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

GeneralVLA-2: Geometry-Aware Reconstruction and Governed Memory for Robot Planning

Generalist vision-language-action systems need object-centric 3D evidence and reusable manipulation experience to plan reliable robot trajectories. GeneralVLA provides a hierarchical interface for converting language and RGB-D observations into 3D end-effector paths, but two bottlenecks remain. First, monocular SAM3D-style object reconstruction can hallucinate pose and unseen geometry, while manipulation benefits from stable object shape when calibrated multi-view observations are available. Second, the original KnowledgeBank mainly retrieves semantically similar snippets and appends new knowledge, which makes it difficult to control memory quality, conflicts, confidence, and geometric relevance. To address the first challenge, we introduce GeoFuse-MV3D, a geometry-prior-guided MV-SAM3D reconstruction branch that verifies external geometry cues with input-view masks, applies soft visual-hull support, performs axis-wise refinement, and fuses only geometry while preserving appearance. To address the second challenge, we upgrade KnowledgeBank into a governed long-term memory system with explicit quality, confidence, lifecycle, verifier, and conflict metadata, together with precision-oriented retrieval. Finally, we evaluate the reconstruction branch on GSO-30 and the memory module on Terminal-Bench 2.0 and SWE-Bench Verified; GeoFuse-MV3D improves over the MV-SAM3D baseline by reducing CD and LPIPS by 2.20% and 2.02% while increasing PSNR and SSIM by 2.36% and 1.03%, and KnowledgeBank improves over ReasoningBank by 4.53% on Terminal-Bench SR and 3.73% on SWE-Bench resolve rate, while reducing AS by 4.95% and 5.65%, respectively. Code: https://github.com/AIGeeksGroup/GeneralVLA-2. Website: https://aigeeksgroup.github.io/GeneralVLA-2.

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

Beyond Artifacts: Towards Generalizable Synthetic Song Detection via Music-Intrinsic Features

arXiv:2606.16612v1 Announce Type: cross Abstract: The rapid advancement of AI music generators highlights the urgent need for reliable Synthetic Song Detection (SSD). Existing SSD methods often rely on low-level artifacts or fixed feature assumptions, struggling to capture generator-agnostic cues. To address this, we propose Sofia (Synthetic-song detection framework via music features), a flexible framework that models music-intrinsic attributes via feature-specific experts and an adaptive Mixture-of-Experts (MoE) module. By configuring Sofia with representative Vocal, Audio-effect, Global structure features, and their combinations, we present their individual and complementary contributions. To comprehensively evaluate our framework, we further construct MUSIC8K, a challenging benchmark featuring lastest emerging generators and realistic audio perturbations. Experiments show that Sofia learns generator-agnostic representations from music-intrinsic features, improving the F1 score by 18.5 points over the strongest baseline on MUSIC8K-O while maintaining strong robustness.

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

Optimizing Health Coverage in Ethiopia: A Learning-augmented Approach and Persistent Proportionality Under an Online Budget

arXiv:2509.00135v2 Announce Type: replace Abstract: As part of nationwide efforts aligned with the United Nations' Sustainable Development Goal 3 on Universal Health Coverage, Ethiopia's Ministry of Health is strengthening health posts to expand access to essential healthcare services. However, only a fraction of this health system strengthening effort can be implemented each year due to limited budgets and other competing priorities, thus the need for an optimization framework to guide prioritization across the regions of Ethiopia. In this paper, we develop a tool, Health Access Resource Planner (HARP), based on a principled decision-support optimization framework for sequential facility planning that aims to maximize population coverage under budget uncertainty while satisfying region-specific proportionality targets at every time step. We then propose two algorithms: (i) a learning-augmented approach that improves upon expert recommendations at any single-step; and (ii) a greedy algorithm for multi-step planning, both with strong worst-case approximation estimation. In collaboration with the Ethiopian Public Health Institute and Ministry of Health, we demonstrated the empirical efficacy of our method on three regions across various planning scenarios.

