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

Beyond Models: Reflections on Engineering AI-enabled Systems in a Project-Based Course

arXiv:2606.16842v1 Announce Type: cross Abstract: Teaching Software Engineering for AI-enabled systems entails addressing the integration of AI components within full-scale software architectures under realistic constraints. While machine learning courses emphasize model development, students often lack experience in architectural design, deployment, and monitoring of AI-enabled systems. Empirical evaluations of such system-oriented AI courses remain limited. This paper reflects on the design and implementation of a project-based master's-level course titled AI Algorithms: Theory and Engineering, at the University of Bremen, in which students developed a movie recommendation system while making architectural design decisions to address challenges related to scalability, deployment, and evolving requirements. We conducted a mixed-methods study combining analyses of student submissions and questionnaire responses to investigate integration challenges, learning outcomes, and opportunities for improvement. Our results indicate persistent difficulties in early architectural decisions, heterogeneous ML integration, evolving requirements, and data management, largely due to uneven ML and software engineering expertise. From the educator's perspective, the course fostered system-level reasoning and strengthened awareness of data-centric ML practices in AI-enabled systems.

02.
arXiv (CS.AI) 2026-06-12

WISE: A Long-Horizon Agent in Minecraft with Why-Which Reasoning

arXiv:2606.12852v1 Announce Type: new Abstract: Rapid advances have been made in developing general-purpose embodied agent in environments like Minecraft through the adoption of LLM-augmented hierarchical approaches. Despite their promise, low-level controllers often become performance bottlenecks due to repeated execution failures. We argue that a key limitation is not only the lack of episodic memory, but also the decoupling of what-where-when memory from which-why reasoning. To address this, we propose WISE (Which-Why Informed Semantic Explorer), a long-horizon agent framework with an enhanced low-level controller equipped with a Causal Event Graph that augments episodic memory with explicit causal structure linking observations to task relevance. Unlike prior work such as MrSteve, which relies on feature similarity for retrieval, WISE enables robust recall under viewpoint changes and supports opportunistic task reordering through causal reasoning. Building on this memory, we propose an Opportunistic Task Scheduler that dynamically re-prioritizes subtasks when causally relevant opportunities are detected. We further equip WISE with a multi-scale progressive exploration strategy to provide spatially comprehensive observations for downstream reasoning. Experiments show that WISE largely improves task success and efficiency on long-horizon sparse tasks, particularly in settings requiring adaptive decision-making.

03.
medRxiv (Medicine) 2026-06-18

Artificial Intelligence-informed mobile behavioural interventions to support adolescents mental health in schools: protocol for a randomised controlled trial using the MindCraft app

Background: Children and young people (CYP) are particularly affected by mental health problems. Mobile apps provide a scalable and accessible approach to adolescent mental health support, and schools are well-positioned to address multiple risk factors and deliver large-scale interventions. By combining active (self-reported) and passive (sensor-derived) data, mobile apps can model mental states and deliver context-aware support. Artificial Intelligence (AI) enables adaptive, context-aware recommendations tailored to each user. However, there is limited research on AI-based mental health interventions in community CYP. MindCraft is a mobile app designed to monitor adolescents mental health using active and passive data and provide AI-informed recommendations ("nudges"). This study aims to investigate the effectiveness of personalised AI nudges delivered through MindCraft on improving mental health outcomes among adolescents in schools in the United Kingdom. Methods: The study is a three-arm RCT using a prospective cohort of secondary school students aged 14-19. Following informed consent, participants complete a baseline online assessment at school and download MindCraft. The primary outcome is the Strengths and Difficulties Questionnaire global and subscale scores. Secondary outcomes include the Eating Disorders Diagnostic Scale, the Sleep Condition Indicator Questionnaire, the Self-Injurious Thoughts and Behaviours Interview, the Self-Efficacy Questionnaire for Children and the World Health Organisation-Five Well-Being Index. Participants are randomised to: (1) an AI-informed intervention group receiving personalised nudges, (2) an active control receiving non-personalised nudges, or (3) a control group with self-monitoring only. Participants use the app for four weeks, with follow-up at one month. Repeated-measures analyses will assess changes across time points. Discussion: We hypothesise that AI nudges will have a greater positive effect on mental health outcomes at one month than general nudges and self-monitoring. Our findings will provide key evidence on the effectiveness of personalised mobile AI recommendations for adolescents mental health and inform school-based mental health prevention and early intervention. This study will contribute evidence on the ethical, acceptable, and scalable integration of AI-enabled digital mental health tools within public health and educational systems, with implications for the design of future digital public health interventions and policies supporting their safe integration in schools.

