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

A Stabilized Path-Space Approach to Diffusion-Based Posterior Sampling

arXiv:2606.12710v1 Announce Type: new Abstract: Diffusion models provide expressive data-driven priors for Bayesian inverse problems, but many diffusion posterior samplers rely on heuristic guidance approximations that can fail for nonlinear operators and multimodal posteriors. In this work, we develop a stabilized path-space framework for diffusion-based posterior sampling. Starting from a base diffusion process whose terminal marginal represents the prior, we define a likelihood-weighted target measure on trajectories and cast posterior sampling as learning a controlled stochastic process whose path measure matches this target. This formulation connects diffusion posterior sampling to stochastic optimal control while preserving the Bayesian structure needed for uncertainty quantification. We introduce a time reparameterization that makes the path-space control problem well posed by removing the bias induced by the unknown initial value function, without auxiliary training. We then learn the control via a trust-region path-space optimization method with log-variance objectives. The path-space perspective also unifies our learned control approach with existing guidance-based samplers, quantifies the sampling error induced by approximate controls, and yields importance sampling corrections for asymptotically exact posterior expectations. We evaluate the proposed framework on a suite of benchmark inverse problems with analytically characterized or high-quality reference posteriors, enabling principled assessment of sampling accuracy and uncertainty quantification. These experiments provide insight into the behavior of diffusion-based posterior samplers and demonstrate improved accuracy and robustness over leading approaches.

02.
arXiv (math.PR) 2026-06-15

Scaling limits of multitype Bienaymé trees

arXiv:2507.23241v2 Announce Type: replace Abstract: We consider critical multitype Bienaymé trees that are either irreducible or possess a critical irreducible component with attached subcritical components. These trees are studied under two distinct conditioning frameworks: first, conditioning on the value of a linear combination of the numbers of vertices of given types; and second, conditioning on the precise number of vertices belonging to a selected subset of types. We prove that, under a finite exponential moment condition, the scaling limit as the tree size tends to infinity is given by the Brownian Continuum Random Tree. Additionally, we establish strong nonasymptotic tail bounds for the height of such trees. Our main tools include a flattening operation applied to multitype trees and sharp estimates regarding the structure of monotype trees with a given sequence of degrees.

03.
arXiv (quant-ph) 2026-06-15

Multiple-time Quantum Imaginary Time Evolution

arXiv:2512.10875v2 Announce Type: replace Abstract: Quantum Imaginary-Time Evolution (QITE) is a powerful method for preparing ground states on quantum hardware. However, executing QITE has costly measurement budgets for general Hamiltonians. Both fidelity and computational cost are strongly dependent on the definition of suitable local domains and Hamiltonian partitions. In this work, we introduce the Multiple-Time QITE algorithm (MT-QITE). We show how using more than one imaginary time substantially improves the fidelity of the resulting ground state as well as the measurement overhead with respect to the previously published QITE algorithm, while preserving its deterministic character and its independence from ad hoc ansatze. Moreover, unlike QITE and other QITE-based algorithms, MT-QITE is parallelizable, and we show that even in Hamiltonians with non-local interactions, partitioning may entail a computational advantage.

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

Beyond Defensive Reporting: Machine Learning for Active Anti-Money Laundering Control in Insurance

arXiv:2606.16663v1 Announce Type: new Abstract: Money laundering through insurance claims poses a threat to insurers both through fraudulent payouts and reputational and regulatory risk. Despite this, little research has examined how such laundering can be prevented. This paper examines whether machine learning can help insurers flag suspicious claims before payout, shifting the focus from passive reporting to active prevention. Using production data from a major Norwegian insurer, we train gradient-boosted decision tree models to detect claims later reported to authorities for suspected money laundering. Because fraud and laundering may share behavioural patterns, we also examine whether insurance fraud labels can serve as an auxiliary training signal. We compare different learning setups using the Budget-Weighted Capture Rate, a metric introduced in this paper to measure how many laundering cases are captured when only a small share of claims can be manually reviewed. The results show that incorporating fraud-related investigation labels substantially improves laundering detection. The best-performing model captures nearly two-thirds of laundering cases within the top-ranked 2 to 6 percent of claims selected for investigation. To our knowledge, this is the first empirical study of machine learning for money laundering detection in insurance claims.