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

On Local Population-Risk Certificates

作者:

arXiv:2606.19147v1 Announce Type: cross Abstract: This paper develops local certificates for population-risk increments around a current model. For a local candidate set \(\mathcal D\), the certificate is a two-sided confidence band for \(P({\ell_{\theta+v}-\ell_\theta})\) over \(v\in\mathcal D\). As an application, the upper endpoint of this band yields a risk-controlled update rule: an update is accepted only when its certified upper endpoint is nonpositive; otherwise the current model is retained.

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

Autonomous Event-Driven Multi-Agent Orchestration for Enterprise AI at Scale

arXiv:2606.20058v1 Announce Type: new Abstract: Enterprise AI aims to move toward continuous event monitoring, detection, and action across specialist agents, yet existing multi-agent systems largely assume discrete request-response workflows and remain underexplored at enterprise scale. We evaluate DAG Plan and Execute and ReAct across 208 production-derived enterprise scenarios spanning Persona (

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

A Comparative Study of Bayesian Contextual Bandits for Real-Time Warehouse Sorter Optimization

arXiv:2606.23977v1 Announce Type: new Abstract: Efficient sorter diversion control of automated material handling systems (MHS) is critical for optimizing operational efficiency in large-scale warehouse environments. In this study, we use an inbound receiving sorter at a high-volume e-commerce warehouse as our primary use case, where the sorter diversion system relies on cost functions with static weight configurations that fail to adapt to highly dynamic system contexts, such as volume mode, congestion level, equipment physical status, and upstream/downstream dependencies. To address this real-time sorter diversion optimization challenge, we conducted a comparative study of three candidate hybrid machine learning frameworks: Linear Regression with Gradient Descent Optimization (LR+GDO), XGBoost with Bayesian Optimization (XGB+BO), and Bayesian Contextual Bandits (BCB). Model training and evaluation were enabled by leveraging a high-fidelity physics-aware emulator to overcome the cold-start problem and allow a safe transition from offline to online learning. We performed comprehensive evaluations including reward model predictive accuracy, contextual sensitivity, action distribution, and projected reward uplift. Our results demonstrate that while tree-based reward models offer slightly better predictive power, the BCB framework achieved overall higher performance with 2.03% reward uplift over the heuristic baseline. Furthermore, BCB exhibits several superior characteristics, such as its decisive time-optimal policy backed by Bang-Bang control theory, continuous online learning capability, strategic balance between exploration and exploitation, and significantly shorter inference latency. These results demonstrate the potential of the BCB framework for real-time control optimization in large-scale warehouse environments, motivating further investigation toward operational deployment.

08.
arXiv (quant-ph) 2026-06-19

Purity and bound energy in ancilla-assisted work extraction

arXiv:2606.19945v1 Announce Type: new Abstract: We investigate ancilla-assisted work extraction in quantum batteries from the perspective of bound energy and purity. We show that the bound energy of the reduced system provides a tight upper bound to the daemonic gain and that this bound is saturated for globally pure system–ancilla states. Motivated by this relation, we introduce a purity-based gain that qualitatively predicts the daemonic gain without requiring explicit optimization over measurements. We further introduce a protocol to analyze the role of dissipation and intrinsic interactions on daemonic gain. Under a collective environment, dissipation can dynamically generate and stabilize finite daemonic gain through environment-induced correlations. In interacting systems, level crossings and spectral restructuring strongly modify the attainable gain through their influence on the accessible bound energy. Our results demonstrate that daemonic gain is governed not only by correlations, but also by the spectral structure of the underlying Hamiltonian and information loss captured by bound energy and purity.

