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

Building Customer Support AI Agents at 100M-User Scale: An Evaluation-Driven Framework

The rapid rise in LLM capabilities has made AI agents increasingly viable across a broad range of tasks. Among the most promising applications is building production-ready customer-facing agents, a challenge that demands coordinated excellence in evaluation methodology, context engineering, training, and online measurement. Yet these critical pillars are typically developed in isolation, creating blind spots that only surface after deployment. In this paper, we present a unified framework that bridges offline development with online impact for customer support AI agents at Nubank, a company with 100M+ users. Our approach integrates several key components: (1) structured context engineering tailored to customer support agents, (2) systematic human-in-the-loop prompt iteration, (3) rigorous LLM judge evaluation with measured inter-rater agreement and GEPA optimization for consistency, and (4) ideation-to-production validation. A central insight is that evaluation-pipeline quality directly determines iteration velocity. We present results from five production deployments spanning distinct domains: card delivery, debt management, credit-limit support, card management, and product explanation. These deployments deliver consistent customer-satisfaction gains while substantially accelerating iteration. In our card-delivery deployment, large-scale A/B testing yields a 37 percentage-point improvement in AI transactional Net Promoter Score and a 29 percentage-point gain in self-service rate over prior agent variants, alongside a strong correlation between offline simulation metrics and online outcomes, demonstrating that eval-driven development reliably predicts production impact. On most use cases, AI satisfaction reaches within a few percentage points of expert human agents.

02.
arXiv (CS.CL) 2026-06-17

Do We Still Need Humans in the Loop? Comparing Human and LLM Annotation in Active Learning for Hostility Detection

Instruction-tuned LLMs can annotate thousands of instances at low cost. This raises two questions for active learning (AL): can LLM labels replace human labels within the AL loop, and does AL remain necessary when entire corpora can be cheaply labeled? We investigate both on a new dataset of 277,902 German political TikTok comments (25,974 LLM-labeled, 5,000 human-annotated), comparing LLM and human annotation across seven conditions, four encoders, and 10 random seeds. Under a two-question interface that mirrors the human annotation task, LLM annotation at scale outperforms human-supervised classifiers at roughly one-tenth the cost (\$28 for GPT-5.2 Batch API vs. \$316 for Prolific). The advantage holds for both a closed-source (GPT-5.2) and an open-weight (Qwen3.5-122B-10B) LLM, is robust under soft-label evaluation, and is unlocked specifically by the two-question decomposition; a holistic single-prompt baseline only ties with human supervision. AL provides no reliable advantage over random sampling under either LLM annotator. However, error structure varies sharply: only GPT-5.2 under the two-question interface produces classifiers with near-human FP/FN balance, while other LLM variants over-flag border-control and economic competition discourse. We release the dataset and code.

03.
arXiv (CS.LG) 2026-06-18

A Streaming Sparse Cholesky Method for Derivative-Informed Gaussian Process Surrogates Within Digital Twin Applications

arXiv:2511.00366v2 Announce Type: replace-cross Abstract: Digital twins are developed to model the behavior of a specific physical asset (or twin), and they can consist of high-fidelity physics-based models or surrogates. A highly accurate surrogate is often preferred over multi-physics models as they enable forecasting the physical twin future state in real-time. To adapt to a specific physical twin, the digital twin model must be updated using in-service data from that physical twin. In this paper, we combine and extend several previous surrogate-related advancements with the goal of demonstrating an end-to-end digital twin (DT) solution for predicting performance of an aircraft structure (the physical asset). To this end, we extend Gaussian process (GP) models to include derivative data, for improved accuracy, with dynamic updating to ingest physical twin data during service. Including derivative data, however, comes at a prohibitive cost of increased covariance matrix dimension. We circumvent this issue through our modified dynamic sparse Cholesky linear system solver. Numerical experiments demonstrate that the prediction accuracy of the derivative-enhanced sparse Cholesky GP method produces improved models upon dynamic data additions. Lastly, we demonstrate the developed algorithm within a DT framework to model fatigue crack growth in an aerospace vehicle, thereby exhibiting through our assembled engineered system how digital twin technologies can be combined in practice.