05.
arXiv (quant-ph) 2026-06-12

Approximate quantum error correction theory of non-isometric codes

arXiv:2606.13559v1 Announce Type: new Abstract: Non-isometric encoding arises in various important contexts in quantum error correction, most notably in the finite-energy, non-ideal codewords inevitable in experimental realizations of continuous-variable codes, and holographic quantum gravity. In this work, we present a general and systematic theory of non-isometric quantum error-correcting codes. In particular, we employ the approximate quantum error correction framework to quantitatively study the fundamental limitations imposed by non-isometric encodings on the accuracy of quantum error correction and implementation of logical operations. We apply our theory to analyze GKP and tiger codes under energy constraints, and discuss the implications to holography.

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

Rethinking the Trust Region in LLM Reinforcement Learning

Reinforcement learning (RL) has become a cornerstone for fine-tuning Large Language Models (LLMs), with Proximal Policy Optimization (PPO) serving as the de facto standard algorithm. Despite its ubiquity, we argue that the core ratio clipping mechanism in PPO is structurally ill-suited for the large vocabularies inherent to LLMs. PPO constrains policy updates based on the probability ratio of sampled tokens, which serves as a noisy single-sample Monte Carlo estimate of the true policy divergence. This creates a sub-optimal learning dynamic: updates to low-probability tokens are aggressively over-penalized, while potentially catastrophic shifts in high-probability tokens are under-constrained, leading to training inefficiency and instability. To address this, we propose Divergence Proximal Policy Optimization (DPPO), which substitutes heuristic clipping with a more principled constraint based on a direct estimate of policy divergence (e.g., Total Variation or KL). To avoid huge memory footprint, we introduce the efficient Binary and Top-K approximations to capture the essential divergence with negligible overhead. Extensive empirical evaluations demonstrate that DPPO achieves superior training stability and efficiency compared to existing methods, offering a more robust foundation for RL-based LLM fine-tuning. Our code is available at https://github.com/sail-sg/Stable-RL.

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

Verified Detection and Prevention of Concurrency Anomalies in Multi-Agent Large Language Model Systems

作者:

arXiv:2606.17182v1 Announce Type: new Abstract: Multi-agent LLM systems share state through memory stores, vector indices, and tool registries. We model such sharing as long-running read-generate-write operations under deterministic-generation semantics – the regime durable-execution engines enforce by deterministic replay – and formalize four concurrency anomalies in TLA+: stale-generation, phantom-tool, causal-cascade, and tool-effect reordering, structural analogues of classical isolation anomalies, each with a TLC counter-example. The exclusion lattice over these anomalies is trivial; the contribution is the mechanically verified realizability and strict separation of one maximal chain within it, $L_0 \subsetneq \cdots \subsetneq L_4$, to our knowledge the first machine-checked consistency hierarchy for such runtimes. A development of 274 Verus obligations (zero assume, zero admit; trust base: two structural axioms and a mutex correspondence) proves the detectors sound and complete against the specifications and each runtime its avoidance set. Three deployed Rust runtimes realize L0-L1 (pessimistic locking, serializable snapshot isolation, default-SI), each verified against stale-generation and refined to its state machine; L2-L4 are exec-mode-verified with dependency-free prevention twins (A3, A6, A2: 0/1000 versus 1000/1000), and L2 is run live across three model families (A3 prevented in all 120 retracted sessions). We reproduce a silent lost update in ByteDance's deer-flow, formalizing its fix as a verified $L_0 \to L_1$ refinement, and exhibit tool-effect reordering in LangGraph's ToolNode on unmodified output, removed by an L3 commit-order sequencer. The verified detector, refinements, and realizability artifacts are the contribution; the phenomena and lattice are classical.

08.
arXiv (CS.CV) 2026-06-18

A Unified Framework for Efficient Remote Sensing Visual Question Answering: Adapting Dual, Hybrid, and Encoder-Decoder Architectures

Visual Question Answering (VQA) in the Remote Sensing (RS) domain presents unique challenges due to the high resolution, multi scale object distribution, and semantic complexity of aerial imagery. While general domain Foundation Models have achieved remarkable success, their direct application to RSVQA is hindered by massive domain shifts and the computationally prohibitive nature of full fine tuning. This study presents a comparative analysis of RS Adapter, a Parameter Efficient Fine Tuning (PEFT) strategy, applied across three distinct Vision Language Model (VLM) architectures: the Dual Encoder CLIP, the Encoder Decoder BLIP, and the Hybrid FLAVA. We introduce a unified architectural surgery pipeline that injects lightweight bottleneck adapters into the attention and MLP layers of frozen backbones, enabling rapid adaptation with less than 5 percent of trainable parameters. Experimental results on the high resolution RSVQA x dataset demonstrate that while all adapted models achieve convergence, the Hybrid FLAVA architecture offers a superior balance of multimodal reasoning and retrieval capabilities compared to its unimodal counterparts. Our findings establish a new baseline for resource efficient VQA in disaster assessment and urban monitoring.

