Retraction: Two Birds with One Stone? Possible Dual-Targeting H1N1 Inhibitors from Traditional Chinese Medicine
by The PLOS Computational Biology Editors
Academic Intelligence · Curated Daily
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by The PLOS Computational Biology Editors
by Gokul Parameswaran, Sadeer Al-Kindi, Sanjay Rajagopalan Climate change accelerates non-communicable diseases (NCDs) through cascading environmental disruptions and is attributed to driving increased NCD-related mortality. Yet this syndemic remains invisible and underfunded. We detail why addressing the climate-NCD intersection is critical for improving health. In this Perspective, Sanjay Rajagopalan and colleagues discusses how climate change accelerates non-communicable diseases (NCDs) and exacerbates NCD-related mortality, and calls for greater visibility and funding to address this syndemic and improve human health.
arXiv:2606.14830v1 Announce Type: cross Abstract: This paper develops a climate-aware pricing framework for excess-of-loss (XL) reinsurance contracts and catastrophe (CAT) bonds under non-stationary catastrophe risk. Catastrophe arrivals are modeled as a Cox process whose stochastic intensity depends exponentially on a temperature-related climate index. To represent climate dynamics, the index is modeled as a mean-reverting Ornstein–Uhlenbeck process around a time-dependent warming trend. Within this setting, aggregate losses follow a compound Cox structure with lognormal severities. Pricing is performed under a reduced-form risk-adjusted measure, which provides a tractable valuation approach for XL reinsurance layers and binary zero-coupon CAT bond payoffs in an incomplete market setting. Because catastrophe losses are not dynamically replicable, the framework emphasizes scenario-based valuation rather than model-independent no-arbitrage bounds. A Monte Carlo valuation scheme is implemented to quantify the economic implications of climate-dependent catastrophe intensity. The numerical results show that climate dependence materially changes the loss-generation mechanism and affects the valuation of catastrophe-linked contracts. In the baseline calibration, the climate-aware model increases the excess-of-loss reinsurance premium and lowers the CAT bond price relative to the stationary benchmark. Furthermore, our analysis of the 99.5\% Tail Value-at-Risk (TVaR) indicates that stationary benchmarks may underestimate economic capital requirements by approximately 13.7\% compared to the climate-aware framework, highlighting the potential regulatory relevance of the proposed model. This finding highlights that benchmark design is critical for interpreting climate-pricing effects.
arXiv:2602.10882v4 Announce Type: replace Abstract: Quantum technologies are powered by platforms to generate complex non-classical states of matter or light to realize applications. We investigate the non-classical properties of high-harmonic generation in semiconductors, an emerging photonic platform. Measuring the click statistics of three double-digit orders, we evaluate witness operators to certify the non-classicality of the generated states. We show that higher-order harmonics driven by a coherent laser are squeezed and entangled. The properties of the emission are well retrieved with an entangled Gaussian state model, obtained by numerical state optimization to multiple observables. Additionally, we perform inter-order heralded measurements to engineer the quantum state of the emission. The heralded states have distinct properties, showing sub-Poissonian photon statistics. Further, we witness the generation of a quantum non-Gaussian state, a resource highly relevant for quantum information. With this, we establish high-harmonic generation as a platform for generating quantum optical resources.