09.
medRxiv (Medicine) 2026-06-16

Deployment-readiness audit of calibration, clinical utility, and fairness in perioperative infection prediction

Objective: Clinical risk scores intended to guide patient-level decisions can show strong average performance. However, predicted probabilities can be systematically too high or too low in specific subgroups even when overall performance is strong. We audited deployment readiness of a strong end-of-surgery postoperative infection model across clinically relevant subgroups and tested mitigation strategies in miscalibrated subgroups. Materials and Methods: We analyzed out-of-fold predictions for 10,719 surgical procedures at a Swiss tertiary hospital, with 504 postoperative bacterial infection events. Prespecified axes were recorded sex, age stratum, and an EHR-derived physiological-reserve proxy. Within subgroups and pairwise intersections, we evaluated discrimination, calibration, threshold-specific errors, and decision-curve net benefit at the prespecified operating threshold. We compared group-specific isotonic recalibration with Wasserstein-barycenter postprocessing and demonstrated portability in SUPPORT2. Results: Overall AUROC was 0.876. While sex-marginal discrimination was similar in women and men (0.878 vs 0.875), age and reserve stratification revealed deployment-readiness failures. Calibration-in-the-large ranged from -0.86 in frail patients to -2.47 in non-frail patients. At the 0.10 operating threshold, decision-curve net benefit was positive in frail patients but negative in pre-frail and non-frail patients. Isotonic recalibration corrected average physiological-reserve-stratified calibration without worsening Brier scores, whereas Wasserstein postprocessing worsened calibration in most procedure clusters. Discussion: Discrimination-only or sex-marginal evaluation would have missed subgroup failures with clinical-utility implications. Conclusion: Subgroup fairness audits for clinical deployment should jointly evaluate discrimination, calibration, and utility. We implemented the audit as the open-source isitfair framework for identifying deployment-relevant subgroup failures, comparing mitigation strategies, and generating structured reports.

10.
bioRxiv (Bioinfo) 2026-06-18

A unified smoothing framework for protein domain bigram model

Biomolecular sequences can be represented as strings over an alphabet, an analogy that has motivated many applications of computational linguistic techniques to biological problems. However, such methods must be adapted to the characteristic scale and organization of biomolecular data. Here, we consider the problem of bigram smoothing for multidomain protein architectures, where domain bigram frequency data is extremely sparse and differs from textual data in alphabet size, string length distribution, the relationship between bigram and unigram frequencies, tandem repeat lengths, and the distribution of domain adjacencies. Moreover, some domain combinations are unobserved because they are biologically incompatible, others because the data are incomplete. A smoothing method that distinguishes these two cases is required. We propose a unified smoothing framework based on interpolation that can be tuned to accommodate different bigram data characteristics. Within this framework, we design specific model variants suited to protein domain bigram data: these assign low adjusted counts to pairs that are likely incompatible, while making appropriate adjustments for undersampled pairs. We demonstrate empirically that this approach distinguishes the two cases while preserving the characteristic signatures of multidomain data.

11.
arXiv (CS.AI) 2026-06-19

Multi-Head Attention-Based Feature Extractor Integration with Soft Actor-Critic for Porosity Prediction and Process Parameter Optimization in Additive Manufacturing

arXiv:2606.20087v1 Announce Type: new Abstract: Additive manufacturing process optimization requires precise parameter control to minimize defects such as porosity. Traditional reinforcement learning (RL) approaches using discrete action spaces suffer from slow convergence and susceptibility to local optima, limiting their effectiveness for high-precision manufacturing tasks. This study addresses these limitations by employing a continuous action space combined with a novel architecture that integrates a multi-head attention mechanism with the Soft Actor-Critic (SAC) algorithm. The attention-based feature extractor enhances the agent's ability to capture subtle variations in low-dimensional input features, enabling more effective exploration-exploitation balance for navigating value spaces with local minima. We validate our approach on porosity prediction and process parameter optimization in laser powder bed fusion, demonstrating faster convergence and higher final reward values compared to standard RL methods including DQN, PPO, TD3, and vanilla SAC. The proposed methodology achieves a convergence value of 322.79 within 14 episodes, outperforming existing approaches while maintaining stability throughout training.