09.
arXiv (CS.CL) 2026-06-16

Beyond Text-to-SQL: An Agentic LLM System for Governed Enterprise Analytics APIs

Enterprise analytics aims to make organizational data accessible for decision-making, yet non-technical users still face barriers when using traditional business intelligence tools or Text-to-SQL systems. While recent Text-to-SQL approaches based on Large Language Models (LLMs) promise natural language access to structured data, they fall short in enterprise settings where analytics pipelines rely on governed APIs rather than raw databases. In practice, these APIs encapsulate complex business logic to ensure consistency, auditability, and security. However, delegating mathematical or aggregation logic to an LLM introduces reliability and compliance risks. To this end, we present Analytic Agent, an LLM-based agentic system that translates natural language intents into secure interactions with enterprise analytics APIs. Evaluated on 90 real enterprise use cases constructed by domain experts, it reliably interprets user goals, validates permissions, executes governed queries, and generates compliant visualizations through multi-step reasoning and policy-aware orchestration.

10.
arXiv (CS.AI) 2026-06-16

Discovering Lattice Reduction Strategies via Self-Play

arXiv:2606.15301v1 Announce Type: cross Abstract: The Lenstra-Lenstra-Lovász (LLL) algorithm is a seminal contribution to computer science used for lattice basis reduction, yet its polynomial-time outputs produce bases that are far from optimal as the dimension grows. We show that deep reinforcement learning can discover strictly superior, generalizable reduction strategies by interacting with the primitive action space of LLL. We formulate lattice reduction as a single-player Markov Decision Process (MDP) and train a deep residual network using an AlphaZero-style self-play pipeline augmented with adaptive-horizon MCTS (Monte Carlo Tree Search), which couples multi-step network predictions with an entropy-gated expansion mechanism. The resulting policy, DeltaStar, is trained exclusively on small $8$-dimensional $q$-ary lattices and requires fewer primitive row operations than LLL. Crucially, it generalizes zero-shot to unseen moduli and higher dimensions up to $n=32$ without retraining.

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

Calibrated Triage, Not Autonomy: Confidence Estimation for Medical Vision-Language Models

A vision-language model can answer a question about a medical image fluently and confidently while barely using the image, leaning instead on language priors. In medicine this is the failure that matters most, because the answer looks trustworthy and is not, and the only protection is a confidence score reliable enough to tell the system when to abstain. We ask a deployment question rather than an accuracy one: how much imaging work a model can safely handle alone, and which confidence signal makes that possible. We evaluate seven confidence estimators across five open-weight LVLMs and three medical visual-question-answering datasets spanning broad clinical imaging, radiology, and pathology, with every probe trained only on natural images and applied without adaptation. Recast as bounded selective prediction (automate a case only when confidence clears a threshold, defer the rest), the comparison is cautionary. The standard metrics are poor guides: discrimination barely separates the methods, and the weak calibration of a cheap self-report is cheaply removed by off-domain temperature scaling without changing deployable yield. What distinguishes a usable estimator is the high-confidence region a clinician acts on: the weakest baselines are confidently wrong on 41 to 45 percent of their errors against 1 to 4 percent for the best probe, and no estimator is reliably best across domains or models. Safe handoff is governed at two levels: base-model competence sets a ceiling, so a well-calibrated score recovers roughly a third of radiology cases at a 20 percent error tolerance but almost none of pathology; the confidence layer then decides how much of that ceiling is reachable. The usable role today is calibrated triage, not autonomy: automate the cases a calibrated score marks safe, route the rest to a clinician. We release all outputs, correctness judgments, and confidence scores, with code.