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

Not all Jensen-Shannon Divergence Estimators are Equal

arXiv:2606.16411v1 Announce Type: new Abstract: The Jensen-Shannon divergence is widely reported as a scalar measure of fidelity for synthetic tabular data. Yet, in practice, it is estimated from finite samples using protocols that are often underspecified. This creates a measurement problem. Although the population divergence is well defined, the empirical value depends on the estimator family, sampling protocol, calibration, dimensionality, and class balance. We show that different protocols can yield non-comparable values: marginal-based estimators ignore dependencies in the joint distribution and can severely underestimate divergence, while classifier-based estimators capture joint structure but exhibit strong estimator dependence. We systematically study this behavior across controlled settings with reference divergences and real-world synthetic tabular benchmarks. Our analysis reveals dependence blindness in marginal estimators, prior-shift bias under class imbalance, and estimator sensitivity in high dimensions. To address prior shift, we derive a closed-form posterior correction for classifier-based Jensen-Shannon estimation. Our results show that empirical Jensen-Shannon divergence values are inherently protocol-dependent, making explicit specification of the estimation procedure necessary for meaningful comparison. We provide practical guidelines and an open-source tool for estimator-aware Jensen-Shannon evaluation.

05.
arXiv (quant-ph) 2026-06-16

Optimal learning of quantum channels in diamond distance

arXiv:2512.10214v3 Announce Type: replace Abstract: Quantum process tomography, the task of estimating an unknown quantum channel, is a central problem in quantum information theory. A long-standing open question is how many uses of an unknown channel are required to learn it in diamond distance, the standard metric for distinguishing quantum processes. While quantum state tomography is well understood, for general channels the problem remained open beyond the unitary case. Here we establish the query complexity of channel tomography with optimal dependence on the dimension parameters, at any fixed constant accuracy. We design an algorithm showing that any channel with input/output dimensions $d_{\mathrm{in}},d_{\mathrm{out}}$ and Kraus rank at most $k$ can be learned to accuracy $\varepsilon$ using $O(d_{\mathrm{in}}d_{\mathrm{out}}k/\varepsilon^{2})$ channel uses. Conversely, we prove that $\Omega(d_{\mathrm{in}}d_{\mathrm{out}}k)$ uses are necessary at constant accuracy and that, for non-minimal Kraus rank, a separate $\Omega(1/\varepsilon^{2})$ contribution is unavoidable. Since channels subsume states, unitaries, isometries, and measurements as special cases, our protocol provides a unified framework for these tomography tasks, yielding new guarantees for isometry and measurement tomography while recovering known optimal scalings for state and unitary tomography. Our algorithm follows the natural strategy of performing optimal tomography on the Choi state. The main technical contribution is to show that this suffices to control the induced diamond-distance error, avoiding the dimension loss incurred by a naive conversion from Choi-state trace distance to channel diamond distance. The protocol uses the channel non-adaptively to prepare Choi-state copies, purifies them in parallel, and performs optimal pure-state tomography on the resulting purifications. Hence, we reduce channel tomography to pure-state tomography.

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

Cinematic Compositing Using Character-Environment-Harmonized Video Generation Models

Cinematic compositing aims to integrate green-screen characters into novel environments while maintaining physical and photometric realism. Previous methods often fail to capture the complex bidirectional interactions between characters and their surroundings, which we characterize as Character-to-Environment (C2E) physical interaction and Environment-to-Character (E2C) lighting harmonization. To address this, we propose an end-to-end video diffusion framework that jointly models C2E and E2C interactions, specifically handling the challenges of interactive props. Our approach introduces a tri-mask-guided architecture with RGB-D joint denoising to ensure physically consistent interactions among the character, props, and environment. We further develop an efficient prior-driven data curation pipeline to construct high-quality relighting pairs without expensive rendering. Finally, a reference-conditioned mechanism enables controllable environment synthesis and precise prop replacement. Extensive experiments demonstrate that our framework significantly outperforms existing methods in cinematic-quality dynamic video compositing.