04.
medRxiv (Medicine) 2026-06-10

General-purpose large language models can achieve physician-level accuracy in complex medical data extraction

Background: Unstructured data represent about 80% of total electronic health records (EHR) data. Structuring this free text is essential for advancing clinical research, including cohort selection for trials, retrospective studies, and the development of disease registries. While manual chart review (MCR) remains the gold standard for extracting this clinical data, the process is inherently slow, resource-intensive, and susceptible to errors from human fatigue. We evaluated the extraction accuracy, safety, and efficiency of the HeLIX (Hepatology Logic-Integrated Extraction) framework, a Large Language Model (LLM) protocol using Google Gemini 3 Pro, compared to a gold-standard Manual Chart Review (MCR). Methods: A prospective validation study was conducted using 50 high-complexity, simulated hepatology discharge summaries designed to replicate the real-world heterogeneity of EHRs. The HeLIX framework employed a Zero-Shot, Structured Chain-of-Thought (CoT) prompting strategy enforced by a three-layer architecture: Clinical Reasoning Trace, Schema Enforcement, and Evidence Verification. The model extracted 45 distinct clinical variables. Performance was benchmarked against a consensus MCR. Results: Across 2,250 evaluated data points, the model achieved an overall Extraction Accuracy of 99.24% (95% CI: 98.8%-99.5%), with perfect concordance in 35/45 (77.8%) variables. For binary diagnostic variables, the model demonstrated an overall F1-score of 0.98, Recall of 0.99 and substantial inter-rater reliability (Cohens {kappa} = 0.97). Hallucinations were exceptionally rare (2/2250; 0.08%). Critical errors affecting clinical management occurred in only 2 instances (

05.
arXiv (CS.AI) 2026-06-16

RetailBench: Benchmarking long horizon reasoning and coherent decision making of LLM agents in realistic retail environments

arXiv:2606.15862v1 Announce Type: new Abstract: Large language model (LLM) agents have made rapid progress on short-horizon, well-scoped tasks, yet their ability to sustain coherent decisions in dynamic long-horizon environments remains uncertain. We introduce RetailBench, a data-grounded simulation benchmark for evaluating tool-using LLM agents in single-store supermarket operation. RetailBench models retail management as a partially observable decision process and is designed to support thousand-day-scale simulations. In this environment, agents must manage pricing, replenishment, supplier selection, shelf assortment, inventory aging, customer feedback, external events, and cash-flow constraints. We evaluate seven contemporary LLMs under representative agent frameworks over a 180-day evaluation horizon and compare them with a privileged oracle policy. Results show substantial variation across models: only a small subset survives the full evaluation horizon, and even the strongest LLM runs remain substantially behind the oracle policy in final net worth and sales outcomes. Behavioral analysis attributes these gaps to incomplete evidence acquisition, surface-level decision making, and the lack of a consistent long-horizon policy. RetailBench provides a controlled testbed for studying reliable autonomy in economically grounded long-horizon decision-making.

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

Mapping AI Programs in the U.S: A Status Report from Early 2026 and an Analysis of AI Majors and Minors