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

Privacy-Preserving Federated Autoencoder for ECG Anomaly Detection on Edge Devices

arXiv:2606.11556v1 Announce Type: cross Abstract: Continuous electrocardiography (ECG) monitoring could surface rhythm abnormalities before they escalate into cardiovascular events. However, a deployable system must satisfy three requirements simultaneously: legal-grade privacy (GDPR, HIPAA), real-time inference on constrained edge hardware, and detection quality under non-IID cross-hospital data. We design and evaluate an end-to-end federated system addressing all three for unsupervised 12-lead ECG anomaly detection on PTB-XL dataset, combining three autoencoder families (VanillaAE, ConvAE, VAE), Flower-based federated averaging (FedAvg) across ten simulated hospitals, client-side differentially private SGD (DP-SGD) with a Rényi-DP accountant, and 8-bit integer (INT8) post-training quantization with Raspberry Pi 4 benchmarking. Our main contributions are: an empirical characterization of how these mechanisms compose, practical DP-specific recommendations, and technical and security insights for a clinically sensitive setting. Federated learning matches or exceeds the centralized baseline across all architectures (ConvAE federated area under the ROC curve, AUROC, $0.782$), and an $\varepsilon$ sweep identifies $\varepsilon=4$ as the recommended clinical operating point. INT8 quantization roughly halves model size and cuts Pi 4 latency by up to $44%$ with $

13.
arXiv (CS.AI) 2026-06-24

Token Complexity of Certifying Stochastic-Oracle Reliability

作者:

arXiv:2606.24074v1 Announce Type: cross Abstract: Wang[Wang2026] introduced the Stochastic-Oracle Turing Machine (SOTM) framework and defined token complexity as the minimum expected cost of interacting with a stochastic oracle needed to attain a specified solution quality for a task. This paper develops an analogous notion for certifying the reliability of a stochastic oracle on a given domain. Certification token complexity is the minimum expected token cost required, with controlled error probability, to distinguish oracles that meet a target reliability level from those that fall below a lower reliability threshold. We construct an SPRT-based certification SOTM that queries the oracle, computes binary correctness scores, and stops when the accumulated log-likelihood evidence crosses a decision threshold. The SOTM halts almost surely, satisfies the desired two-sided error guarantee over the reliability regions to be certified, and yields an explicit upper bound on certification token complexity in terms of the reliability thresholds, the error bound, and the expected per-turn token cost. We then establish a matching information-theoretic lower bound: even with adaptive queries, every error-bounded certification SOTM must incur the same leading-order expected token cost as the SPRT-based construction as the prescribed error bound tends to zero. Together, these bounds characterize the leading-order certification token complexity in the small-error regime.

14.
arXiv (CS.LG) 2026-06-15

Multidimensional Bayesian Active Machine Learning of Working Memory Task Performance

arXiv:2510.00375v2 Announce Type: replace Abstract: While adaptive experimental design has outgrown one-dimensional, staircase-based adaptations, most cognitive experiments still control a single factor and summarize performance with a scalar. We show a validation of a Bayesian, two-axis, active-classification approach, carried out in an immersive virtual testing environment for a 5-by-5 working-memory reconstruction task. Two variables are controlled: spatial load L (number of occupied tiles) and feature-binding load K (number of distinct colors) of items. Stimulus acquisition is guided by posterior uncertainty of a nonparametric Gaussian Process (GP) probabilistic classifier, which outputs a surface over (L, K) rather than a single threshold or max span value. In a young adult population, we compare GP-driven Adaptive Mode (AM) with a traditional adaptive staircase Classic Mode (CM), which varies L only at K = 3. Parity between the methods is achieved for this cohort, with an intraclass coefficient of 0.755 at K = 3. Additionally, AM reveals individual differences in interactions between spatial load and feature binding. AM estimates converge more quickly than other sampling strategies, demonstrating that only about 30 samples are required for accurate fitting of the full model.

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

ProPlay: Procedural World Models for Self-Evolving LLM Agents

Self-evolving agents are expected to improve through interaction without external supervision, but this remains difficult in partially observable environments where agents must explore actively, learn from limited feedback, and decide when to trust prior experience. Existing LLM-agent methods often rely on memory or planning modules, yet they rarely close the loop between them to continually refine an internal understanding of environment dynamics. We introduce ProPlay, a procedural world model that supports procedure-level preplay, where agents can rehearse future procedural paths using the learned world knowledge. Rather than representing experience as isolated rules or low-level action constraints, ProPlay abstracts successful trajectories into procedures and organizes them in a procedure graph that captures causal transitions among task stages. Each transition is associated with a reliability record embedding to estimate its task-specific contribution from past outcomes. Before each episode, ProPlay simulates future procedural trajectories over known graph structures as structured soft guidance; after execution, it refines the graph using environment feedback. Experiments on public benchmarks show that ProPlay consistently improves environment understanding and self-evolution capability over strong baselines. Our code has been released in https://github.com/antman9914/proplay.