07.
arXiv (CS.LG) 2026-06-19

Optimal Ansatz-free Hamiltonian Learning In Situ

arXiv:2606.19486v1 Announce Type: cross Abstract: Characterizing the features of a Hamiltonian that governs a quantum system serves as a fundamental subroutine of quantum device calibration, signal sensing, and error correction. Recent works proposed protocols have achieved the optimal Heisenberg-limited scaling learning ansatz-free Hamiltonians from their real-time evolutions without fully specifying interaction structures. However, these protocols rely on both deep circuits with interleaving probes and control, and extremely short time resolution, making them difficult to implement on near- and intermediate-term in situ quantum experiments. In this work, we propose a computationally efficient, control-free, and ancilla-free algorithm that uses only Pauli product state preparation and measurement, and learns an ansatz-free Hamiltonian $H$ with $||H||\leq\Lambda$ in total evolution time of $\Theta(\frac{\Lambda}{\epsilon^2}\log(\frac{\Lambda}{\epsilon}))$. The evolution time cost of our algorithm is optimal for any control-free protocols as we further prove a lower bound of $\Omega(\frac{\Lambda}{\epsilon^2}\log(\frac{\Lambda}{\epsilon}))$. Technically, our method introduces a randomized-sampling framework that combines band-limited kernel-based time sampling with a displacement sieve for Hamiltonian structure learning. The characteristic probe time resolution depends only on $\Lambda$ instead of $\varepsilon$, which makes our protocol especially appealing in the high-precision regime for sensing and calibration applications. We also show that the algorithm maintains the same asymptotic total evolution time in the presence of state-preparation-and-measurement (SPAM) noise when the Hamiltonian is local after calibration. Our results demonstrate the fundamental cost of experimentally friendly Hamiltonian learning and provide a practical route to rigorous in situ characterization of near-term quantum platforms.

08.
arXiv (math.PR) 2026-06-18

First to reach $n$ game

arXiv:2506.08782v4 Announce Type: replace Abstract: We consider a game with two players, consisting of a number of rounds, where the first player to win $n$ rounds becomes the overall winner. Who wins each individual round is governed by a certain urn having two types of balls (type 1 and type 2). At each round, we randomly pick a ball from the urn, and its type determines which of the two players wins. We study the game under three regimes. In the first and the third regimes, a ball is taken without replacement, whilst in the second regime, it is returned to the urn with one more ball of the same colour. We study the properties of the random variables equal to the properly defined overall net profits of the players, and the results are drastically different in all three regimes.

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

Learning Sparse Latent Predictive Foundation Model for Multimodal Neuroimaging

Brain MRIs are routinely acquired as multiple complementary sequences with unique contrast weighting, including T1-weighed imaging (T1w) anatomic and fluid-sensitive T2-weighted (T2w) contrasts. However, methods for learning unified representations across the multitude of MRI contrast mechanisms at health-system scale are lacking. In this study, we introduce Neuro-JEPA, a sparse multimodal neuroimaging foundation model that combines a latent predictive objective with a Mixture-of-Experts architecture to encode brain MRI across core T1w, T2w, and fluid-suppressed FLAIR imaging (FLAIR). We further provide a systematic methodological study of architectural, masking, objective, and sparsity design choices beneficial for robust neuroimaging multimodal representation learning. Neuro-JEPA was pretrained on 1,551,862 scans from 428,647 studies after modality-specific preprocessing with data curation across three core structural brain MRI sequences. We evaluated the learned representations across clinical and research settings, including 25 tasks from three health systems: NYU Langone, NYU Long Island, and Massachusetts General Hospital, and 22 tasks from 12 public datasets, covering unimodal, multimodal and cross-domain evaluation configurations. Across these benchmarks, existing neuroimaging foundation models showed inconsistent gains over a simple convolutional neural network (CNN) baseline, whereas Neuro-JEPA achieved stronger and more consistent performance across all evaluated settings. These results establish a scalable methodological framework for multimodal neuroimaging representation learning and highlight the need for foundation model evaluation protocols that include simple baselines, clinically heterogeneous cohorts and controlled multimodal comparisons.

