.
arXiv (CS.CV) 2026-06-15

Representation Forcing for Bottleneck-Free Unified Multimodal Models

Unified multimodal models (UMMs) aim to handle perception and generation in a single model. Yet existing UMMs still rely on a frozen, separately pretrained VAE for image generation, imposing a structural bottleneck. Naively removing it introduces a quality gap, as the model must learn both high-level structure and low-level details from raw pixels. In this paper, we propose Representation Forcing (RF), a technique that closes this gap by making representation prediction a native capability of the model. Concretely, RF forces the decoder to autoregressively predict visual representations as intermediate tokens before pixels; these tokens then stay in context to guide pixel diffusion within the same backbone. By turning representations from perception outputs into generation targets, RF eliminates the need for any external generative latent space. We find that RF benefits both understanding and generation. On image generation, our pixel-space model with RF matches state-of-the-art VAE-based unified models. On image understanding, pixel-space RF generally outperforms its VAE-based variant. Together, these results offer an effective step toward end-to-end, bottleneck-free UMMs.

09.
medRxiv (Medicine) 2026-06-16

Re-evaluating the Cross-Sectional Prevalence of Severe Age-Related Hearing Loss Using Extreme Value Statistics

Authors:

Standard demographic models of age-related hearing loss (presbycusis) predominantly utilize symmetric functions, such as log-normal distributions for age-binned thresholds and 4-parameter logistic curves for prevalence estimates. While these models capture early-to-moderate degradation effectively, they structurally struggle to characterize the heavy tails associated with severe clinical impairment. In this study, we present a statistical critique using a secondary analysis of the historical Medical Research Council (MRC) National Study of Hearing (1980-1986) dataset. By applying Generalized Extreme Value (GEV) distribution theory, we demonstrate that as severity increases, the underlying statistical geometry of hearing loss shifts. The asymmetric, heavy-tailed GEV distribution provides a parsimonious description of severe impairment, requiring fewer parameters than standard symmetric models. However, we explicitly acknowledge that utilizing static population data to infer progression introduces an ecological fallacy. Furthermore, the dataset's historical nature embeds unquantified generational cohort effects. We conclude that while extreme value statistics offer a compelling mathematical framework for modeling the variance of severe presbycusis, true longitudinal datasets are required to isolate physiological degradation from historical cohort variance.

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

Too long; didn't solve

arXiv:2604.07593v2 Announce Type: replace Abstract: Mathematical benchmarks consisting of a range of mathematics problems are widely used to evaluate the reasoning abilities of large language models, yet little is known about how their structural properties influence model behaviour. In this work, we investigate two structural length variables, prompt length and solution length, and analyse how they relate to model performance on a newly constructed adversarial dataset of expert-authored mathematics problems. We find that both prompt and solution lengths correlate positively with increased model failure across models. We also include a secondary, exploratory analysis of cross-model disagreement. Under a difficulty-adjusted normalised analysis, both variables retain weak negative associations with realised model separation, slightly stronger for prompt length. Overall, our main robust finding is that structural length is linked to empirical difficulty in this dataset.

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

pFedUL: Layer-Aware Federated Unlearning for Personalized Federated Learning

arXiv:2606.16304v1 Announce Type: new Abstract: Federated unlearning (FU) enables the removal of specific data contributions from federated learning (FL) models to comply with regulations such as the General Data Protection Regulation (GDPR). However, most existing FU methods are designed for the FedAvg paradigm, where all clients share a single global model. In practice, personalized federated learning (pFL) methods such as FedPer, FedRep, Ditto, and FedBN have become widely adopted due to their superior handling of non-IID data. These methods decompose the model into shared global layers and client-specific personalized layers, fundamentally altering the semantics of unlearning, yet this setting has received little attention. We formalize FU under the pFL paradigm, identifying a tension between unlearning completeness on shared layers and personalization preservation for remaining clients. We then propose pFedUL, a layer-aware selective unlearning framework comprising three components: (1) gradient-based layer-wise contribution attribution that separately quantifies the target client's influence on shared and personalized parameters, (2) adaptive selective unlearning that applies differentiated forgetting strategies across layer types, and (3) a lightweight recalibration protocol enabling remaining clients to restore personalization with minimal overhead. We further introduce two new metrics, Personalization Preservation Score (PPS) and Cross-client Fairness Index (CFI), to evaluate pFL-specific unlearning quality. Experiments on CIFAR-10, CIFAR-100, and FEMNIST under varying non-IID settings indicate that pFedUL achieves unlearning effectiveness comparable to full retraining while maintaining an average of 97.3\% personalized accuracy for remaining clients. Compared with six state-of-the-art FU methods adapted to the pFL setting, pFedUL consistently achieves superior personalization preservation.