16.
medRxiv (Medicine) 2026-06-22

Development of a Novel Risk Prediction Model for Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD): A Longitudinal Study

Background: Interstitial lung disease (ILD) is one of the most common and potentially most devastating extra-articular complication of rheumatoid arthritis (RA) and is associated with substantial morbidity and mortality. However, reliable tools for the early identification of ILD in patients with RA remain limited. This study aimed to identify plasma protein biomarkers of RA-ILD and develop an interpretable machine learning model for risk prediction using data from the UK Biobank. Methods: We first evaluated the association between baseline RA and the risk of incident ILD in the UK Biobank using Cox proportional hazards models. Mendelian randomization analysis was then performed to investigate the potential causal relationship between RA and ILD. Finally, we analyzed 2,920 plasma proteins measured using the Olink platform in 781 eligible RA patients. Proteins associated with ILD risk were identified using Cox proportional hazards models and subsequently used to construct eight machine learning models. Model performance was assessed using the receiver operating characteristic curve (ROC) and decision curve analysis. The best-performing model was further interpreted using Shapley additive explanations (SHAP) to evaluate feature importance. Results: Compared with participants without RA, Patients with baseline RA had a significantly higher risk of developing ILD (Hazard ratio: 4.425, 95% CI: 3.549,5.518). The MR supported a potential causal association between RA and ILD (Odds ratio: 1.227, 95% CI: 1.121,1.343). Among the eight machine learning models, the CatBoost model showed the best performance, achieving an area under the curve (AUC) of 0.884 (95% CI: 0.773,0.996). The SHAP analysis identified LAG3, NPC2, and LAMP3 are the three most important plasma protein predictors of ILD development in patients with RA. Conclusion: Plasma proteomics combined with machine learning may provide a promising approach for identifying biomarkers and predicting ILD risk in patients with RA. LAG3, NPC2, and LAMP3 may serve as candidate biomarkers for RA-ILD and warrant further validation. Keywords: Rheumatoid arthritis, Interstitial lung disease, Mendelian randomization, Machine learning, Plasma proteins.

17.
arXiv (CS.LG) 2026-06-18

Trainable Photonic Measurement for Physics-Informed PDE Learning

arXiv:2606.18713v1 Announce Type: new Abstract: Photonic quantum machine learning offers a route to trainable physical representations built from phase, interference and measurement. However, its role in scientific machine learning remains largely unexplored. Physics-informed neural fields provide a natural setting, because differential equations require trial spaces that preserve phase, frequency and derivative structure. Here we introduce a photonic quantum neural field in which coordinates become trainable optical phases, are mixed by multi-photon Fock-space interference and are decoded from photon-number measurements. The photonic circuit is optimized as the neural-field representation itself, not as a fixed feature map or hardware accelerator. Photonic measurement is therefore a trainable representation on which the physics-informed residual is minimized. Across seven elliptic, wave, nonlinear dispersive and inverse PDE benchmarks, we observe a phase-complexity transition: classical coordinate and Fourier-feature networks suffice in smooth regimes, whereas the photonic field is most accurate when residual derivatives amplify phase mismatch. In the hardest regimes it gives the lowest errors, with margins reaching an order of magnitude and about one quarter of the trainable parameters of classical baselines. Frozen and shuffled controls, together with noise stress tests, attribute this gain to learned interference and stable Fock-probability readout under compound perturbations. These results identify photonic quantum measurement as a representation-learning principle for scientific machine learning.

