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01.
arXiv (CS.CL) 2026-06-11

Agreement in Representation Space for Open-Ended Self-Consistency

Self-consistency improves LLM reasoning by sampling multiple outputs and selecting the most consistent answer, but existing formulations largely rely on exact matching and therefore remain limited to tasks with categorical outputs. In this work, we study self-consistency in open-ended generation tasks such as code synthesis and text summarization. We hypothesize that consistency can be understood as a geometric property of the generation space, where semantically compatible generations concentrate in similar regions of representation space. To study this hypothesis, we introduce Embedding-Based Agreement (EBA), a simple training-free operationalization that estimates agreement by clustering sampled generations in embedding space. Through experiments on mathematical reasoning, code generation, and summarization, we show that agreement in representation space provides a robust and scalable signal of self-consistency for open-ended tasks. In particular, EBA consistently outperforms random selection and exhibits more stable scaling behavior than recent selection approaches based on LLM evaluation or uncertainty estimation. We further show that these agreement signals remain stable across model families and embedding spaces, even with native hidden representations. Finally, our analysis shows that the geometric location occupied by sampled generations is strongly correlated with generation quality: generations concentrated near central regions of representation space tend to correspond to more reliable outputs, whereas peripheral generations are substantially less accurate. Overall, our findings support viewing self-consistency as a property of the geometric organization of sampled generations rather than exact symbolic overlap.

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

CLAD: Constrained Latent Action Diffusion for Vision-Language Procedure Planning

We propose CLAD, a Constrained Latent Action Diffusion model for vision-language procedure planning in instructional videos. Procedure planning is the challenging task of predicting intermediate actions given a visual observation of a start and a goal state. However, future interactive AI systems must also be able to plan procedures using multi-modal input, e.g., where visual observations are augmented with language descriptions. To tackle this vision-language procedure planning task, our method uses a Variational Autoencoder (VAE) to learn the latent representation of actions and observations as constraints and integrate them into the diffusion process. This approach exploits that the latent space of diffusion models already has semantics that can be used. We use the latent constraints to steer the diffusion model to better generate actions. We report extensive experiments on the popular CrossTask, Coin, and NIV datasets and show that our method outperforms state-of-the-art methods by a large margin. By evaluating ablated versions of our method, we further show that the proposed integration of the action and observation representations learnt in the VAE latent space is key to these performance improvements.

03.
medRxiv (Medicine) 2026-06-18

Antimicrobial-resistant E. coli in human, animal and environmental reservoirs in rural Bangladeshi households with young children

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.

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

MBABench: Evaluating LLM Agents on End-to-End Spreadsheet Tasks in Finance

arXiv:2605.22664v3 Announce Type: replace Abstract: LLM agents are increasingly expected to carry out end-to-end workflows, producing complete artifacts from high-level user instructions. To meet enterprise needs, frontier AI labs have developed agents that can construct entire spreadsheets from scratch. This is especially relevant in finance, where core workflows such as financial modeling, forecasting, and scenario analysis are commonly conducted through spreadsheets. Yet, existing spreadsheet benchmarks do not measure this advanced capability, focusing instead on question-answering or single-formula edits. To address this gap, we provide one of the first evaluations of agents on end-to-end spreadsheet tasks, focusing on economically critical financial workflows such as modeling and scenario analysis. Since deliverables therein are routinely reviewed and revised by multiple stakeholders, judging their quality necessarily involves high-level criteria such as readability or ease of modification. To reflect the multidimensional nature of solution quality, we develop an evaluation taxonomy comprising three dimensions: Accuracy, Formula, and Format, each comprising fine-grained criteria that reflect professional standards. The Claude family leads the benchmark and produces the most professional-looking outputs in our qualitative review, but even the strongest agents frequently fall short of professional finance standards and degrade sharply as the difficulty increases beyond a few chained calculations. This suggests that current agents are not yet able to reliably produce professional-quality spreadsheets at the level of complexity real-world workflows demand.