Effective exploration is a key challenge in reinforcement learning for large language models: discovering high-quality trajectories within a limited sampling budget from the vast natural language sequence space. Existing methods face notable limitations: GRPO samples exclusively from the root, saturating high-probability trajectories while leaving deep, error-prone states under-explored. Tree-based methods blindly disperse budgets across trivial or unrecoverable states, causing sampling dilution that fails to uncover rare correct suffixes and destabilizes local baselines. To address this, we propose Deep Dense Exploration (DDE), a strategy that focuses exploration on $pivots$-deep, recoverable states within unsuccessful trajectories. We instantiate DDE with DEEP-GRPO, which introduces three key innovations: (1) a lightweight data-driven utility function that automatically balances recoverability and depth bias to identify pivot states; (2) local dense resampling at each pivot to increase the probability of discovering correct subsequent trajectories; and (3) a dual-stream optimization objective that decouples global policy learning from local corrective updates. Experiments on mathematical reasoning benchmarks demonstrate that our method consistently outperforms GRPO, tree-based methods, and other strong baselines. Code is available at https://github.com/AgentCombo/DEEP-GRPO
Chain-of-thought (CoT) reasoning can improve LLM performance, but high answer confidence may be misleading when the accompanying CoT rationale is plausible yet incomplete or poorly supported. We study confidence–rationale alignment: whether a model's confidence in its committed answer is justified by its generated rationale. We introduce a GRPO-based reinforcement learning framework that jointly rewards answer correctness, committed-answer probability, and rubric-based rationale support, where the rubric assesses grounding, coherence, task match, and connection to the selected answer without revealing the gold answer to the judge. Across MedQA, MathQA, and OpenBookQA using three open-weight LLMs, our method reduces the confidence–rationale alignment error by up to 26.51% compared with untuned checkpoints, SFT, and correctness-only GRPO, while maintaining competitive accuracy and often improving calibration. These results show that reliable CoT reasoning requires not only confident answers, but rationales that substantively support them.
arXiv:2606.19413v1 Announce Type: new Abstract: Multimodal time series forecasting, which pairs numerical sequences with domain-relevant textual reports, promises to inject world knowledge into forecasting pipelines. However, we uncover a critical failure mode in existing frameworks that we term text collapse: the text branch converges to a content-independent transformation, contributing negligible discriminative signal regardless of the input description. We argue that text collapse is a consequence of a fundamental asymmetry in time series forecasting: the numerical input is strongly autocorrelated with the output, making the numerical backbone inherently dominant, while the text branch, despite carrying complementary and often critical information, is insufficiently utilized, leading to its systematic underexploitation. To address this, we propose REST-TS (Residual-Exclusive Supervision for Text in Time Series), which turns the asymmetry into a design principle: the numerical backbone produces its own independent numerical forecast, and the text branch is exclusively supervised to predict the structured components of the residual, the prediction gap that numbers cannot explain. Because no numerical pathway can reduce these losses, the text branch must extract genuine content from the input description. Evaluated across diverse real-world domains and backbone architectures, REST-TS achieves state-of-the-art performance and consistently demonstrates greater text-branch utilization than existing frameworks, providing strong empirical evidence that supervising the text branch on the residual compels it to extract genuine content from the input.
Warning: This paper studies stereotypes and biases, and contains potentially disturbing examples, used for illustration purposes only. Our findings should not be interpreted as an argument against alignment. Instead, this paper highlights the need for principled approaches to more advanced alignment. Alignment aims to ensure that large language models (LLMs) behave safely and reliably, including by avoiding unsafe inferences. However, we show that such safety-oriented behaviors can misfire: models may reject warranted conclusions even when they are explicitly supported by context. We call this failure mode misfired alignment, where alignment-induced changes cause LLMs to override explicit evidence. To quantify this phenomenon, specifically on stereotype-related alignment, we introduce VETO, a benchmark consisting of 2,032 BBQ-derived contrastive pairs, and define a new metric, Misfired Alignment Rate (MAR), which measures on a 0 to 100 scale how often a model fails on a stereotype-related question but succeeds on its contrastive counterpart. We benchmark 25 LLMs on VETO, and show that all LLMs, including the most recent ones, exhibit non-trivial (4.7 to 18.9%) MARs while all human participants achieve 0.0% MAR. Controlled priming experiments further show that alignment-induced cues can substantially amplify MAR across LLMs, indicating that these failures are not merely artifacts of individual examples but can be induced by safety-related framing. Mechanistic analyses on open-weight LLMs reveal late-layer suppression of evidence-supported answers, and comparisons between instruct and base LLMs suggest that this suppression emerges after instruction training. These findings show that current alignment methods can overgeneralize surface-level safety cues, to the point of overriding objective evidence, motivating more work on alignment objectives that better preserve contextual grounding.