18.
arXiv (CS.CV) 2026-06-24

Quantum CT via Dynamic Interval Encoding and Prior-Balanced QUBO Reconstruction

Quadratic unconstrained binary optimization (QUBO)-based quantum computed tomography (CT) casts reconstruction as a binary quadratic problem for quantum annealing and hybrid quantum–classical solvers. For grayscale CT, however, image encoding is constrained by the binary-variable budget: fixed global bit-plane encodings increase QUBO size and coupling complexity as gray-level precision improves, whereas low-bit encodings introduce quantization error. We propose a QUBO-based grayscale CT reconstruction framework that combines dynamic interval encoding with prior-balanced optimization. Each refinement round encodes active pixels only within local gray-level intervals around the current estimate, and a boundary-hit-guided update rule adaptively switches between search expansion and local refinement. To improve optimization stability, the method balances projection-domain data consistency and an edge-preserving quadratic prior before forming the final QUBO. Sparse-view and limited-angle fan-beam CT experiments show that the proposed method recovers structures and gray-level distributions more faithfully than the evaluated analytic, iterative, variational, and representation-based baselines. Expressivity analysis and ablation studies further indicate that the improvement mainly arises from effective gray-level representation through dynamic local encoding and more stable data-fidelity–prior coupling. Experiments on the D-Wave hybrid binary quadratic model (BQM) solver further demonstrate that the formulation is executable on a hardware-backed hybrid quantum–classical backend.

19.
Nature Medicine 2026-06-15

Adaptive deep brain stimulation for dynamic gait control in Parkinson’s disease: a randomized feasibility trial

A randomized crossover study of five patients with Parkinson’s disease (PD) demonstrates that gait-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared with continuous stimulation. Gait dysfunction in PD is a major source of disability and is often insufficiently treated by continuous deep brain stimulation (cDBS). Although adaptive DBS (aDBS) has shown efficacy for other motor symptoms using β-based, state-driven neural signals, gait is a dynamic, cyclical behavior that may require temporally precise modulation. Here we evaluated a behavior-contingent aDBS approach that synchronizes stimulation to gait phase. We reported a single-center, blinded, randomized, crossover study evaluating the feasibility of identifying patient-specific biomarkers to drive aDBS. The primary outcome was feasibility of successful identification of gait-phase biomarkers to implement aDBS. Five participants with PD undergoing pallidal DBS and subdural electrode paddle implantation were enrolled. We successfully identified personalized gait-phase biomarkers from cortical or pallidal field potentials in all five patients and embedded them into a bidirectional neurostimulator. During acute in-clinic testing, aDBS improved step variability and step symmetry versus cDBS. Three participants subsequently completed a double-blinded, multi-day crossover phase. In this setting, aDBS maintained general motor symptom control, reduced falls and yielded patient-specific gait improvements. No adverse events occurred and aDBS was well tolerated. These findings establish the feasibility of biomarker-driven, movement-synchronized neuromodulation and support the development of a larger randomized trial to determine clinical efficacy. ClinicalTrial.gov registration: NCT04675398 . A randomized crossover study shows that gait-phase-synchronized adaptive deep brain stimulation is feasible and safe, and reduces falls compared to continuous stimulation in Parkinson’s disease.

20.
arXiv (CS.LG) 2026-06-12

SMGFM: Spectral Multimodal Graph Pretraining for Multimodal-Attributed Graphs

arXiv:2606.12867v1 Announce Type: new Abstract: Multimodal-attributed graphs (MAGs) couple graph topology with node semantics from text, images, and other modalities. Traditional graph learning contextualizes node semantics by coupling topology with node features. However, this coupling design becomes troublesome in MAGs, where structure-induced and modality-intrinsic semantics may contribute differently to downstream tasks. Structure-induced semantics promote relational consistency through smooth topological variation, whereas modality-intrinsic semantics often encode local, fine-grained distinctions that should not be uniformly smoothed or aligned. Therefore, the key challenge is to identify semantic roles before cross-modal fusion. To this end, we leverage graph-frequency variation as a prior, where low-frequency components capture topology-consistent semantics and high-frequency components preserve modality-specific semantics. Based on this intuition, we propose SMGFM, a spectral multimodal graph pretraining framework that decomposes each modality-specific node signal into graph-frequency bands and assigns band-level semantic roles before cross-modal interaction. Concretely, SMGFM constructs frequency-resolved modality tokens with scalable Chebyshev filters, estimates their coupling reliability through topology-conditioned routing, and performs band-modality interaction before fusion. Its frequency-routed objectives align smooth consensus routes while preserving modality-specific routes, mitigating spatial-domain entanglement and uniform cross-modal alignment. Extensive experiments conducted on the MAG datasets demonstrate that SMGFM achieves state-of-the-art performance across graph-level and modality-level tasks.