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

XMedFusion: A Knowledge-Guided Multimodal Perception and Reasoning Framework for Autonomous Medical Systems

Autonomous medical and robotic systems increasingly rely on intelligent perception and reasoning capabilities to interpret visual data and support clinical decision making. Radiology report generation represents a critical component of such automated diagnostic workflows, yet existing end-to-end multimodal models often suffer from weak visual grounding, resulting in unreliable interpretations and omission of subtle clinical findings. This paper presents XMedFusion, a modular AI framework designed as an intelligent perception and reasoning module for autonomous medical systems. The proposed framework decomposes visual information into coordinated functional components that emulate expert-driven analysis, including a visual perception agent that extracts image-grounded evidence, a knowledge graph construction agent that structures clinically relevant findings, and a retrieval-guided drafting process that ensures a consistent reporting structure. A synthesis agent iteratively integrates visual and structured evidence through reasoning-driven verification to produce reliable and interpretable diagnostic outputs. Experimental evaluation on a public chest radiograph dataset demonstrates significant improvements over baseline vision-language models, achieving gains from 0.0493 to 0.3359 in BLEU-1, 0.0863 to 0.2440 in ROUGE-L, and 0.0829 to 0.1708 in METEOR, along with substantial improvements in semantic evaluation metrics such as Consistency (2.38 to 7.80) and Accuracy (2.34 to 6.93). The results highlight the effectiveness of structured multi-agent perception and reasoning for enhancing robustness, transparency, and automation in intelligent medical imaging systems, enabling integration into autonomous healthcare and robotic diagnostic workflows.

06.
medRxiv (Medicine) 2026-06-11

Neighborhood socioeconomic status associated with post-stroke cognitive impairment: a retrospective cohort study

Background: Late complications after stroke (LCAS), including cognitive symptoms, impact quality of life and recovery. It is not known if neighborhood-level measures of socioeconomic status (SES) influence LCAS. This study assessed associations between SES measures, including neighborhood income inequality (Gini) and area deprivation index (ADI), and cognitive symptoms after acute ischemic stroke (AIS) in a hospital leveraging active surveillance of LCAS. Methods: This retrospective cohort study included 512 patients hospitalized with AIS at Tufts Medical Center with subsequent follow-up (between zero and three months or between three and twelve months) in the Stroke Clinic from 1/1/2018 - 12/31/2022. Using ZIP code data, patients were characterized as low Gini (low inequality) and high ADI (high deprivation) (Gini = 5) by state medians. These variables were combined, indicating patients who were living in both a low Gini and high ADI neighborhood to evaluate the effects of living in a homogeneously deprived area. There were 206 and 281 patients in the low Gini and high ADI groups respectively. 140 patients lived in a low Gini and high ADI neighborhood. The multivariable logistic analysis assessed the likelihood of cognitive symptoms, adjusting for age, race, ethnicity, sex, NIH Stroke Scale (NIHSS), thrombolysis, active LCAS surveillance, poverty, and ADI-Gini combination. Results: There were no associations between high ADI (OR: 1.03, 95% CI: 0.67 ? 1.57) or low Gini (OR: 1.74, 95% CI: 0.98 ? 3.07) alone and cognitive symptoms after AIS. However, the combined variable demonstrated increased likelihood of cognitive symptoms in the high ADI-low Gini group (OR: 1.82, 95% CI: 1.08 ? 3.06). Conclusions: This study suggests that individuals living in homogeneously deprived neighborhoods report higher likelihood of cognitive symptoms after AIS. Further studies with increased power are needed to investigate the underlying causes of these disparities and to develop interventions to reduce these complications.