arXiv:2603.04438v3 Announce Type: replace-cross Abstract: Fully unsupervised deep generative modeling (FU-DGM) offers significant potential for compressively sampled magnetic resonance imaging (CS-MRI) reconstruction. Representative FU-DGM formulations, such as deep image prior (DIP) and implicit neural representation (INR), employ architectural bias to induce a low-dimensional manifold in the image space that aligns with the forward observation. However, as the underlying inverse system is highly ill-posed, prolonged iterative fitting in FU-DGM typically leads to poor efficiency and noise amplification. In this paper, guided by the cognitive principle of easy-to-hard learning, we propose CogGen, an FU-DGM framework that reformulates CS-MRI reconstruction as a staged inversion problem. Specifically, CogGen implements an self-paced curriculum learning (SPCL)-driven progressive scheduling strategy through an MRI-aware dual-threshold weighting criterion, which adaptively regulates k-space measurement participation. The data-consistency residual thresholding evaluates the fitting reliability of the current generator, while the k-space radius thresholding controls stage-wise measurement exposure, thereby avoiding uniform fitting throughout optimization. Theoretically, our analysis shows that, when early stages favor easy-to-fit measurements, CogGen yields a reduced local sufficient-iteration bound and a smaller cumulative noise-amplification bound, explaining the improved convergence behavior and reconstruction fidelity of CogGen within a finite iteration budget. Numerical experiments demonstrate that both CogGen instantiations, CogGen-DIP and CogGen-INR, achieve superior performance over prevailing CS-MRI reconstruction techniques, including unsupervised and supervised pipelines.
Image-based AI assistants are now deployed at production scale on e-commerce platforms, where a single uploaded image can trigger fundamentally different user intents: product search, style recommendation, visual encyclopedia, or utility tool calls, each demanding its own response format, tool invocation, and domain knowledge. Without per-intent behavioral constraints, LLM-based systems conflate these heterogeneous modes and fall short of domain quality standards, while the breadth and dynamism of the intent space render manual engineering infeasible. To address this, we present SkillChain, which closes the production feedback loop on Skill evolution, automating the lifecycle of Skills through three stages: Skill Creator for bootstrapping from task specs and trajectories, Route Optimizer for routing alignment, and Body Refiner for iterative Skill Body refinement via dual-path LLM-Judge evaluation. Deployed on a production-scale e-commerce image assistant, SkillChain substantially improves aggregate response quality, with the strongest gains on structural compliance and content quality; a one-week online A/B experiment further confirms significant gains in user engagement, content consumption, and long-term retention.
Current cultural alignment approaches focus on inference-time interventions, assuming models already contain sufficient cultural knowledge. We argue modern LLM pipelines suffer from a cultural data funnel. Using a multidimensional tagging framework across pretraining, fine-tuning, alignment, and reasoning datasets, we show explicit cultural signals decline sharply during post-training, while geographically concentrated, task-specialized data dominates. Multilinguality enhances geographic diversity of cultural knowledge but does not ensure balanced representation. Our tags improve downstream cultural benchmark performance, demonstrating that advances require shifting focus in training data pipelines. To facilitate future research, we release our culturally tagged dataset with 5.6M samples at https://huggingface.co/datasets/CohereLabs/CultureMarkers.