12.
arXiv (quant-ph) 2026-06-19

Simulation of Non-Markovian Quantum Accelerated Dynamics via Time-Fractional Schrödinger Equation

arXiv:2606.20024v1 Announce Type: new Abstract: The Time-Fractional Schrödinger Equation (TFSE) is an effective tool for simulating the dynamics of non-Markovian quantum systems. The Quantum Speed Limit (QSL) time characterizes the minimum time required for the evolution of a non-Markovian quantum system. In this paper, Wei's TFSE is employed to simulate the non-Markovian quantum accelerated evolution process in the Resonant Dissipative Jaynes-Cummings (RDJC) model. By solving the QSL time of a time-fractional single-qubit open system, the enhancement mechanism of the system evolution speed induced by the non-Markovian memory effects of the environment is revealed. Further studies show that the optimized acceleration of the system evolution can be achieved by jointly regulating the fractional order, coupling strength, and photon number. Comparative analyses indicate that Wei's TFSE can accurately capture the non-Markovian accelerated dynamical features of the system over the entire fractional order range, whereas Naber's TFSE is applicable only within a limited fractional order interval. In addition, the comparisons of the average simulation time for calculating the dynamical trajectory of the excited-state probability demonstrate that Wei's TFSE has a significant simulation advantage in computational efficiency. Therefore, Wei's TFSE is more accurate and efficient for simulating the accelerated dynamics of non-Markovian quantum systems.

13.
arXiv (quant-ph) 2026-06-19

Exact Markovian Dissipation Requires Singular Energy Resources

arXiv:2606.19510v1 Announce Type: new Abstract: The Gorini–Kossakowski–Lindblad–Sudarshan (GKLS) equation describes irreversible quantum dynamical semigroups. We show that this description cannot be exact under physically regular energy conditions. We prove that the open-system survival probability under physically regular energy conditions has sublinear decay, whereas any dissipative GKLS semigroup has a linear short-time decay. Hence exact Markovian dissipation requires singular energy resources: an unbounded-below total Hamiltonian or infinite initial energy, and a divergent interaction-energy moment. Therefore, a dissipative time-independent GKLS equation should be regarded as an effective description rather than the exact reduced dynamics of a Hamiltonian dilation satisfying physically regular energy conditions.

14.
PLOS Computational Biology 2026-06-10

Interpreting higher-order dependence in multimorbidity using cohort data: A partial information decomposition approach

by Cillian Hourican, Geeske Peeters, René J. F. Melis, Almar Kok, Natasja M. van Schoor, Sandra Wezeman, Mike Lees, Marcel G. M. Olde Rikkert, Rick Quax In the context of multimorbidity, clinical features seldom act in isolation: symptoms, signs and behaviours form interdependent systems in which joint effects on function can be demonstrated only when features are considered together. We introduce an open, reusable workflow that detects and interprets these “together-only” interactions using bivariate Partial Information Decomposition (PID; two sources to one target), linking synergy-based dependence to the broader network of clinical variables rather than to a single target. The workflow estimates synergy with small-sample bias correction and summarises each pair in a Breadth–Uniformity–Synergy–Total (BUST) map: breadth of synergy across target variables (broad “generalist” vs narrow “specialist” patterns), cross-stratum uniformity across age, sex and multimorbidity (uniform vs subgroup-specific), synergy strength, and total shared information. Simple diagnostics contrast observed targets with additive expectations, revealing the specific joint configurations through which non-additive effects arise. Applied to data from the Longitudinal Ageing Study Amsterdam, we treated all health-related variables—covering symptoms, clinical signs, behaviours, lifestyle factors, and self-rated health indicators—as both sources and targets in the PID framework. This symmetric design permits synergy to be quantified for every pair of variables with respect to every other variable. The workflow identifies synergistic constellations that additive models miss. Multidomain cliques involving subjective health, pain, cognition and grip strength showed multiple non-additive configurations, whereas pairs such as alcohol use with grip strength exhibited focused, narrow but uniform synergy. Notably, the pairs with the strongest synergistic contributions were largely distinct from those with the highest total mutual information, indicating that synergy captures dependency structure overlooked by conventional association measures. Rather than a new measure, this work provides a bias-aware workflow that makes higher-order dependence visible and transferable. Our results support synergy-aware mapping as a practical complement to conventional multimorbidity analyses: it highlights specific combinations of routinely assessed features whose joint states may be especially informative across multiple health targets and therefore candidates for prioritised joint assessment and future multi-domain intervention studies.