21.
PLOS Medicine 2026-06-01

Prenatal exposure to asthma medications and risk of neurodevelopmental disorders and educational difficulties: A systematic review and meta-analysis

by Lama A. Shakhshir, Alexia Karain, Jill P. Pell, Claire E. Hastie, Scott M. Nelson, Michael Fleming Background Since asthma exacerbations during pregnancy risk maternal and fetal health, continued medication is important. However, some studies have reported adverse neurodevelopmental outcomes following prenatal exposure to asthma medication. Therefore, this systematic review aimed to collate the existing evidence on the associations between prenatal exposure to asthma medication and neurodevelopmental and educational outcomes. Methods and findings A systematic review was conducted in accordance with PRISMA guidelines and the PECO framework. PubMed, Medline and Embase databases were searched for studies investigating prenatal exposure to one or more asthma medication and neurodevelopmental or educational outcomes published, in English, between January 2003 and September 2024, and updated in November 2025. Studies of asthma medication used for other indications were excluded. Study quality was assessed using the Newcastle-Ottawa scale. Random-effects meta-analyses were conducted where appropriate and heterogeneity was evaluated using Cochran’s Q and I2 tests.Of 16,824 studies identified by the initial search, seven were eligible for inclusion. All investigated beta-2-adrenergic agonists (B2AA), with one including B2AA as mono- and polytherapy—and one study also investigated inhaled corticosteroids (ICS) exposure. Two reported associations with autism spectrum disorder (ASD) and one with attention-deficit hyperactivity disorder (ADHD). An updated search identified one additional eligible study, which examined both ADHD and ASD, as well as other neurodevelopmental disorders. The included eight studies (n = 3,867,170 participants) comprised cohort (n = 5) and case-control (n = 3) designs and reported inconsistent results. Meta-analysis of three studies (n = 1,380,871) indicated significant associations with ASD for exposure to B2AA both preconception (aOR 1.34, 95% CI [1.19,1.52]) and during pregnancy (aOR 1.29, 95% CI [1.16,1.42]). Heterogeneity was low, with no evidence of significant publication bias. Limitations of the included studies comprised residual confounding and exposure misclassification. Additionally, studies included in the meta-analysis were few in number and did not adequately distinguish between medication effects and underlying maternal asthma. Conclusion Meta-analysis suggested an association between prenatal exposure to B2AA and ASD. An association with ADHD, reported in a single study, requires corroboration. To date, based on our search strategy, no association has been reported with communication skills, motor skills, problem-solving and personal-social skills, or cerebral palsy.

22.
Nature Medicine 2026-06-17

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

作者: 未知作者

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

23.
arXiv (CS.AI) 2026-06-24

DeepBD: A Grounded Agentic Workflow for Variant Prioritization and Diagnosis of Genetic Birth Defects