arXiv:2606.12428v1 Announce Type: cross Abstract: We present a report on the status of undergraduate Artificial Intelligence (AI) programs in the United States in Spring 2026. In so doing, we 1) describe our scraping and mapping tools, which dynamically update to track the state of AI education in the U.S., and 2) create a historic record at a time of great upheaval. The tool we developed, available at https://cicmap.ai, detects, scrapes, and displays data from more than 350 undergraduate AI programs–majors, minors, concentrations, and certificates–at 4-year universities. Our tool searched over 560 institutions to locate these programs, a sample that represents 86\% of all undergraduate Computer Science (CS) graduates in the U.S. This tool allows prospective students, guidance counselors, administrators, and faculty to easily access AI program requirements and is designed to continually update as new programs emerge. To the best of our knowledge, this survey represents the most comprehensive snapshot of the state of AI programs in the U.S. to date. With this work we offer three important contributions: 1) a record of AI programs in the U.S. at a time of great upheaval; 2) a tool to explore AI programs and their requirements; and 3) an analysis of the courses required for 66 AI majors and 87 AI minors. Our analysis of majors and minors shows great variability in the size and the requirements of these degrees, but we note two takeaways. First, not all majors require a general AI course, but if they don't, they do require a Machine Learning (ML) course. Second, while more than a third of majors require an Ethics in AI course, just under a quarter of AI minors do.

07.
arXiv (math.PR) 2026-06-18

A random recursive tree model with doubling events

arXiv:2501.18466v3 Announce Type: replace Abstract: We introduce a new model of random tree that grows like a random recursive tree, except at some exceptional "doubling events" when the tree is replaced by two copies of itself attached to a new root. We prove asymptotic results for the size of this tree at large times, its degree distribution, and its height profile. We also prove a lower bound for its height. Because of the doubling events that affect the tree globally, the proofs are all much more intricate than in the case of the random recursive tree in which the growing operation is always local.

08.
arXiv (CS.CV) 2026-06-19

LooseControlVideo: Directorial Video Control using Spatial Blocking

Precise 3D spatial orchestration in text-to-video generation remains a significant challenge, particularly for multi-object scenes where semantic layout and temporal dynamics are often entangled. While existing depth-conditioned models achieve good structural fidelity, they necessitate dense, frame-accurate guidance that is labor-intensive to author for dynamic events involving deformable objects. We present LooseControlVideo, a framework that enables intuitive and expressive control by using sparse, oriented 3D boxes as a "blocking" proxy. This allows users to author high-level layout and trajectory while leveraging a video generative model to generate realistic occlusions, dynamics and interactions. We achieve this by fine-tuning a Wan 2.2 backbone on a video dataset annotated with DNOCS, a novel encoding for 3D size, orientation and depth-ordered occlusions. Furthermore, our method allows for localized refinement, such as adjusting a jump trajectory or adding an interaction, with minimal disruption to the global scene context. Extensive evaluations on the nuScenes, HO-3D, and BEHAVE benchmarks demonstrate that LooseControlVideo significantly outperforms existing 2D-box and flow-based baselines. Our findings indicate a 1.2x to 3x improvement in Trajectory Error; 2x improvement in Rigid Motion Consistency; and a 1.5x to 2x increase in Occlusion Accuracy over current state-of-the-art layout-conditioned models, demonstrating that oriented 3D primitives provide good geometric prior for complex, multi-agent video authoring.

09.
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.

10.
arXiv (quant-ph) 2026-06-16

Quantum optimal control of steady orbits

arXiv:2606.15383v1 Announce Type: new Abstract: Periodically driven dissipative systems can settle into steady orbits - fixed loops on their dynamical manifolds. In quantum mechanics, steady orbits occur in cooling engines (used to initialise quantum devices), coherent oscillators (such as lasers and masers), precision metrology devices (atomic clocks, optical and spin magnetometers), and magnetic resonance (steady state free precession, dynamic nuclear polarisation). Steady orbits and stroboscopic steady states are a promising target for quantum optimal control, but the numerical complexity is prohibitive: the infinite loop defeats gradient ascent pulse engineering (GRAPE) which relies on explicit numerical propagation in the time domain. Here we propose an efficient quantum control strategy for stroboscopic steady states and limit cycles that are approached asymptotically when a control sequence is repeated infinitely many times. The formalism is different from Floquet-Lindblad state engineering and effective Hamiltonian theories: it finds control sequences that drive a dissipative quantum system towards a steady orbit passing through user-specified waypoints. The software implementation (same numerical complexity scaling as GRAPE) is done for the Spinach library.