In low-income countries, ESBL-producing Escherichia coli (ESBL-EC) is frequently detected in humans, animals and household environments, indicating widespread exposure to antimicrobial resistance (AMR). Established risk factors such as antibiotic use do not explain the high community carriage of AMR in all settings; identifying the dominant exposure pathways can inform interventions against AMR. We aimed to investigate (i) animal-human-environment sharing of AMR by assessing associations between the abundance of ESBL-EC in the household environment, domestic animal feces and young children's stool and (ii) household factors associated with ESBL-EC abundance in these reservoirs. We enrolled 112 households from the CRADLE trial in rural Bangladesh. We enumerated ESBL-EC in drinking water, food, child hand rinses, outdoor soil, indoor floor swabs, chicken and cow feces, and stool from children aged 6 months. We recorded indicators of sanitation, animal ownership/management, human and animal antibiotic use, and child exposure behaviors using structured questionnaires and spot checks. The highest prevalence of ESBL-EC was in child stool (95.6%) and animal feces (82.3-96.9%), followed by soil (48.2%) and floors (36.6%); < 10% of food, child hands and drinking water harbored ESBL-EC. The abundance of ESBL-EC in child stool was not associated with its abundance in any sampled matrix; the abundance in chicken but not cow feces showed positive correlations with soil, floors, child hands, and drinking water (correlation coefficients: 0.19-0.39, p-values < 0.05). Higher-quality latrines (improved, pour-flush, with slab) were associated with lower ESBL-EC abundance across matrices; unsafe animal management (animals roaming or spending the night inside the home) was associated with higher abundance. Child antibiotic use and exposure behaviors (soil ingestion, time spent on floor) were not associated with ESBL-EC abundance in child stool. We observed high AMR colonization among young children and domestic animals in rural Bangladesh not explained by traditional fecal-oral exposure pathways. Future studies should explore additional pathways and assess whether sanitation and animal management improvements can reduce AMR.
LLMs can personalize education, although current static-prompt tutoring systems struggle to adapt to diverse academic disciplines. We develop and test a system with subject-aware prompting, based on 14 pedagogical features (e.g., tutor scaffolding, student understanding) extracted from raw transcripts. We first train a prompt routing model in a simulation environment, and then deploy it for online adaptation with actual high-school students. The simulation benchmark shows the router outperforming two static baselines ($0.694$ vs. $0.647$ and $0.64$, $p
by Huihui Zhang, Jiaxing Chang, Zirong Li, Yue Sun, Pinli Hu, Haoxiu Wang, Hang Yang, Yonglin Ren, Xingtan Zhang, Zehua Chen, Kok Wai Wong, Haojing Shao Identifying spatial domains is crucial in spatial transcriptomics, yet effectively integrating gene expression, spatial location, and histology remains challenging. We present STESH, a Spatial Transcriptomics clustering method that combines Expression, Spatial information and Histology. STESH extracts histological features using a convolutional neural network and generates expression, histology, spatial, and collaborative convolution modules for a multi-view graph convolutional network with a decoder and attention mechanism. We evaluated STESH on multiple tissue types and technology platforms. STESH consistently outperformed ten state-of-the-art methods, achieving superior clustering accuracy with the highest scores in adjusted Rand index, normalized mutual information, and Fowlkes-Mallows index.
arXiv:2511.10223v4 Announce Type: replace Abstract: Stochastic reaction networks with mass-action kinetics provide a useful framework for understanding processes – biochemical and otherwise – in homogeneous environments. However, cellular reactions are often compartmentalized, either at the cell level or within cells, and hence non-homogeneous. We investigate a model of compartmentalization in which the rate of fragmentation of a compartment depends on the abundance of some designated species inside that compartment. The particular model of study is part of a general framework for compartmentalized chemistry with dynamic compartments that was proposed in (Duso and Zechner, PNAS, 2020). This paper builds on (Anderson and Howells, Bull. Math. Biol., 2023) where the special case where the compartment dynamics do not depend on their contents was studied mathematically. In particular, we demonstrate that the explosivity characterization from (Anderson and Howells, Bull. Math. Biol., 2023) fails in this setting and provide new sufficient conditions for non-explosivity and positive recurrence, under the assumption that the underlying CRN admits a linear Lyapunov function. These results extend the theoretical foundation for modeling content-mediated compartment dynamics, with implications for systems such as cell division and intracellular transport.