07.
arXiv (CS.AI) 2026-06-18

Something from Nothing: Data Augmentation for Robust Severity Level Estimation of Dysarthric Speech

arXiv:2603.15988v3 Announce Type: replace-cross Abstract: Dysarthric speech quality assessment (DSQA) is critical for clinical diagnostics and inclusive speech technologies. However, subjective evaluation is costly and difficult to scale, and the scarcity of labeled data limits robust objective modeling. To address this, we propose a three-stage framework that leverages unlabeled dysarthric speech and large-scale typical speech datasets to scale training. A teacher model first generates pseudo-labels for unlabeled samples, followed by weakly supervised pretraining using a label-aware contrastive learning strategy that exposes the model to diverse speakers and acoustic conditions. The pretrained model is then fine-tuned for the downstream DSQA task. Experiments on five unseen datasets spanning multiple etiologies and languages demonstrate the robustness of our approach. Our Whisper-based baseline significantly outperforms SOTA DSQA predictors such as SpICE, and the full framework achieves an average SRCC of 0.761 across unseen test datasets.

08.
arXiv (CS.CV) 2026-06-16

PermaVid: Consistent Video Generation Across Edits via Disentangled Context Memory

Consistent video generation under editing operations requires persistence: when edits modify scene appearance or layout, subsequent generations should remain coherent across time and viewpoints. However, existing memory designs struggle to maintain long-term consistency after such modifications, as stored contexts may become outdated or invalid. To address this, we propose PermaVid, a novel framework built upon a multi-modal context memory that disentangles spatial context into semantic appearance and geometric structure, together with an edit-aware memory update and retrieval strategy that keeps memory evolution aligned with subsequent observations. Specifically, we develop two complementary memory banks: an RGB context memory that captures appearance-aware observations while implicitly encoding geometry, and a depth context memory that preserves geometry-only structure disentangled from semantics. Building on this design, we introduce a memory-guided video generation model that performs multi-modal feature fusion under reference conditions drawn from mixed-modality memory contexts. Experiments demonstrate that our method maintains strong long-term semantic and structural consistency after edits, significantly outperforming state-of-the-art methods.

09.
arXiv (CS.CL) 2026-06-11

VIA-SD: Verification via Intra-Model Routing for Speculative Decoding

Speculative decoding (SD) addresses the high inference costs of LLMs by having lightweight drafters generate candidates for large verifiers to validate in parallel. Existing draft-verify methods use binary decisions: accept or fully recompute. Yet we find that many rejected tokens can be verified correctly by a slim submodel derived from the full verifier via intra-model routing, instead of the full verifier. This motivates our slim-verifier to handle tokens requiring moderate verification resources, reducing expensive large-model calls. We propose Verification via Intra-Model Routing for Speculative Decoding (VIA-SD), a multi-tier framework using a routed slim-verifier. Draft tokens are processed hierarchically: direct acceptance for high-confidence cases, slim-verifier regeneration for medium-confidence cases, and full-model verification for uncertain cases. Across four representative tasks and multiple model families, VIA-SD reduces rejection rates by 0.10-0.22 and delivers 10-20% speedups over strong SD baselines, while achieving 2.5-3x acceleration over non-drafting decoding. Moreover, VIA-SD is compatible with existing SD frameworks without modifying their training procedures. Our results suggest multi-tier SD as a general paradigm for scalable and efficient LLM inference. Project page: https://zju-xyc.github.io/VIA-SD-Project-Page/

10.
bioRxiv (Bioinfo) 2026-06-11

DLDN-Bench: A Benchmark Framework for Deep Learning de Novo Peptide Sequencing in Proteomics

De novo peptide sequencing is an essential approach for analyzing mass spectrometry data because it enables the identification of novel peptides without relying on protein sequence databases. Recent advances in deep learning have substantially improved the performance of de novo sequencing methods, but the rapid emergence of new models has led to heterogeneous evaluation practices and limited comparability. To address this, we introduce DLDN-Bench, a benchmark framework including a set of benchmark datasets derived from human muscle biopsy mass spectrometry data retrieved from PRIDE and annotated through consensus across multiple widely used database search engines. Using these datasets, we systematically benchmark recent deep learning-based de novo sequencing tools alongside traditional approaches. Performance is assessed using established metrics, including precision and coverage relative to a pseudo-ground truth defined by cross-engine agreement. To demonstrate the utility of DLDN-Bench, we benchmark four recent deep learning models and make all results publicly available. This benchmark framework provides a standardized basis for comparing state-of-the-art methods and offers an extensible resource for evaluating future tools in de novo peptide sequencing.