11.
medRxiv (Medicine) 2026-06-16

Diurnal variation in brain-derived tau and five other blood-based biomarkers for dementia and their association with cognitive performance

Blood-based biomarkers of dementia are a promising scalable tool for early diagnosis, tracking disease progression, and evaluating therapeutic efficacy. Utility of these biomarkers will not only be dependent on the reliability of their association with pathology but also contingent on their ability to track cognitive status. Previously, we demonstrated diurnal variation in several biomarkers (amyloid beta (A{beta}) 42 and 40, 42/40 ratio, glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and phosphorylated-Tau 217 (p-Tau217)) which has implications for their reliability. Here, we extend these observations to a larger cohort, include brain-derived tau (BD-Tau), which is assumed to be produced exclusively in the brain, and report endocrine measures of circadian rhythmicity. We not only assessed whether these biomarkers vary with time of day, but also whether they associate with daytime function and whether these associations vary with cognitive domain and number of repeated assessments. Data collected in 20 PLWA (72.4{+/-}5.9 years, mean{+/-}SD) and 19 controls (68.9{+/-}9.8 years) were analysed. Participants completed 14 days of home monitoring and one laboratory assessment of sleep and daytime function: mood, daytime sleepiness, reaction time, immediate and delayed memory recall, everyday memory errors. During the 27-hour residential laboratory session, 3-hourly blood samples were collected and analysed for the six blood-based biomarkers of dementia as well as melatonin and cortisol. Rhythmicity of melatonin and cortisol did not differ between groups. P-Tau217 and GFAP (p

12.
medRxiv (Medicine) 2026-06-17

A multistate model of frailty progression after severe infections in adults >=65 years in England: a matched-cohort study

Background Evidence on frailty progression following severe infections is limited. We compared rates of transition to greater frailty or death between adults with and without severe infection in England. Methods We conducted a matched-cohort study among adults aged [≥]65 years (1,452,117: median age 76 years, 45% male) in Clinical Practice Research Datalink Aurum (2006-2019). Adults with severe infection (hospitalised primarily due to infection) were matched on calendar time to individuals without severe infection on age, sex, and primary care practice. The admission date was used as index date and same was assigned to matched unexposed adults. We measured frailty using Electronic Frailty Index, a proportion of 36 health deficits in validated categories (Fit 0-0.12, Mild >0.12-0.24, Moderate >0.24-0.36, Severe >0.36). In a time-varying Markov multistate model, we focused on forward transitions from baseline or intermediate frailty states to higher states or death. For each transition, we used Cox regression to estimate cause-specific transition hazard ratios (HR) with 95% confidence intervals (CIs), comparing adults with and without severe infection. We adjusted for baseline frailty score, age, sex, deprivation, harmful alcohol use, smoking, and primary care infection history 5 years before index date. We estimated state occupancy probabilities, and expected length of stay (ELOS) in each state at year five among adults with and without severe infection. We explored effect modification by infection type. Results Across all transitions, severe infection was associated with higher adjusted hazards of transitioning to worsening frailty or death, HR, 95% CI: (fit to: mild[1.56, 1.54-1.58], moderate[2.51, 1.79-3.51], death[4.57, 4.50-4.65]; mild to: moderate[1.52, 1.50-1.53], severe[1.90, 1.43-2.52], death[2.67, 2.64-2.70]; moderate to: severe[1.40, 1.38-1.42], death[1.87, 1.85-1.90]; severe to death[1.48, 1.46-1.50]). Transition hazard ratios were strongest for lower respiratory tract infections, followed by sepsis, urinary tract infections, meningitis/encephalitis, gastroenteritis, and skin and soft tissue infections. At five years, adults with severe infection had higher probabilities of transitioning to greater frailty or death across all transitions and lower ELOS in each frailty state than those without severe infection. Interpretation Severe infections may accelerate frailty deterioration in older age. Prevention through vaccination, early detection, and prompt management may help mitigate this decline.