10.
arXiv (CS.CV) 2026-06-11

DroneShield-AI: A Multi-Modal Sensor Fusion Framework for Real-Time Autonomous Drone Threat Detection, Behavioral Intent Classification, and Swarm Intelligence in Contested Airspace

Unmanned Aerial Vehicle (UAV) threats have emerged as a defining security challenge of the 21st century. This paper presents DroneShield-AI, a unified open framework integrating six processing layers: RF signal classification, acoustic motor-signature detection, YOLOv8-based visual detection, evidence-weighted sensor fusion, a Behavioral Intent Classification Engine (BICE), and a Graph Neural Network Swarm Intelligence Module (GNN-SIM). BICE introduces the first systematic six-class threat taxonomy for drone flight patterns, enabling predictive operator alerts with a 30-second advance-warning horizon. GNN-SIM is the first open framework for adversarial multi-drone formation analysis using Graph Attention Networks. Evaluated on three publicly available real-world datasets, the fused pipeline achieves 96.1% detection accuracy, 3.2% false alarm rate, AUC-ROC: 0.981, and 142ms end-to-end latency on commodity CPU-class hardware at approximately $500-$780 USD total system cost. All code, model weights, and simulation datasets are publicly released at submission.

12.
arXiv (CS.LG) 2026-06-16

Manifold-Orthogonal Dual-spectrum Extrapolation for Parameterized Physics-Informed Neural Networks

arXiv:2603.13751v2 Announce Type: replace Abstract: Physics-informed neural networks (PINNs) have achieved notable success in modeling dynamical systems governed by partial differential equations (PDEs). To avoid computationally expensive retraining under new physical conditions, parameterized PINNs (P$^2$INNs) commonly adapt pre-trained operators using singular value decomposition (SVD) for out-of-distribution (OOD) regimes. However, SVD-based fine-tuning often suffers from rigid subspace locking and truncation of important high-frequency spectral modes, limiting its ability to capture complex physical transitions. While parameter-efficient fine-tuning (PEFT) methods appear to be promising alternatives, applying conventional adapters such as LoRA to P$^2$INNs introduces a severe Pareto trade-off, as additive updates increase parameter overhead and disrupt the structured physical manifolds inherent in operator representations. To address these limitations, we propose Manifold-Orthogonal Dual-spectrum Extrapolation (MODE), a lightweight micro-architecture designed for physics operator adaptation. MODE decomposes physical evolution into complementary mechanisms including principal-spectrum dense mixing that enables cross-modal energy transfer within frozen orthogonal bases, residual-spectrum awakening that activates high-frequency spectral components through a single trainable scalar, and affine Galilean unlocking that explicitly isolates spatial translation dynamics. Experiments on challenging PDE benchmarks including the 1D Convection–Diffusion–Reaction equation and the 2D Helmholtz equation demonstrate that MODE achieves strong out-of-distribution generalization while preserving the minimal parameter complexity of native SVD and outperforming existing PEFT-based baselines.

13.
arXiv (CS.AI) 2026-06-12

Proprioceptive-visual correspondence enables self-other distinction in humanoid robots

arXiv:2606.13222v1 Announce Type: cross Abstract: Distinguishing self from others is a prerequisite for social intelligence, yet humanoid robots that increasingly share workspaces with humans still lack this ability. Here we show that a humanoid robot can learn self-other distinction from proprioceptive-visual correspondence, without any identity labels or kinematic models. Once established, this distinction bootstraps a predictive self-model that maps joint configurations to three-dimensional body occupancy, capturing how the robot's body changes with action. In multi-agent scenes involving humans or morphologically identical robots, the system reliably identifies itself, learns a 3D self-model, and supports downstream tasks including target reaching, collision-aware motion planning, and human-to-robot motion retargeting. Together, these results outline a route toward bodily self-representation in robots that act and coordinate alongside others in shared physical environments. Project page: https://euron-zc.github.io/humanoid-self-model/.

16.
arXiv (quant-ph) 2026-06-11

Entanglement generation between field modes mediated by a fluctuating conducting wall

arXiv:2606.12338v1 Announce Type: cross Abstract: We consider a movable conducting plate of finite mass, between two fixed ones, whose mechanical degrees of freedom are treated quantum-mechanically and bound to its equilibrium position by a harmonic potential. The movable wall is thus subjected to quantum fluctuations of its position. This creates a system of two sub-cavities separated by the movable fluctuating plate, and two massless one-dimensional scalar fields, one in each sub-cavity. This system is described by an appropriate generalization of the Law Hamiltonian. The presence of the movable wall yields an effective plate-fields interaction, as well as an effective interaction between the field modes. We obtain, at the second order in perturbation theory, the ground state of the interacting system and the reduced density operator of the fields in each sub-cavity by tracing out the wall's degrees of freedom. We calculate the entanglement between two field modes, one in each cavity, by evaluating analytically the negativity; we then evaluate numerically also the total multimode negativity. Our results show that in both cases the fields in the two sub-cavities are entangled, in contrast to the case in which the wall is fixed in space. We discuss the amount of the field entanglement present as a function of relevant physical parameters of the system such as the mass and oscillation frequency of the movable wall, its distance from the fixed walls and the frequencies of the field modes considered.