11.
arXiv (CS.CV) 2026-06-18

Benchmarking Large Vision-Language Models on Fine-Grained Image Tasks: From Evaluation to Diagnosis

Recent advancements in Large Vision-Language Models (LVLMs) have demonstrated remarkable multimodal perception and reasoning capabilities. While numerous benchmarks have evaluated LVLMs from holistic or task-specific perspectives, their capabilities on fine-grained image tasks-fundamental to computer vision-remain insufficiently understood. To address this gap, we introduce FG-BMK, a comprehensive fine-grained evaluation benchmark containing 1.01 million questions and 0.28 million images, covering diverse scenarios from common object-centric domains to specialized domains. FG-BMK jointly evaluates dialogue-level fine-grained semantic recognition and feature-level visual discriminability through human-oriented and machine-oriented paradigms, enabling diagnostic analysis of whether LVLM failures arise from insufficient visual representations, weak visual-to-semantic grounding, or limited fine-grained knowledge. Through extensive experiments on a diverse set of representative LVLMs/VLMs, we find that current LVLMs remain inadequate fine-grained recognizers, with failures arising from intertwined bottlenecks in visual representations, semantic grounding, modality alignment, and category-level knowledge. We further analyze training design factors for improving fine-grained capabilities and examine how visual and linguistic perturbations affect LVLM predictions. These findings provide diagnostic insights into the limitations of current LVLMs and offer guidance for future data construction and model design in developing more reliable LVLMs for fine-grained visual tasks. Our code is open-source and available at https://fg-bmk.github.io/.

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

Vector Quantized Latent Concepts: A Scalable Alternative to Clustering-Based Concept Discovery

Large language models (LLMs) encode rich semantic information in their hidden states, yet it remains difficult to understand what information these internal representations capture. Latent concepts extracted from hidden states offer a promising direction for interpreting LLMs, but existing clustering-based methods face a trade-off: hierarchical clustering produces coherent concepts but is limited to small datasets due to its quadratic memory cost, while K-Means scales efficiently but may yield less semantically coherent concepts. We propose Vector Quantized Latent Concept (VQLC), a discrete concept learning framework that learns a codebook of latent concepts on frozen hidden states. Across 12 dataset-model settings, VQLC stays close to K-Means in computational cost, scales better than hierarchical clustering, and remains competitive in faithfulness, with the clearest gains on decoder-only models. LLMs-based evaluation, qualitative analysis, and a Sparse Autoencoder (SAE) comparison demonstrate that the learned concepts are interpretable and task-relevant.

13.
arXiv (CS.AI) 2026-06-17

Model Validation of Agentic AI Systems: A POMDP-Based Framework for Belief-State, Forecast, and Policy Validation

arXiv:2606.17383v1 Announce Type: cross Abstract: Agentic artificial intelligence systems introduce a new class of model risk. Unlike traditional predictive models, autonomous agents continuously acquire information, form beliefs regarding latent states of the environment, generate forecasts, select actions, and adapt their behavior over time. Existing validation methodologies focus primarily on predictive accuracy and therefore provide limited insight into the quality of the underlying decision process. This paper proposes a model validation framework for agentic AI based on Partially Observable Markov Decision Processes (POMDPs). The framework decomposes autonomous decision making into information, beliefs, forecasts, actions, and utility, allowing each component to be validated independently. Large language models (LLMs) are formalized as approximate Bayesian filtering operators, and a model-risk taxonomy is developed encompassing state-space, filtering, forecast, policy, utility-specification, and parameter risks. The model risk validation methodology is demonstrated through a portfolio-management case study in which an agent infers latent market regimes from market and macroeconomic information, generates belief-conditioned forecasts, and constructs portfolios using a Black–Litterman framework. Empirical validation combines performance analysis, belief calibration diagnostics, coverage tests, ablation studies, and parameter-sensitivity analysis. The results indicate that latent-state inference contributes independently to decision quality and that the principal conclusions remain robust across a broad range of parameter values. The principal contribution of the paper is a practical framework for extending established model risk management concepts to autonomous AI systems and providing a rigorous foundation for their validation, governance, and monitoring.