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

GAGPO: Generalized Advantage Grouped Policy Optimization

arXiv:2605.13217v1 Announce Type: cross Abstract: Reinforcement learning has become a powerful paradigm for post-training large language model agents, yet credit assignment in multi-turn environments remains a challenge. Agents often receive sparse, trajectory-level rewards only at the end of an episode, making it difficult to determine which intermediate actions contributed to success or failure. As a result, propagating delayed outcomes back to individual decision steps without relying on costly auxiliary value models remains an open problem. We propose Generalized Advantage Grouped Policy Optimization (GAGPO), a critic-free reinforcement learning method for precise, step-aligned temporal credit assignment. GAGPO constructs a non-parametric grouped value proxy from sampled rollouts and uses it to compute TD/GAE-style temporal advantages, recursively propagating outcome supervision backward through time. Combined with group-wise advantage normalization and an action-level importance ratio, GAGPO extracts stable, localized optimization signals directly from multi-turn trajectories. Experiments on ALFWorld and WebShop show that GAGPO outperforms strong reinforcement learning baselines. Further analyses demonstrate faster early-stage learning, improved interaction efficiency, and smoother optimization dynamics, suggesting that GAGPO offers a simple yet effective framework for multi-turn agentic reinforcement learning.

14.
arXiv (CS.CL) 2026-06-12

EvoArena: Tracking Memory Evolution for Robust LLM Agents in Dynamic Environments

Large language model (LLM) agents have achieved strong performance on a wide range of benchmarks, yet most evaluations assume static environments. In contrast, real-world deployment is inherently dynamic, requiring agents to continually align their knowledge, skills, and behavior with changing environments and updated task conditions. To address this gap, we introduce EvoArena, a benchmark suite that models environment changes as sequences of progressive updates across terminal, software, and social domains. We further propose EvoMem, a patch-based memory paradigm that records memory evolution as structured update histories, enabling agents to reason about environmental evolution through changes in their memory. Experiments show that current agents struggle on EvoArena, achieving an average accuracy of 39.6% across evolving terminal, software, and social-preference domains. EvoMem consistently improves performance, yielding an average gain of 1.5% on EvoArena and also improving standard benchmarks such as GAIA and LoCoMo by 6.1% and 4.8%. Beyond individual tasks, EvoMem further improves chain-level accuracy by 3.7% on EvoArena, where success requires completing a consecutive sequence of related evolutionary subtasks. Mechanistic analysis shows that EvoMem improves evidence capture in the memory, indicating better preservation of complete evolving environment states. Our results highlight the importance of modeling evolution in both evaluation and memory for reliable agent deployment.

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

Zeta: Dual Whitening for Matrix Optimization via Coordinate-Adaptive Preconditioning

arXiv:2606.14187v1 Announce Type: new Abstract: Large-scale neural network training increasingly relies on matrix-aware optimizers that exploit the structure of weight parameters beyond element-wise adaptation. However, existing matrix-aware methods such as Muon have an underappreciated vulnerability: their core operation, Newton-Schulz iteration, depends critically on input conditioning, yet the raw momentum matrices exhibit severe coordinate-wise scale heterogeneity. In this paper, we first verify this scale heterogeneity through a chi-square uniformity test, showing that intra-matrix scale imbalance is prevalent across Transformer layers and that coordinate whitening effectively corrects it. Motivated by this finding, we propose Zeta, a dual whitening optimizer that applies coordinate whitening and spectral whitening in a strictly ordered pipeline. The ordering is not a tunable choice but follows from a mathematical dependency: coordinate whitening establishes the statistical isotropy that spectral whitening requires to function reliably. We further prove that this dual pipeline strictly reduces orthogonalization error relative to pure spectral methods by improving the condition number of the input. Empirically, Zeta matches or surpasses strong baselines across language modeling (0.6B to 8B parameters), mixture-of-experts architectures, and vision tasks, demonstrating that resolving scale imbalance before orthogonalization leads to faster convergence and better generalization. Code is available at https://gitcode.com/kevin259/MindSpeed.

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

StepGuard: Guarding Web Navigation via Single-Step Calibration

arXiv:2606.17871v1 Announce Type: new Abstract: Web navigation requires agents to follow natural language goals, interact with web pages, and produce accurate answers. While recent advances leverage vision-language models and reinforcement learning, existing methods still suffer from single-step fragility due to reward misalignment and error propagation. To tackle the reward entanglement, we design Dynamic Dual-Policy Optimization (DDPO), which dynamically switches between a navigation-first mode for exploration and an answer-first mode for question-answering to mitigate reward conflict. To calibrate the single-step error, we propose Confidence-Guided Adaptive Navigation Reflection (CANR), a mechanism that estimates per-step confidence, triggers reflection only when necessary, and uses contrastive rewards to encourage self-correction to calibrate the single-step inaccuracy. With the above as the main components, we finally develop our StepGuard, a new framework of Guarding Web Navigation via Single-Step Calibration. Experiments demonstrate that our approach significantly improves navigation and answer accuracy, setting new state-of-the-art performance on standard web navigation benchmarks.