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

WorldLines: Benchmarking and Modeling Long-Horizon Stateful Embodied Agents

arXiv:2606.18847v1 Announce Type: new Abstract: To assist humans over extended periods in real homes, embodied agents must remember user routines, world states, and past interactions. Existing long-term memory benchmarks mainly evaluate language-centric retrieval and question answering, while embodied benchmarks often focus on short-horizon task execution without testing long-term memory use in dynamic environments. We introduce WorldLines, a project-driven benchmark for long-horizon embodied household assistance. It constructs temporally extended household traces with dialogues, actions, execution feedback, object and device state changes, and converts them into evidence-linked samples for Memory QA and Embodied Task Planning. We further propose ObsMem, an observer-grounded memory framework that maintains visibility-aware memories and action-native state trails for state-aware decisions. Experiments reveal persistent challenges in partial observability, overwritten world states, and translating long-term memory into embodied plans, while ObsMem offers a stronger reference architecture for this setting.

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

TSAssistant: A Human-in-the-Loop Agentic Framework for Automated Target Safety Assessment

Target Safety Assessment (TSA) requires systematic integration of genetic, transcriptomic, target homology, pharmacological, and clinical data to evaluate potential safety liabilities of therapeutic targets. This process is labor-intensive and expert-dependent, posing challenges in scalability and reproducibility. We present TSAssistant, a human-in-the-loop multi-agent framework that decomposes TSA report generation into a workflow of specialized subagents: Research Subagents that each ground and cite a single TSA domain, and Synthesis Subagents that integrate findings across domains. Subagents retrieve and synthesize evidence from curated biomedical sources through standardized tool interfaces and produce individually citable, evidence-grounded sections, with behavior shaped by a hierarchical instruction architecture that separates coordination logic from domain expertise and user intent. To complement these soft constraints, programmatic execution hooks and persistent memory stores enforce hard constraints across the workflow, while an interactive refinement loop allows experts to review and revise individual sections with full conversational context preserved across iterations. Rather than a single holistic comparison, we decompose report quality into reproducibility, evidential grounding, task-level accuracy, and controllability under expert oversight, finding high reproducibility and grounding, substantial agreement with the human reference, and net-positive expert-driven refinement.

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

AnnotateAnything: Automatic Annotation of 3D Assets for Robot Manipulation

Simulation enables scalable robot data collection, but raw 3D assets provide only geometry, lacking the semantic, interactive, and physical knowledge needed to specify where and how robots should act. In this work, we present AnnotateAnything, a general automatic annotation framework that converts passive 3D assets into manipulation-ready assets with structured, diverse, and executable manipulation labels. AnnotateAnything is built around two complementary pipelines. First, a unified visual-language annotation pipeline using vision-language reasoning to infer object semantics, interaction constraints, and 3D-grounded cues, providing human-prior guidance for identifying meaningful interaction regions. Second, a fully automatic and massively parallel physics annotation pipeline grounds these priors in each asset's geometry and physical constraints through candidate generation, geometry optimization and trajectory generation. This pipeline produces diverse and executable action annotations, including grasp poses, dexterous contacts, articulation waypoints, insertion directions, hanging affordances, and navigation targets. Using the generated annotations, we further build an asynchronous parallel simulation data-collection system across diverse objects, tasks, and robot embodiments. Experiments demonstrate that AnnotateAnything achieves superior annotation efficiency, data-collection efficiency, and task success rates over existing annotation and data-generation pipelines, while also supporting downstream tasks such as affordance detection, robotic VQA, and visual instruction finetuning. We provide project materials on the project page and plan to release the full code, annotations, and benchmark to facilitate future research. Videos, code, demo assets, and annotations are provided in supplementary materials Project page: https://tourmaline-caramel-169490.netlify.app.