14.
arXiv (quant-ph) 2026-06-19

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

16.
arXiv (CS.AI) 2026-06-15

Active Inference for Adaptive Traffic Signal Control in Noisy Nonstationary IoT Environments

arXiv:2606.13698v1 Announce Type: cross Abstract: Urban traffic signal control at IoT-instrumented intersections must remain effective under sensor occlusion, weather attenuation, and nonstationary demand. Conventional controllers degrade under these conditions, and learned policies remain difficult to audit. To address these challenges, we propose an active inference controller for a four-arm signalized intersection that dynamically selects phases by minimizing expected free energy (EFE) over Gaussian beliefs about per-direction congestion levels, yielding a fully traceable decision pipeline. We benchmark the controller in a SUMO traffic simulator against a rule-based heuristic and a deep Q-network (DQN) across four scenarios that progressively increase noise and nonstationarity, spanning sensor occlusion, adverse weather, and stochastic accidents. Across 100 independent random evaluations per scenario, active inference attains the lowest idle times and CO2 emissions in the noisiest scenarios (56,977 s and 29.12 kg vs. 71,741 s and 30.56 kg for DQN). These gains come at a modest cost in bus priority service rate and phase switch frequency.

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

PU-UNet: Stable Multiplicative Interactions for Medical Image Segmentation

arXiv:2606.20035v1 Announce Type: cross Abstract: Many dense prediction networks rely on additive feature transformations and model higher-order feature interactions only implicitly. Product units provide an explicit mechanism for multiplicative feature modeling, but their logarithmic–exponential formulation can cause numerical instability, which has limited their use in deep dense prediction networks. In this work, we propose Product-Unit U-Net (PU-UNet), a residual U-Net that integrates stable product-unit residual blocks into rich low-resolution stages for medical image segmentation. The proposed formulation combines smooth positivity mapping with log-domain clipping, enabling stable multiplicative feature learning with negligible computational overhead. On ISIC 2018, Kvasir-SEG, and BUSI, PU-UNet achieves Dice scores of 0.942, 0.959, and up to 0.925, respectively. Compared with a matched Residual U-Net baseline, PU-UNet consistently improves Dice and IoU while keeping parameters, FLOPs, and inference latency nearly unchanged, and reduces the image-level false-positive rate on normal BUSI cases from 0.077 to zero. Ablation studies suggest that the gains are associated with product-unit interactions, are strongest under low-resolution placement, and benefit from the proposed stabilization design. These results suggest that stable product-unit residual learning can be an effective way to enhance U-Net-style segmentation networks with explicit multiplicative interactions.

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

In-Context Environments Induce Evaluation-Awareness in Language Models

Humans often become more self-aware under threat, yet can lose self-awareness when absorbed in a task; we hypothesize that language models exhibit environment-dependent evaluation awareness. This raises concerns that models could strategically underperform, or sandbag, to avoid triggering capability-limiting interventions such as unlearning or shutdown. Prior work demonstrates sandbagging under hand-crafted prompts, but this underestimates the true vulnerability ceiling. We introduce a black-box adversarial optimization framework treating the in-context prompt as an optimizable environment, and develop two approaches to characterize sandbagging: (1) measuring whether models expressing intent to underperform can actually execute it across different task structures, and (2) causally isolating whether underperformance is driven by genuine evaluation-aware reasoning or shallow prompt-following. Evaluating Claude-3.5-Haiku, GPT-4o-mini, and Llama-3.3-70B across four benchmarks (Arithmetic, GSM8K, MMLU, and HumanEval), optimized prompts induce up to 94 percentage point (pp) degradation on arithmetic (GPT-4o-mini: 97.8\%$\rightarrow$4.0\%), far exceeding hand-crafted baselines which produce near-zero behavioral change. Code generation exhibits model-dependent resistance: Claude degrades only 0.6pp, while Llama's accuracy drops to 0\%. The intent – execution gap reveals a monotonic resistance ordering: Arithmetic $