12.
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.

13.
arXiv (CS.LG) 2026-06-15

Stability of a Generalized Debiased Lasso with Applications to Resampling-Based Variable Selection

Authors:

arXiv:2405.03063v3 Announce Type: replace-cross Abstract: We propose a generalized debiased Lasso estimator based on a stability principle. When a single column of the design matrix is perturbed, the estimator admits a simple update formula that can be computed from the original solution. Under sub-Gaussian designs with well-conditioned covariance, this approximation is asymptotically accurate for all but a vanishing fraction of coordinates in the proportional growth regime. The proof relies on concentration and anti-concentration arguments to control error terms and sign changes. In contrast, establishing comparable distributional limits (e.g., Gaussianity) under similar assumptions remains open. As an application, we show that the approximation significantly reduces the computational cost of resampling-based variable selection procedures, including the conditional randomization test and a local knockoff filter.

14.
arXiv (CS.AI) 2026-06-17

IUU+DB: Tracking Illegal, Unreported, and Unregulated Fishing, Seafood Fraud, and Labor Abuse through LLM-driven Information Extraction

arXiv:2606.18181v1 Announce Type: cross Abstract: Illegal, unreported, and unregulated fishing (IUU) traditionally refers to fishing activities that violate applicable laws or occur in areas that lack applicable laws. We propose the term IUU+ to capture a broader suite of fisheries sector environmental and associated supply chain trade-related crimes and behaviors. Although IUU+ activity is widely recognized as a serious threat to marine ecosystems, markets, and livelihoods, a quantitative understanding of these incidents, e.g., their frequency, geography, species, actors, and patterns in the type of illicit activity, remains difficult to obtain. We propose IUU+DB, a large language model driven system for building a global incident database of IUU+ activity. The system ingests heterogeneous documents, classifies whether they describe relevant incidents, extracts key data elements such as actors, locations, species, vessels, violations, and enforcement outcomes, and supports deduplication and trend analysis. Case studies and validation results show that IUU+DB can help organize fragmented evidence, surface geographic and behavioral hotspots, support fisheries-domain specific research in academia and non-government organizations, assist source and species risk assessments for industry, and provide support for policy implementation and targeted enforcement efforts to government agencies.

15.
arXiv (math.PR) 2026-06-16

Structure preserving properties of higher order moment closures for TASEP

arXiv:2604.15925v2 Announce Type: replace-cross Abstract: The totally asymmetric simple exclusion process (TASEP) is a stochastic model for the unidirectional flow of interacting particles on a 1D-lattice that is much used in systems biology and statistical physics. Its master equation describes the evolution of the probability distribution on the configuration space. The size of the master equation grows exponentially with the length of the lattice. It is known that the complexity of the system may be reduced using mean-field approximations. We provide a rigorous definition of a family of such models using moments of any order and an extension to the pair approximation for obtaining closures for the system. The dimension of these models grows linearly with the lattice size and exponentially in the order of the approximation. Moreover, we show that the states of these models still have a probabilistic interpretation and that basic structural properties of the master equation are preserved. This extends known results on the Ribosome Flow Model which can be viewed as the first order approximation for TASEP.

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

WavSLM: Single-Stream Speech Language Modeling via WavLM Distillation

Large language models show that simple autoregressive training can yield scalable and coherent generation, but extending this paradigm to speech remains challenging due to the entanglement of semantic and acoustic information. Most existing speech language models rely on text supervision, hierarchical token streams, or complex hybrid architectures, departing from the single-stream generative pretraining paradigm that has proven effective in text. In this work, we introduce WavSLM, a speech language model trained by quantizing and distilling self-supervised WavLM representations into a single codebook and optimizing an autoregressive next-chunk prediction objective. WavSLM jointly models semantic and acoustic information within a single token stream without text supervision or text pretraining. Despite its simplicity, it achieves competitive performance on consistency benchmarks and speech generation while using fewer parameters, less training data, and supporting streaming inference.