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

SmartFont: Dynamic Condition Allocation for Few-Shot Font Generation

Few-shot font generation simultaneously requires global structural completeness and fine-grained local style fidelity. Existing methods usually either rely on global content-style modeling, which is robust but imperfectly disentangled, or emphasize component/local modeling, which captures fine details but relies heavily on local priors and reference coverage. We argue that the key challenge is not merely to learn purer conditions, but to organize complementary yet biased global and local conditions through multi-level allocation during generation. To this end, we propose SmartFont, a diffusion-based few-shot font generation framework that combines global content-style generation with weakly supervised local corrective experts. The local branch performs semantic-spatial allocation by learning expert-wise local concepts and semantically meaningful spatial maps under weak component supervision, enabling fine-grained correction without requiring explicit component-conditioned inference. On top of this, a denoising-state condition allocation module adaptively weights global content, global style, and local corrective feature across timesteps and injection blocks. Extensive experiments show that SmartFont achieves better global-local balance, improves glyph quality and local detail fidelity.

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

Reassessing High-Performing LLMs on Polish Medical Exams: True Competence or Bias-Driven Performance?

Large language models (LLMs) in medicine are mainly evaluated using multiple-choice question answering (MCQA), which can overestimate real clinical ability due to guessing strategies and answer biases. To address these limitations, we introduce an expanded and more challenging benchmark based on Polish medical exams, adding over 15,000 questions, two new domains, and four structural modifications that reduce MCQA-specific artifacts and better test reasoning. We evaluate 21 LLMs and show that evaluation design strongly affects results. Under our harder setup, the best model (Qwen3.5-122B) drops by 28.4 and 31 pp on English and Polish exams, respectively. Despite low evidence of data contamination, standard MCQA scores do not reliably reflect true medical competence. To facilitate further research, we make our benchmark publicly available.

17.
PLOS Medicine 2026-05-08

Optimal minimal residual disease threshold in pediatric acute myeloid leukemia: A retrospective cohort study based on the TARGET database

by Xiong-yu Liao, Hong Zheng, Jian-pei Fang, Dun-hua Zhou, Kun-yin Qiu Background Minimal residual disease (MRD) monitoring is a cornerstone of risk stratification in pediatric acute myeloid leukemia (AML), with a threshold of 0.1% conventionally defining positivity by flow cytometry. Advances in flow cytometric technologies, enabling detection of leukemic cells with higher sensitivity and specificity, warrant a reevaluation of whether a lower threshold improves prognostic accuracy. Methods and findings We conducted a retrospective cohort study using data from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET)-AML initiative. The study population comprised 1,205 pediatric patients with de novo AML treated across Children’s Oncology Group (COG) clinical trial centers. Patients were enrolled between September 1996 and December 2016, with a median follow-up of 6.2 years (range: 0.5–20.1 years). The primary objective was to compare the prognostic performance of the traditional MRD threshold (≥0.1%) with a lower threshold (≥0.05%) after induction courses 1 and 2. The main outcome measure was 5-year event-free survival (EFS). Analyses included Kaplan−Meier survival estimates, Cox proportional hazards models to calculate hazard ratios (HR) with 95% confidence intervals (CI), receiver operating characteristic (ROC) curves, and net reclassification improvement (NRI). The optimal threshold for predicting 5-year EFS, determined by ROC analysis, was 0.05% after both induction course 1 (AUC: 0.840, 95%CI[0.76,0.88]) and course 2 (AUC: 0.854, 95%CI[0.78,0.89]). The 0.05% threshold demonstrated higher HR for the first event than the 0.1% threshold (after course 1: HR = 2.8, 95%CI[2.3,3.3]; P 

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

Temporally Consistent and Controllable Video Generation of 2D Cine CMR via Latent Space Motion Modeling

Cine cardiac magnetic resonance is the gold standard for assessing cardiac function, but the scarcity of public datasets limits the development of advanced data-driven models. To address this limitation, we propose a generative method for synthesizing temporally coherent and anatomically consistent cardiac sequences. Our text-to-video framework decouples cardiac spatial structure from temporal motion. First, a fine-tuned diffusion model synthesizes an initial frame from a clinical text prompt, controlling anatomical features. Then, a latent flow model conditioned on a cardiac phase embedding generates the complete cardiac motion, ensuring spatial consistency and temporal control. Our model generates anatomically and pathologically diverse sequences with high temporal coherence and strong fidelity to input prompts, achieving a FID of 31.68 for image realism and a CLIP score of 31.04 for text-image alignment. These experimental results highlight its potential to produce high-fidelity, on-demand medical data, offering a scalable solution to data scarcity.