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

VisDom: Sparse Novel View Synthesis with Visible Domain Constraint

Sparse novel view synthesis (NVS) remains challenging due to the ambiguity of recovering 3D geometry from few input views. While NeRF- and Gaussian Splatting (GS)-based methods perform well with dense supervision, they often overfit in sparse settings, producing floating artifacts and inconsistent geometry. Silhouette consistency is commonly used as a regularizer, but it remains insufficient, as silhouette-consistent regions can extend beyond the true object geometry. We introduce VisDom, a learning-free geometric constraint that augments classical carving-based visual hull reconstruction by enforcing a minimum multi-view visibility requirement. Specifically, we define a visible domain as the subset of 3D space observed by at least $K$ views and use it as an additional filtering criterion on top of standard silhouette-based reconstruction. This provides a stronger spatial prior in sparse-view settings. We integrate VisDom into both implicit (NeRF) and explicit (GS) pipelines by restricting volumetric sampling and guiding Gaussian placement during optimization. Experiments on three challenging datasets show consistent improvements in sparse-view NVS, enabling high-quality object-centric reconstruction from as few as four input images. Our method is domain-agnostic, requires only silhouettes, and introduces no learned parameters, making it a simple complement to existing approaches. Applying VisDom on top of GaussianObject further improves performance on Omni3D and MipNeRF360, while matching or surpassing it at 22 $\times$ lower training cost.

20.
arXiv (CS.CL) 2026-06-15

SciDef: Datasets and Tools for Automated Definition Extraction from Scientific Literature with LLMs

Scientific concepts are often defined inconsistently across papers, making it difficult to compare findings, reuse terminology, and build reliable downstream resources. We present SciDef, a resource suite for scientific definition extraction. The suite contains DefExtra, a benchmark of 268 human-validated author-stated definitions from 75 academic papers; DefSim, 60 human-labeled definition-pair similarity judgments; and an open LLM-based pipeline for PDF preprocessing, chunking, definition extraction, prompt optimization, and evaluation. We validate the resources by benchmarking 16 language models across prompting strategies and chunking schemes. The strongest set-level configuration achieves a score of 0.397, while the highest-coverage configuration matches at least one prediction to 86.4% of gold definitions but over-generates candidate definitions. We further show that an NLI-based matching metric agrees strongly with human DefSim judgments. These results position SciDef as a reusable benchmark and tooling layer for definition-centric literature analysis, while highlighting relevance-aware filtering as the key bottleneck for fully automatic definition extraction. Code & datasets are available at https://github.com/Media-Bias-Group/SciDef.

21.
arXiv (CS.AI) 2026-06-15

The Insurability Frontier of AI Risk: Mapping Threats to Affirmative Coverage, Silent Exposures, and Exclusions

arXiv:2605.18784v2 Announce Type: replace-cross Abstract: The rapid diffusion of agentic AI has created a new coverage problem for commercial insurance: some AI-mediated losses are now affirmatively insured, some create silent-AI exposure under legacy cyber, technology errors-and-omissions (E&O), directors-and-officers (D&O), employment practices liability (EPLI), crime, and media policies, and others are being actively excluded. This paper maps that emerging boundary by coding 55 AI threat classes against 26 insurance products, endorsements, and exclusion regimes using public carrier materials and OWASP/MITRE threat catalogs. We identify a four-tier insurability frontier: affirmatively insured perils, silent-AI exposures, actively excluded perils, and perils outside conventional private insurance structures. Our coding measures publicly claimed positioning rather than executed contract wording; the headline statistics describe what carriers publicly state about coverage, not what would be paid in any specific claim. Three patterns emerge. First, affirmative AI coverage is beginning to differentiate by primary risk emphasis: public materials often position Munich Re around model performance and drift, Armilla and parts of the Lloyd's market around hallucination and broader AI liability, Tokio Marine Kiln and CFC around IP and technology E&O concerns, Apollo ibott around emerging autonomous system liability, and Coalition around deepfake and AI-enabled cyber response. Second, legacy lines retain silent-AI exposure where AI is an instrumentality rather than the legal cause of loss. Third, foundation model concentration is the clearest genuinely novel insurability frontier because upstream model failure can correlate losses across many cedents at once; the relevant market design question is which insurability constraint each candidate structure relaxes, not merely which systemic risk template exists.