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

SPEA2$^+$: Improved Density Estimation in SPEA2 with Provable Runtime Guarantees

arXiv:2606.12382v1 Announce Type: cross Abstract: The Strength Pareto Evolutionary Algorithm 2 (SPEA2) is a popular and prominent evolutionary algorithm for solving multi-objective optimisation problems. Despite its popularity, theoretical analyses of SPEA2 have only appeared recently. Moreover, these analyses focus exclusively on how SPEA2 handles non-dominated solutions and disregard the algorithmic components responsible for handling dominated solutions. We conduct a first runtime analysis of SPEA2 for which these components are analysed. We prove that, unlike other prominent algorithms, including NSGA-II, NSGA-III and SMS-EMOA under the same setting of constant population size and duplicate elimination, SPEA2 is unable to cover the Pareto front of the OneTrapZeroTrap benchmark efficiently. Our results indicate that using k-th nearest-neighbour distance in the fitness assignment provides an insufficient signal to maintain diversity among dominated individuals. To address this issue, we propose an improved variant, SPEA2$^+$, that considers all pairwise distances. The new algorithm achieves the same performance guarantees as the other prominent algorithms on OneTrapZeroTrap, while matching the performance of the original SPEA2 on simpler problems. Experimental results complement our theoretical findings.

18.
arXiv (math.PR) 2026-06-12

Symmetric Cooperative Motion in Higher Dimensions

arXiv:2606.13459v1 Announce Type: new Abstract: We prove a distributional convergence result for a multidimensional version of symmetric cooperative motion which was introduced and studied in one dimension in [HRW, SCM1]. Our approach relies on framing the associated recursive distributional equation as a discretization of the porous medium equation. A major challenge is to analyze the behaviour of finite difference schemes which approximate weak solutions of the porous medium equation with unbounded initial data. In overcoming this difficulty, we perform a detailed analysis of the probability mass function of symmetric cooperative motion, in which we introduce several new comparison arguments for the discrete process. Consequently, along the way, we establish a novel multidimensional convergence result for a finite difference scheme approximating the ZKB/Barenblatt solution of the porous medium equation, which is of independent interest.

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

The Slop Paradox: How Synthetic Standardization Erodes Clinical Uncertainty and Cross-Modal Alignment in AI-Rewritten Radiology Reports

作者:

AI-assisted clinical documentation tools increasingly summarize, standardize, and reformat radiology reports using large language models (LLMs). We present a controlled measurement of the resulting information degradation. Using 450 chest X-ray reports from the Indiana University dataset, we generate synthetic versions via three realistic LLM rewriting tasks: EHR summarization, standardized rewriting, and teaching case preparation. We measure entity erosion (via medical NER), hedging collapse (loss of clinical uncertainty language), and cross-modal alignment degradation (via BiomedCLIP image-text similarity). Our central finding is a dissociation between information loss and cross-modal fidelity. EHR summarization is the most destructive at the content level, eroding 51.4% of clinical entities and 43.7% of hedging language, yet it preserves image-text alignment almost entirely (a 2.5% drop). The two tasks meant to produce cleaner training data, standardized rewriting and teaching case preparation, do the reverse: they preserve more entities (26.8% and 29.3% eroded) but cause 14.9-16.5% alignment drops, six to seven times those of EHR summarization. We term this the slop paradox: rewriting that makes clinical text look cleaner for multimodal training is precisely what pulls it away from the image. Contrary to our pre-specified hypothesis, rare pathologies were not preferentially degraded: across nine rare-versus-common comparisons, no difference survived multiple-comparison correction, and nominal differences ran in the opposite direction (common > rare), so contamination is invisible to condition-specific monitoring. The dominant determinant of degradation is the type of AI rewriting task, not the clinical content. These findings bear on multimodal medical AI dataset construction and the governance of AI-assisted clinical documentation.