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

Retell, Reward, Repeat: Reinforcement Learning for Narrative Theory-Informed Story Retelling

Counterfactual story retelling exposes LLM shortcomings in constrained narrative solution spaces where they can no longer rely on recalling memorised training data. Ground-truth-based post-training, such as SFT, fails to teach LLMs how to generate logical and rational narrative events. In this paper, we introduce Retell, Reward, Repeat (RRR), an RL-based pipeline synthesising Structuralist Narratology with scalar narrativity to teach storytelling structure. We extend the TimeTravel dataset with human-annotated stages of narrative equilibrium to evaluate reward models. By using d-RLAIF, RRR derives training signals from the narrativity of textual features without the need for reference outputs. Evaluations demonstrate that RRR-trained LLMs outperform few-shot and SFT baselines in logic, rationality, and completeness, with output quality additionally validated by blind human preference. Relying on a small, query-only dataset, RRR provides a linguistically grounded, cost-effective post-training mechanism for storytelling–a domain currently lacking effective post-training methods. RRR highlights the continued relevance of integrating established linguistic theories into contemporary NLP.

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

Design Criteria for SGD Preconditioners: Local Conditioning, Noise Floors, and Basin Stability

arXiv:2511.19716v2 Announce Type: replace-cross Abstract: Stochastic Gradient Descent (SGD) often slows in the late stage of training due to anisotropic curvature and gradient noise. We analyze preconditioned SGD in the geometry induced by a symmetric positive definite matrix $\mathbf{M}$, deriving bounds in which both the convergence rate and the stochastic noise floor are governed by $\mathbf{M}$-dependent quantities: the rate through an effective condition number in the $\mathbf{M}$-metric, and the floor through the product of that condition number and the preconditioned noise level. For nonconvex objectives, we establish a preconditioner-dependent basin-stability guarantee: when smoothness and basin size are measured in the $\mathbf{M}$-norm, the probability that the iterates remain in a well-behaved local region admits an explicit lower bound. This perspective is particularly relevant in Scientific Machine Learning (SciML), where achieving small training loss under stochastic updates is closely tied to physical fidelity, numerical stability, and constraint satisfaction. The framework applies to both diagonal/adaptive and curvature-aware preconditioners and yields a simple design principle: choose $\mathbf{M}$ to improve local conditioning while attenuating noise. Experiments on a quadratic diagnostic and three SciML benchmarks validate the predicted rate-floor behavior.

21.
medRxiv (Medicine) 2026-06-19

Extraction of Glaucoma Diagnosis, Type, and Severity from Clinical Notes using Secure Cloud-based Large Language Models

Purpose: To evaluate the performance of secure cloud-based large language models (LLMs) in extracting glaucoma diagnosis, type, and severity from free-text clinical notes in the electronic health record (EHR). Design: Retrospective chart review analysis. Participants: 1,250 subjects from the Bascom Palmer Ophthalmic Repository. Methods: Clinical notes of glaucoma-related encounters between 2014 and 2024 were extracted from the Bascom Palmer Ophthalmic Repository. Two fellowship-trained glaucoma specialists annotated clinical notes for glaucoma presence, type, and severity at the eye level. The dataset was split into development (10%), validation (10%), and test (80%) sets. Development and validation sets were used for prompt engineering and refinement, and the held-out test set was used for evaluation. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT-5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Azure AI Foundry within HIPAA-compliant containers. Model performance was assessed using standard metrics. Clinician-entered ICD-10 codes were also compared with adjudicated labels. Main Outcome Measures: Gwet AC1, accuracy, sensitivity, specificity, and F1-score. Results: Inter-grader agreement was high for glaucoma detection (Gwet AC1= 0.930 (95% CI: 0.917-0.945), type classification (Gwet AC1= 0.917 (95% CI: 0.904-0.930), and severity staging (Gwet AC1= 0.901 (95% CI: 0.884-0.916). For glaucoma diagnosis, LLMs demonstrated high overall accuracy, with Claude achieving 97.5%, DeepSeek 96.0%, GPT 96.2%, Grok 94.4%, and Qwen 95.5%. F1 scores for glaucoma detection ranged from 95.4% to 98.9% across models. For glaucoma type classification, accuracies were 97.1%, 94.2%, 94.2%, 94.0%, and 94.4% for Claude, DeepSeek, GPT, Grok, and Qwen, respectively. F1 scores for the most prevalent type (POAG) ranged from 96.3% to 98.9%. For severity staging, accuracies were 95.0%, 94.8%, 94.5%, 94.0%, and 95.2%, respectively, with F1 scores ranging from 89.7% to 96.3% across severity categories and models. ICD-10 codes demonstrated substantially lower performance for type and severity staging, with overall accuracies of 89.2% and 58.5%, respectively. Conclusions: Secure cloud-based LLMs accurately extracted glaucoma diagnosis, type, and severity information from free-text ophthalmology notes, achieving performance approaching expert clinician adjudication while substantially outperforming ICD-based phenotyping approaches, particularly for disease severity classification. These findings demonstrate the potential of LLMs to transform unstructured clinical documentation into scalable, research-ready phenotypic data for large-scale glaucoma cohort development and EHR-based ophthalmic research.