arXiv:2606.18305v1 Announce Type: cross Abstract: Operator learning is an emerging interdisciplinary field that integrates machine learning with scientific computing. By mapping infinite-dimensional function spaces, this approach provides an efficient surrogate modeling framework for high-dimensional partial differential equations (PDEs). Compared to traditional numerical solvers, it achieves a superior trade-off between computational complexity and approximation accuracy, demonstrating significant advantages in many-query tasks such as real-time prediction and parameter sweeps. Given the stringent accuracy requirements of both forward simulation and inverse inference, as well as the precision bottlenecks of existing operator learning methods in handling complex boundaries or long-term evolution, we propose the Starter-Iterator Neural Operator (SINO). Our framework reinterprets the initialization strategies and iterative formats of traditional iterative methods through neural networks, establishing an efficient approach for spectral-spatiotemporal collaborative modeling. Specifically, the frequency-domain initialization module captures globally stable low-frequency features, while the time-domain learning module focuses on optimizing local solution residuals, thereby effectively overcoming the inherent limitations of conventional single-domain modeling approaches. Extensive experiments on typical dynamical systems such as the Navier-Stokes equations and acoustic wave equations, as well as practical applications including super-resolution imaging and weather forecasting, demonstrate that SINO achieves outstanding performance in numerical accuracy, generalization capability, and robustness.
Attention sinks – tokens that receive disproportionate attention mass – are assumed to be functionally important in autoregressive language models, but their role in diffusion transformers remains unclear. We present a causal analysis in text-to-image diffusion, dynamically identifying dominant attention recipients per timestep and suppressing them via paired, training-free interventions on the score and value paths. Across 553 GenEval prompts on Stable Diffusion~3 (with SDXL corroboration), removing these sinks does not degrade text-image alignment (CLIP-T) or preference proxies (ImageReward, HPS-v2) at $k{=}1$; only under stronger interventions ($k\!\geq\!10$) does HPS-v2 exhibit a metric-dependent boundary, while CLIP-T remains robust throughout. The perceptual shifts induced by suppression are nonetheless sink-specific – $\sim\!6\times$ larger than equal-budget random masking – revealing an empirical dissociation between trajectory-level perturbation and semantic alignment in diffusion transformers. \footnote{Code available at https://github.com/wfz666/ICML26-attention-sink.}
arXiv:2606.18283v1 Announce Type: new Abstract: The dense token-to-token interaction pattern of standard dot-product attention remains a central bottleneck in scaling Transformer architectures to long contexts. We introduce Gaussian Mixture Attention (GMA), a probabilistic attention-style sequence mixer that replaces explicit pairwise query–key comparison with routing through $K$ learned Gaussian mixture components. Queries and keys are mapped to posterior responsibility vectors over a shared latent routing space; their overlap defines an implicit responsibility-space affinity, while values are written into and read from a $K$-slot latent memory. By exploiting the associativity of matrix multiplication, GMA avoids materializing the induced $N\times N$ affinity matrix and instead uses two responsibility matrices whose dominant activation storage scales as $\mathcal{O}(NK)$ rather than $\mathcal{O}(N^2)$ for fixed $K$. We formulate bidirectional and causal variants of GMA, provide an end-to-end differentiable parameterization of the Gaussian mixture components, and analyze its responsibility-modulated gradient structure, constrained non-negative low-rank affinity interpretation, and local routing stability. Empirically, GMA exhibits the intended fixed-$K$ linear memory scaling and is competitive with attention-style baselines on long-context classification, while causal GMA improves over tested linear/random-feature attention variants on WikiText-103 but remains behind optimized causal SDPA and Mamba in the current implementation. Analysis of learned responsibilities further shows broad component usage and moderate alignment with surface-form token categories, supporting GMA as a probabilistic, interpretable, fixed-$K$ linear-time attention-style alternative rather than a universal replacement for optimized softmax attention or state-space models.