arXiv:2606.24779v1 Announce Type: cross Abstract: Birth defects are a major cause of fetal loss, neonatal morbidity and long-term disability. In the subset with suspected genetic etiologies, exome and genome sequencing have moved many cases from variant detection to post-sequencing interpretation: clinicians must rank patient-specific candidate variants under incomplete fetal or infant phenotypes and heterogeneous evidence from population genetics, variant-effect prediction, gene-disease validity, phenotype ontologies, cellular and pathway context, protein structure and clinical literature. We present DeepBD, a grounded agentic workflow for variant prioritization and diagnostic interpretation of genetic birth defects. DeepBD organizes the workflow into LLM-assisted case structuring, a pretrained evidence engine, specialist evidence modules and a grounded diagnostic review layer. The evidence engine learns patient-specific variant scores from structured rule evidence, sequence and variant-effect representations and phenotype-conditioned biological context, whereas specialist modules and the agentic layer provide tool-based refinement, candidate-pool review and diagnosis-oriented synthesis from ranked candidates. Developed using an in-house fetal and infant cohort comprising 18,622 cases, DeepBD achieved Recall@1/3/5/10 of 0.658/0.882/0.912/0.929 on an internal held-out solved-case benchmark, outperforming standalone Exomiser, DeepRare and prompted LLM reranking baselines evaluated on Exomiser-derived top-20 candidate variants. Ablation and overlap analyses show that rule evidence, mechanistic context, and specialist refinement provide complementary signals. These findings support a grounded agentic workflow that separates evidence integration, tool-based refinement, and LLM-assisted diagnostic review for retrospective variant prioritization in genetic birth defects.

24.
arXiv (CS.LG) 2026-06-16

MacrOData: New Benchmarks of Thousands of Datasets for Tabular Outlier Detection

arXiv:2602.09329v3 Announce Type: replace Abstract: Quality benchmarks are essential for fairly and accurately tracking scientific progress and enabling practitioners to make informed methodological choices. Outlier detection (OD) on tabular data underpins numerous real-world applications, yet existing OD benchmarks remain limited. The prominent OD benchmark AdBench is the de facto standard in the literature, yet comprises only 57 datasets. In addition to other shortcomings discussed in this work, its small scale severely restricts diversity and statistical power. We introduce MacrOData, a large-scale benchmark suite for tabular OD comprising three carefully curated components: OddBench, with 790 datasets containing real-world semantic anomalies; OvrBench, with 856 datasets featuring real-world statistical outliers; and SynBench, with 800 synthetically generated datasets spanning diverse data priors and outlier archetypes. Owing to its scale and diversity, MacrOData enables comprehensive and statistically robust evaluation of tabular OD methods. Our benchmarks further satisfy several key desiderata: We provide standardized train/test splits for all datasets, public/private benchmark partitions with held-out test labels for the latter reserved toward an online leaderboard, and annotate our datasets with semantic metadata. We conduct extensive experiments across all benchmarks, evaluating a broad range of OD methods comprising classical, deep, and foundation models, over diverse hyperparameter configurations. We report detailed empirical findings, practical guidelines, as well as individual performances as references for future research. All benchmarks containing 2,446 datasets combined are open-sourced, along with a publicly accessible leaderboard hosted at https://huggingface.co/MacrOData-CMU.

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

Latent Geometric Chords for Query-Efficient Decision-Based Adversarial Attacks

While decision-based black-box adversarial attacks present a severe security threat, current methodologies suffer from fundamental limitations. Pixel-wise attacks frequently introduce unnatural, high-frequency visual artifacts, while latent-space frameworks are confined by the limited search space of low-dimensional manifolds and inherent reconstruction flaws. To resolve these limitations, we propose Latent Geometric Chords (LGC) for Query-Efficient Decision-Based Adversarial Attacks alongside a variant, LGC-H. At its core, LGC navigates decision boundaries by executing a curvature-aware geometric search within a compressed semantic manifold. To guarantee high visual fidelity and circumvent dimensionality bottlenecks, we introduce a Residual-based Adversarial Generation (RAG) mechanism. RAG isolates semantic perturbations as geometric chords and superimposes them directly onto the original source image. RAG substantially resolves baseline reconstruction flaws and effectively doubles the permissible search space dimensions. Experimental results demonstrate that LGC achieves robust cross-dataset transferability and substantially outperforms state-of-the-art baselines. Notably, our method, LGC, minimizes perturbation magnitudes while achieving state-of-the-art visual fidelity–with a Structural Similarity Index Measure (SSIM) exceeding 0.99 and a Learned Perceptual Image Patch Similarity (LPIPS) below 0.01 at 5000 queries–and sustaining high attack success rates under stringent perceptual constraints, successfully compromising adversarially trained robust models. The source code is available at: https://github.com/eihmuekhine/Latent-Geometric-Chords.