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

A Definition of Good Explanations and the Challenges Explaining LLM Outputs

arXiv:2606.14838v1 Announce Type: new Abstract: How to define a good explanation is a long-standing philosophical debate which has found recent renewed interest in the context of AI outputs. Explainability is crucial for AI adoption in many contexts, but in order to produce good explanations of AI systems, we must first have an understanding of what good explanations are. In this paper we propose a definition inspired by the notion of counterfactual explanations, however we argue that one must also take into account the interlocutor's prior beliefs in each fact that could be offered in an explanation. We explore the ramifications of this definition for AI explainability and, in particular, why LLM outputs are difficult to produce good explanations for.

23.
PLOS Medicine 2026-06-12

Placenta accreta spectrum in the 21st century: Challenging dogma and redefining disorder

by Eric Jauniaux, Helena C. Bartels, Yalda Afshar Placenta accreta spectrum (PAS) is a serious pregnancy complication caused by abnormal placental attachment to the uterus. In this Perspective, Eric Jauniaux and colleagues discuss emerging evidence that challenges our long-held pathophysiological understanding of PAS, and argue that a critical reassessment of definition, diagnosis, and management is overdue. In this Perspective, Jonathan Evans and colleagues discuss why restricting access to joint replacement surgery based on BMI alone is not supported by evidence, and highlight how such rest rictions risk exacerbating stigma, inequity and avoidable harm to those who would benefit from surgery.

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

Towards Responsibly Non-Compliant Machines

arXiv:2606.12147v1 Announce Type: new Abstract: We consider the problem of engineering autonomous intelligent agents that are capable to responsibly not comply with user requests. We argue that machine non-compliance comes in many different forms, and sketch the issues we should pursue on the road of accomplishing responsibly non-compliant intelligent machines. We anchor responsible non-compliance in justifications for task refusal, pathways to override the non-compliance, as well as careful tracking of security risks and liability transfers.

25.
medRxiv (Medicine) 2026-06-15

Unveiling the Awareness of Private Health Insurance Coverage among Healthcare Professionals in Freetown, Sierra Leone: Insights Extracted from Their Perspectives.

Our study is an assessment of the knowledge, personal coverage, and related determinants of private health insurance as revealed by healthcare professionals in Freetown, the urban capital of Sierra Leone. This study stands as a precursor for Low- and Middle-Income Countries (LMICs), like Sierra Leone, seeking to establish Universal Health Coverage (UHC) to provide healthcare access and coverage through publicly arranged risk pooling, designed to help protect against unmanageable medical costs. In parallel, such countries face significant challenges with achieving sustainable universal coverage due to limited public resources, inefficient allocation systems, uneasy reliance on out-of-pocket payments, and large struggling populations. Our research sheds particular light on how healthcare professionals view their own participation with private healthcare options. A cross-sectional, analytical study was conducted, openly recruiting individuals from various facilities in Freetown. Using the Yamane Formula, a sample size of 109 participants was calculated. STATA 14.0 was used for data analysis. Our findings revealed that 96 (88.9%) participants did not have private health insurance, while 12 (11.1%) did have private coverage. However, 105 (97.2%) reported other modes of health insurance, with only 3 (2.8%) uninsured. Notably, 97.2% expressed willingness to join a private health insurance scheme. Our study found no statistically significant associations between selected indicators (demographic or socioeconomic fac tors) and current insurance coverage among study participants. These results highlight a low prevalence and understanding of private health insurance among healthcare professionals in a representative urban center in Sub-Saharan Africa (SSA), while acknowledging high willingness to enroll. The lack of any significant determinants suggests other unexamined factors, such as cost, accessibility, or awareness, capable of influencing the adoption and implementation of a universal health program.