As AI systems progress, we rely more on them to make decisions with us and for us. To ensure that such decisions are aligned with human values, it is imperative for us to understand not only what decisions they make but also how they come to those decisions. Reasoning language models, which provide both final responses and (partially transparent) intermediate thinking traces, present a timely opportunity to study AI procedural reasoning. Unlike math and code problems which often have objectively correct answers, moral dilemmas are an excellent testbed for process-focused evaluation because they allow for multiple defensible conclusions. To do so, we present MoReBench: 1,000 moral scenarios, each paired with a set of rubric criteria that experts consider essential to include (or avoid) when reasoning about the scenarios. MoReBench contains over 23 thousand criteria including identifying moral considerations, weighing trade-offs, and giving actionable recommendations to cover cases on AI advising humans moral decisions as well as making moral decisions autonomously. Separately, we curate MoReBench-Theory: 150 examples to test whether AI can reason under five major frameworks in normative ethics. Our results show that scaling laws and existing benchmarks on math, code, and scientific reasoning tasks fail to predict models' abilities to perform moral reasoning. Models also show partiality towards specific moral frameworks (e.g., Benthamite Act Utilitarianism and Kantian Deontology), which might be side effects of popular training paradigms. Together, these benchmarks advance process-focused reasoning evaluation towards safer and more transparent AI.
arXiv:2606.11851v1 Announce Type: new Abstract: Open-ended scientific discovery asks agents to move beyond executing analyses for predefined questions. Across multiple rounds of exploration, a discovery agent must decide which phenomena warrant investigation while avoiding overinterpretation, where emerging claims exceed the evidential scope of the analyses supporting them. This creates an evidence-calibration problem: the exploration trajectory must be coupled with claim status so that evidence can guide both what to investigate next and what can be claimed. We introduce StatefulDiscovery, a discovery framework that externalizes investigation state and uses it to coordinate frontier selection, evidence acquisition, and claim adjudication. We evaluate StatefulDiscovery across 40 real-data discovery tasks. Compared with several baselines, StatefulDiscovery produces more claims overall judged to be both well-supported and high-value. Ablations indicate that structured hypotheses, local adjudication, and frontier control contribute to performance. Together, these results suggest that explicit discovery state can couple exploration with evidence-calibrated claim formation.
Abstract (already in the PDF; paste if a box is required): Injury risk prediction in elite football relies almost exclusively on external load metrics derived from GPS tracking, overlooking the molecular state of the athlete. We monitored 26 male players from FC Barcelona's first team across the 2025 calendar year, integrating GPS-derived training load with longitudinal blood-based immune monitoring (systemic inflammation and TCR-derived immune age). Immune age acceleration and inflammation were elevated in the 14 days preceding musculoskeletal injuries. A logistic regression model combining external load, inflammation, immune age acceleration, and career injury history reached an overall AUC of 0.678 and a mean per-player AUC of 0.754 (SD 0.146), improving on a GPS-only baseline of 0.541. Applied to 2026 data, the frozen model ranked players who later sustained non-contact musculoskeletal injuries high in the risk distribution. Together, our data suggest multimodal immune monitoring in elite football to reveal the athlete's internal physiological state, which carries injury-relevant information that external load alone does not capture.