20.
arXiv (CS.CV) 2026-06-16

A Survey on 3D Skeleton Based Person Re-Identification: Taxonomy, Advances, Challenges, and Interdisciplinary Prospects

Person re-identification via 3D skeletons is an important emerging research area that attracts increasing attention within the pattern recognition community. With distinctive advantages across various application scenarios, numerous 3D skeleton based person re-identification (SRID) methods with diverse skeleton modeling and learning paradigms have been proposed in recent years. In this paper, we provide a comprehensive review and analysis of recent SRID advances. First of all, we define the SRID task and provide an overview of its origin and major advancements. Secondly, we formulate a systematic taxonomy that organizes existing methods into three categories centered on hand-crafted, sequence-based, and graph-based modeling. Then, we elaborate on the representative models along these three types with an illustration of foundational mechanisms. Meanwhile, we provide an overview of mainstream supervised, self-supervised, and unsupervised SRID learning paradigms and corresponding common methods. A thorough evaluation of state-of-the-art SRID methods is further conducted over various types of benchmarks and protocols to compare their effectiveness, efficiency, and key properties. Finally, we present the key challenges and prospects to advance future research, and highlight interdisciplinary applications of SRID with a case study.

21.
arXiv (CS.AI) 2026-06-16

Minimal Oversight: Uncertainty-Aware Governance for Delegated AI Systems

arXiv:2606.15563v1 Announce Type: new Abstract: AI systems increasingly delegate decisions to specialized models, evaluators, tools, and supervisory controllers. The central AI problem is no longer only model accuracy, but uncertainty-aware governance: how much autonomy to grant, which evidence should calibrate trust, what performance ceiling a delegated AI system can sustain, and when human intervention becomes necessary. We propose the Minimum Sufficient Oversight Principle (MSO), a variational principle for principled autonomy delegation: minimize governance burden on the Fisher information manifold subject to a delivery constraint. The resulting Euler-Lagrange solution yields a water-filling allocation of governed delegation across the task space. Building on a revealed-action governed delegation channel model, we prove a capacity theorem for stationary symbolwise review policies, derive a local first-order approximation relating workflow complexity to quality degradation, and give a drift-dominated autonomy-time scaling law linking intervention timing to effective capacity, complexity, and drift. Within this framework, masking appears as a structural AI-governance pathology: corrected performance can hide the competence signal needed to calibrate trust. Synthetic simulations and a semi-real reconstructed workflow support design prescriptions including upstream-first correction, sensitivity-based intervention, and explicit feasibility checks before autonomy is expanded. The result is a computable framework for uncertainty, planning, and oversight in delegated AI systems. A companion Python package is available at https://github.com/crbazevedo/delegation-lab.

22.
arXiv (quant-ph) 2026-06-11

Robust Mixed-State Cluster States and Spurious Topological Entanglement Negativity

arXiv:2504.16165v2 Announce Type: replace Abstract: We investigate 1D and 2D cluster states under local decoherence to assess the robustness of their mixed-state subsystem symmetry-protected topological (SSPT) order. By exactly computing fidelity correlators via dimensional reduction of effective statistical mechanics models, we pinpoint the critical error rate for strong-to-weak spontaneous breaking of strong subsystem symmetry. Without resorting to the replica trick, we demonstrate that mixed-state SSPT order remains remarkably robust up to the maximal decoherence rate when noise respects strong subsystem symmetry. Furthermore, we propose that the mixed-state SSPT order can be detected by a constant correction to the area-law scaling of entanglement negativity, termed spurious topological entanglement negativity. This also highlights that topological entanglement negativity, a widely used diagnostic for mixed-state topological order, is generally not invariant under finite-depth quantum channels.

23.
arXiv (CS.CL) 2026-06-11

Experience Makes Skillful: Enabling Generalizable Medical Agent Reasoning via Self-Evolving Skill Memory

Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable experience for long-horizon clinical reasoning. To close this gap, we propose SkeMex, a post-deployment self-evolution framework that improves medical agents through a skill-based memory without updating model weights. SkeMex distills informative interaction trajectories into structured skills that encode reusable procedural knowledge, and organizes them into a multi-branch repository spanning general, task-specific, and action-level experience. To determine which memories should be reused and retained, SkeMex estimates context-dependent utility from environment feedback and uses it to guide value-aware retrieval and repository governance. A closed-loop ``Read–Write–Assess–Govern" lifecycle further supports continual evolution by writing new skills, updating utilities, promoting useful memories, and removing harmful entries. Experiments across diverse clinical tasks show that SkeMex consistently outperforms representative memory-based agents in both offline and online settings. It also generalizes across model backbones and supports transferable skill memory. All data and code will be released publicly.