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

Market Design for AI: Beyond the Copyright Binary

arXiv:2606.12260v1 Announce Type: cross Abstract: How can we design a market of human-generated content for use in training AI models that both enables technological progress and preserves individual incentives for high-quality content creation? Existing approaches take polar positions: a "free-for-all" model based on fair use and a "strong intellectual property rights" model. We show that both fail: Free-for-all does not compensate creators, and – by modeling as a static Stackelberg game – strong intellectual property rights also underpower creative incentives. We find this especially true for more innovative creators, a phenomenon we term the "originality penalty." Extending this insight to a dynamic model, we find another market failure undermining AI model performance, even for an initially good model: Such a model induces greater reliance by humans on AI-assisted creation, resulting in homogenized content feeding back into training, which degrades the model performance – a "curse of precision." We further propose a market design with a data intermediary internalizing cross-creator externalities and subsidizing innovative contributions, thereby restoring efficiency.

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

Physical Atari: A Robust and Accessible Platform for Real-time Reinforcement Learning on Robots

arXiv:2606.19357v1 Announce Type: cross Abstract: We built a robot called the Robotroller that actuates an Atari CX40+ controller and a device called the Atari Devbox that renders the game frame and the reward signal from the Arcade Learning Environment on a screen. The Robotroller and the Atari Devbox, together with an off-the-shelf camera and a desktop computer, constitute a system that can be used to study reinforcement learning algorithms in the physical world. We call the full system Physical Atari. In this paper, we detail the key decisions that make Physical Atari a robust and accessible platform. To make the system robust, we designed the Robotroller so that all movement is done through bearings, which reduces wear. Additionally, we wrote software that monitors the state of the servos at a high frequency and intervenes to limit stress. To make the system accessible, we used affordable off-the-shelf components and parts that can be manufactured using consumer 3D printers. Physical Atari can be built for under $1,000 and has been used for weeks of non-stop reinforcement learning experiments without any mechanical failures. We used it to validate that reinforcement learning algorithms can learn directly on robots and show that even small distribution shifts between learning and deployment can significantly degrade the performance of policies. Our results underscore the importance of on-device adaptation for strong performance on robots.

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

Truncated Wigner dynamics of biclique quantum spin glasses

Authors:

arXiv:2606.20187v1 Announce Type: cross Abstract: Quantum spin glasses are often considered testbeds for studying quantum optimization algorithms and as such have been the subject of various quantum advantage claims. Here we investigate the near adiabatic dynamics of biclique quantum spin glasses within the (discrete) truncated Wigner approximation (TWA). Benchmarks on small systems show that TWA recovers sample-to-sample fluctuations of the Edwards-Anderson order parameter, over a wide range of annealing times, with increasing fidelity when the system size increases. We extract critical exponents from the Binder cumulant in line with theoretical expectations, reproducing recent quantum experiments. The computational cost of the method is minimal and it can easily be applied to tens of thousands of qubits.

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 take patient histories, order tests, interpret findings, diagnose conditions and propose treatments, outperforming experienced clinicians while adhering to safety standards and clinical guidelines.

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

VISA: VLM-Guided Instance Semantic Auditing for 3D Occupancy World Models

Semantic 3D occupancy provides a voxelized world state for autonomous driving and robot decision making, but object and rare-class errors can affect free-space interpretation, collision checking, and temporal state propagation. We show that a common VLM strategy, aligning 3D voxel or object features with crop-caption embeddings, improves text-space similarity without reliably improving closed-set occupancy mIoU. Motivated by this mismatch, we propose VISA, a training-time semantic auditing approach for existing occupancy world models. VISA queries an offline VLM on a representative crop of each physical object instance, obtains a structured audit with class hypotheses, plausible confusions, reliability, attributes, and evidence, and propagates it along the object track. The audit is grounded to matched 3D object voxels and distilled into semantic logits through reliability-weighted taxonomy, attribute-factor, and scene-level audit graph losses, while inference remains unchanged and requires no VLM. On nuScenes, averaged across three runs, VISA improves OccWorld from 19.06 to 20.05 mIoU and GaussianWorld from 21.36 to 21.91 mIoU; on GaussianWorld, object mIoU improves from 18.18 to 19.16 and rare-class mIoU from 15.60 to 16.79. These results suggest that VLMs are better suited to closed-set occupancy as reliability-aware semantic auditors than as generic caption-embedding targets.