Reinforcement Learning with Verifiable Rewards ( RLVR ) has emerged as a transformative paradigm for enhancing the reasoning capabilities of Large Language Models ( LLMs), yet its potential in 3D scene understanding remains under-explored. Existing approaches largely rely on Supervised Fine-Tuning ( SFT), where the token-level cross-entropy loss acts as an indirect proxy for optimization, leading to a misalignment between training objectives and task performances. To bridge this gap, we present Reinforcement Fine-Tuning for Video-based 3D Scene Understanding (3D-RFT ), the first framework to extend RLVR to video-based 3D perception and reasoning. 3D-RFT shifts the paradigm by directly optimizing the model towards evaluation metrics. 3D-RFT first activates 3D-aware Multi-modal Large Language Models ( MLLM s) via SFT, followed by reinforcement fine-tuning using Group Relative Policy Optimization ( GRPO) with strictly verifiable reward functions. We design task-specific reward functions directly from metrics like 3D IoU and F1-Score to provide more effective signals to guide model training. Extensive experiments demonstrate that 3D-RFT-4B achieves state-of-the-art performance on various video-based 3D scene understanding tasks. Notably, 3D-RFT-4B significantly outperforms larger models (e.g., VG LLM-8B) on 3D video detection, 3D visual grounding, and spatial reasoning benchmarks. We further reveal good properties of 3D-RFT such as robust efficacy, and valuable insights into training strategies and data impact. We hope 3D-RFT can serve as a robust and promising paradigm for future development of 3D scene understanding.
arXiv:2512.19647v4 Announce Type: replace-cross Abstract: This article studies the temporal approximation of hyperbolic semilinear stochastic evolution equations with multiplicative Gaussian noise by Milstein-type schemes. We take the term hyperbolic to mean that the leading operator generates a contractive, not necessarily analytic $C_0$-semigroup. Optimal convergence rates are derived for the pathwise uniform strong error \[ E_h^\infty := \Big(\mathbb{E}\Big[\max_{1\le j \le M}\|U_{t_j}-u_j\|_X^p\Big]\Big)^{1/p} \] on a Hilbert space $X$ for $p\in [2,\infty)$. Here, $U$ is the mild solution and $u_j$ its Milstein approximation at time $t_j=jh$ with step size $h>0$ and final time $T=Mh>0$. For sufficiently regular nonlinearity and noise, we establish strong convergence of order one, with the error satisfying $E_h^\infty\lesssim h\sqrt{\log(T/h)}$ for rational Milstein schemes and $E_h^\infty \lesssim h$ for exponential Milstein schemes. This extends previous results from parabolic to hyperbolic SPDEs and from exponential to rational Milstein schemes. Moreover, root-mean-square error estimates are strengthened to pathwise uniform estimates. Numerical experiments validate the convergence rates for the stochastic Schrödinger equation. Further applications to Maxwell's and transport equations are included.
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.
Real-world spatial intelligence requires reasoning over a continuous and evolving 3D world, yet existing VLMs and tool-augmented agents largely remain tied to static, stateless inference from isolated visual observations. We introduce \textsc{S-Agent}, a spatial tool-use agentic paradigm for understanding and reasoning over continuous multi-view images and videos. By formulating spatial reasoning as spatio-temporal evidence accumulation rather than isolated frame-level prediction, \textsc{S-Agent} reshapes spatial perception into scene-centric understanding beyond frame-centric recognition. Specifically, \textsc{S-Agent} casts the VLM as a semantic planner that decides what evidence is needed, while a hierarchy of spatial tools and experts grounds objects in 2D, lifts them into 3D geometric evidence, and aggregates this evidence into high-level spatial knowledge (e.g., counting, measurement, orientation, and relative position). Additionally, a temporal memory mechanism, including Scene Memory for maintaining the evolving scene state and Agent Memory for accumulating reasoning context, enables evidence integration across frames and reasoning steps. Comprehensive experiments on multi-view and video spatial reasoning benchmarks show that \textsc{S-Agent} consistently improves both open-source and closed-source VLMs in a training-free manner. Beyond inference-time augmentation, supervised fine-tuning (SFT) on \textsc{S-Agent}-generated spatial trajectories \textsc{S-300K} yields \textsc{S-Agent-8B}, a compact spatial agent that significantly surpasses similar-scale baselines (e.g., Qwen3-VL-8B) and performs comparably to advanced closed-source models (e.g., GPT-5.4 and Gemini 3).