24.
medRxiv (Medicine) 2026-06-15

Repurposing cardiovascular disease risk models to predict incident and co-occurring cardiovascular, cardiometabolic and neurocognitive outcomes.

Background: Cardiovascular disease (CVD), cardiometabolic and neurocognitive conditions share risk factors and frequently co-occur. We evaluated whether four established CVD risk prediction models (QRISK3, PCE, SCORE2, SCORE2-OP) can be repurposed to predict 10-year risk of these conditions and their co-occurrence with CVD. Methods: The models were recalibrated using 20% of the UK Biobank (UKB) and evaluated in the remaining 80%. We performed external validation using data from Clinical Practice Research Datalink (CPRD) Aurum, assessing model discrimination (c-statistics) and calibration (intercept and slope). We used permuted feature importance to determine the influence of each individual predictor in the models. Results: Depending on the model, the c-statistics for incident CVD ranged from 0.71 to 0.74 in the UKB test set (16,137 events). Discrimination was equal to or higher than CVD when evaluated against non-traditional CVD outcomes: 0.74 to 0.77 for heart failure (3,471 events), 0.72 to 0.73 for atrial fibrillation (9,213 events), 0.73 to 0.75 for peripheral arterial disease (1,927 events) and 0.80 to 0.82 for abdominal aortic aneurysm (595 events). For the multimorbidity endpoints, model discrimination ranged from 0.74 for the composite of CVD and T2DM (SCORE2-OP) to 0.83 for the composite of CVD and dementia or Parkinson's disease (QRISK3). When considering the onset of any cardiovascular, cardiometabolic, or neurocognitive outcome discrimination ranged from 0.71 to 0.72. The repurposed models slightly underestimated the predicted risk in the CPRD compared to the UKB: average difference in calibration intercept was at most -0.64. After age and sex, smoking status and systolic blood pressure contributed most to model predictions. Conclusions: Repurposed CVD models can be used to identify 10-year risk of many CVD-related conditions and their multimorbidity. These may be used to support risk-based approaches to prevention and screening. The repurposed models have been made available at: https://repurposed-cvd-risk-models.shinyapps.io/cvd_cmd_dementia_app/ Keywords: Risk prediction; cardiovascular disease; cardiometabolic disease; dementia; disease prevention.

25.
arXiv (CS.CL) 2026-06-12

Self-Distillation Zero: Self-Revision Turns Binary Rewards into Dense Supervision

Current post-training methods in verifiable settings fall into two categories. Reinforcement learning (RLVR) relies on binary rewards, which are broadly applicable and powerful, but provide only sparse supervision during training. Distillation provides dense token-level supervision, typically obtained from an external teacher or using high-quality demonstrations. Collecting such supervision can be costly or unavailable. We propose Self-Distillation Zero (SD-Zero), a method that is substantially more training sample-efficient than RL and does not require an external teacher or high-quality demonstrations. SD-Zero trains a single model to play two roles: a Generator, which produces an initial response, and a Reviser, which conditions on that response and its binary reward to produce an improved response. We then perform on-policy self-distillation to distill the reviser into the generator, using the reviser's token distributions conditioned on the generator's response and its reward as supervision. In effect, SD-Zero trains the model to transform binary rewards into dense token-level self-supervision. On math and code reasoning benchmarks with Qwen3-4B-Instruct and Olmo-3-7B-Instruct, SD-Zero improves performance by at least 10% over the base models and outperforms strong baselines, including Rejection Fine-Tuning (RFT), GRPO, and Self-Distillation Fine-Tuning (SDFT), under the same question set and training sample budget. Extensive ablation studies show two novel characteristics of our proposed algorithm: (a) token-level self-localization, where the reviser can identify the key tokens that need to be revised in the generator's response based on reward, and (b) iterative self-evolution, where the improving ability to revise answers can be distilled back into generation performance with regular teacher synchronization. Code: https://github.com/princeton-pli/Self-Distillation-Zero.