20.
arXiv (CS.CL) 2026-06-18

Are LLMs Ready to Assist Physicians? PhysAssistBench for Interactive Doctor-Patient-EHR Assistance

The most plausible near-term role of medical LLMs is to assist rather than replace physicians, yet current evaluations often test isolated capabilities: clinical knowledge, EHR system interaction, or patient communication. Physician assistance instead requires coordinating these capabilities within the same interaction, where physicians issue underspecified requests, patients describe symptoms ambiguously, and EHR systems demand precise tool use. We introduce PhysAssistBench, a benchmark for interactive doctor-patient-EHR assistance. Built from real MIMIC-IV cases, PhysAssistBench uses a scalable pipeline to construct agentic patients: interactive, record-grounded agents that turn static EHR records into multi-turn clinical scenarios while preserving clinical factuality. PhysAssistBench provides a curated bilingual evaluation set of 1,296 manually reviewed and physician-validated turns. Experiments with leading LLMs show that current models remain unreliable in this setting, which exposes a key bottleneck for clinical LLMs: reliable assistance requires coordination across knowledge, communication, and systems, not isolated gains in any of them.

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

Multi-Bitwidth Quantization for LLMs Using Additive Codebooks

As large language models (LLMs) are increasingly deployed across heterogeneous hardware with varying resource constraints, the ability to adaptively manage the trade-off between performance and efficiency without retraining is critical. We propose Drop-by-Drop, a novel multi-bitwidth post-training quantization framework that enables inference-time precision control over LLM weights from a single trained model. Our method is theoretically grounded in information theory and successive refinement. We establish that LLM weights, which commonly follow a Gaussian distribution, can be optimally reconstructed with increasing fidelity as additional bits are incorporated, under a weighted mean squared error distortion motivated by LLM loss functions. To realize this in practice, Drop-by-Drop incorporates Matryoshka-style supervision into the loss function, exploiting the structure of additive codebooks. Drop-by-Drop produces a single model where ordered subsets of codebooks yield accurate partial reconstructions at each precision level. This approach significantly reduces storage and memory overhead by allowing a single checkpoint to serve multiple bitwidths, while maintaining competitive perplexity and accuracy across major architectures, such as Qwen, LLaMA, Gemma, and Mistral.

24.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

25.
arXiv (CS.AI) 2026-06-15

No Accidental Software Agent First Canonical Code for Human Code Entropy Reduction and 30 to 500 times Lower Frontier Model Requirements

arXiv:2606.14357v1 Announce Type: cross Abstract: Frontier coding models may spend substantial capacity learning not only program behavior, but also accidental entropy in human repositories. Such repositories contain valuable signals: tests, incidents, migrations, edge cases, product judgment, and operational history. These signals are entangled with framework churn, naming drift, generated-source ambiguity, dependency rituals, CI dialects, weak proof routes, and human-oriented review customs. We propose agent-first canonical code, a proof-carrying substrate that rewrites routine product software into canonical behavior profiles, typed change algebra, proof lanes, constrained edit grammars, semantic patch cells, runtime negative memory, and proof-carrying change objects. The core hypothesis is that quotienting software by behavior equivalence under a declared oracle can collapse equivalent encodings into governed representatives with explicit evidence and proof obligations. The endpoint is amortized cost per verified correct change, including source, context, reasoning, tools, verification, security, provenance, review, failed loops, defects, and foundry cost under a common oracle. Reported reduction bands are hypotheses, not measured frontier results. The proposed limit is a No-Accident Horizon: removable accident decreases until residual novelty, evidence, governance, risk, and future optionality dominate. For supported routine-product distributions, this gives a defensible planning target near 100-fold all-in cost reduction, not a guarantee for all software. Preliminary QLoRA experiments on Qwen2.5-Coder-14B show that 64,088 canonical trajectories are learnable and suppress tested forbidden-language markers, but do not establish behavior preservation, scaling economics, or verified-change cost. The contribution is a falsifiable program centered on minimum functional description length and verified-change cost.