22.
medRxiv (Medicine) 2026-06-15

Quantitative insights into the role of phages and plasmids in the persistence of nontuberculous mycobacteria in chloraminated drinking water

Nontuberculous mycobacteria (NTM) are opportunistic pathogens that persist in chloraminated drinking water systems, yet the roles of phages and plasmids in their persistence remain largely unexplored. Using genome-resolved and quantitative metagenomics, we characterized NTM, phages, prophages, and plasmids in a chloraminated building plumbing system. Bacterial metagenome-assembled genomes (MAGs) and viral operational taxonomic units (vOTUs) were quantified at mean concentrations of 8.41 * 10^7 and 8.00 * 10^8 copies/L, respectively, including seven NTM MAGs at a mean total concentration of 4.01 * 10^5 copies/L. NTM concentrations were highest at the site with the lowest bacterial and viral diversity. Predicted NTM-infecting virus concentrations were inversely related to NTM concentrations across sites, suggesting complex phage-host dynamics that warrant direct experimental investigation. NTM, putative phages, prophages, and plasmids encoded functions related to disinfectant tolerance, stress response, metal resistance, and secretion. These findings identify phage interactions, prophages, and plasmids as overlooked genomic and ecological dimensions of NTM persistence in engineered water systems.

23.
PLOS Medicine 2026-05-21

Semaglutide-associated risk of nonarteritic anterior ischemic optic neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis of observational studies

by Jędrzej Chrzanowski, Magdalena Walicka, Jacek Burzyński, Małgorzata Zaraś, Arkadiusz Michalak, Wojciech Fendler Background Semaglutide, a glucagon-like peptide-1 receptor agonist, is widely used for the management of type 2 diabetes (T2DM). Recent case reports have raised concerns about a potential association between semaglutide use and the development of nonarteritic anterior ischemic optic neuropathy (NAION), a rare but vision-threatening condition. We aimed to evaluate whether semaglutide use is associated with an increased risk of NAION in patients with T2DM. Methods and findings We conducted a systematic review and meta-analysis of observational studies comparing patients with T2DM aged ≥12 years treated with semaglutide to those receiving other glucose-lowering therapies. We searched PubMed, Scopus, and Web of Science databases from January 2023 to November 2025. Two reviewers independently extracted data on study design, population characteristics, and outcomes. Risk of bias was assessed using the Newcastle–Ottawa Scale, and ROBINS-I v.2. Certainty of the evidence was graded according to the GRADE framework. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using fixed-effects models; sensitivity analyses included crude and subgroup HRs, and overlapping study replacement. Leave-one-out analysis was conducted to assess small-study effects and publication bias. Results were contextualized within other meta-analyses, systematic reviews, consensus statements, and regulatory communications on the topic.Five eligible observational studies met the inclusion criteria, and 7 additional studies were included in the sensitivity analysis. Semaglutide use was associated with a significantly increased hazard of NAION compared with nonsemaglutide glucose-lowering regimens (HR 2.17, 95% CI [1.73, 2.74]; p 

24.
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.

25.
arXiv (CS.CL) 2026-06-18

GrowthHacker: Automated Off-Policy Evaluation Optimization Using Code-Modifying LLM Agents

With data-driven development now widely adopted, online A/B testing is an established method for measuring the effects of new technologies. However, deploying online experiments demands resources for design, implementation, and deployment, and may negatively impact users (e.g., unsafe or unethical outcomes) while requiring weeks of data collection. To address this, the growing research area of off-policy evaluation (OPE), or offline A/B testing, assesses new technologies offline using previously collected logged data. OPE is also a fundamental problem in reinforcement learning and is important where online testing is expensive or risky, such as healthcare, recommender systems, education, and robotics. Despite advances in code-generation large language models (LLMs) and agentic workflows, little is known about whether and how LLMs and LLM-based agents can automatically optimize OPE implementations. We propose GrowthHacker, a benchmark that evaluates baseline LLMs and LLM-based agents on large-scale public datasets. GrowthHacker autonomously and iteratively modifies code, runs OPE, and uses the metrics to guide subsequent optimization. We evaluate methods on Open Bandit Pipeline (OBP) and Scope-RL, and develop a two_agent framework that addresses limitations of existing frameworks while reducing complexity. Across both libraries, two_agent shows the highest reliability (98.1%-100% success rate) and positive-outcome rate (78%), with a median improvement of 4.4% among positive outcomes; CrewAI achieves the highest average improvement (37.9%) and is the only framework with zero extreme-value failures. AutoGen and Default each reach 65% positive-outcome rates. These results establish the feasibility of using LLM-based agents as automated "growth hackers" to continuously improve OPE systems, with implications for scaling data-driven decision-making where manual optimization is expensive.