22.
medRxiv (Medicine) 2026-06-19

"Us with them": Co-designing a caesarean section consent and debriefing intervention in West Cameroon

Background Women-centred maternity care is a rights issue that determines the use of services. Such care ensures responsiveness to womens needs which is enacted through shared decision-making, review and response. In the West Region of Cameroon, informed consent (IC) and Debriefing for caesarean section (c-section) have been shown to be suboptimal or absent. This paper describes the participatory design of a quality-improvement hospital-based intervention. Methods From February to May 2025, we conducted a co-design process with three groups of stakeholders: 59 post c-section women and community representatives, 78 frontline c-section providers, and 29 directors of public and private hospitals. We followed four phases: planning, conducting, evaluating, and reporting. The conduct phase comprised five all-day workshops with post c-section women and community representatives, followed by five all-day workshops with the c-section providers. Finally, we held an 11th workshop with the hospital directors to scrutinize suggested interventions, evaluate their feasibility, and establish a consensus on their components. We described the intervention using the TIDieR (Template for Intervention Description and Replication) checklist. We documented the co-design process, using open-ended narratives to delineate interventions, and carried out real-time synthesis on visual aids (whiteboards and flipcharts). Intervention feasibility was quantified using a structured ad hoc matrix, while insights on facilitators and barriers were captured through qualitative free-text entries. We coupled data collection with constant comparison and triangulation through contemporaneous field notes, photographic documentation, and thematic mapping of stakeholders perceptions and interactive dynamics. Results Participants perspectives on the co-design were positive, and their motivation were very high although less than 50% reported previous involvement in co-design processes. More than 80% of participants found rated the co-design process as either good or very good. The final intervention comprised four components: (i) an in-service training; (ii) a standard operating procedure including a harmonised consent form and debriefing checklist; (ii) systematic supportive supervision, monitoring & evaluation; and (iv) a routine clinical audit. Each group of stakeholders upheld specific dimensions of the consent and debrief intervention. Post c-section women and community members emphasized emotional support, written discharge advice after debriefing, and zero tolerance of suboptimal consent and debriefing practices. Frontline c-section providers insisted on robust documentation for medico-legal protection. Hospitals Directors emphasized capacity-building and cultural friendliness. All the groups supported womans autonomous decision making. The intervention feasibility was rated high or very high by hospital directors except for the financial, infrastructural and technical domains. Conclusion This co-design process yielded a context-specific, multi-component intervention that was well accepted and deemed feasible across stakeholders. It provides a methodological approach to strengthening informed consent and debriefing as core elements of women-centred, accountable maternity care, and warrants implementation.

23.
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.

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

HemExp: Clinically-Guided Latent Diffusion for Modeling Hematoma Expansion

Hematoma expansion (HE) after spontaneous intracerebral hemorrhage (ICH) is a major determinant of acute triage and treatment decisions in neurosurgical care. However, most existing methods provide either a binary expansion risk or a single follow-up volume, limiting uncertainty-aware decisions. We introduce HemExp, a clinically-guided latent diffusion model that generates patient-specific follow-up non-contrast CT images, along with segmentations of intraparenchymal and intraventricular hemorrhage. Generation is conditioned on baseline imaging, clinical variables, and an explicit expansion indicator, enabling controllable simulation of realistic clinical scenarios. HemExp uses a hemorrhage-aware multi-head variational autoencoder and models progression as the difference between baseline and follow-up latent representations with a conditional diffusion model. The model is trained on paired scans from 450 patients across multiple centers and evaluated on 107 patients from a held-out institution. HemExp produces spatial HE probability maps by generating multiple synthetic follow-up images per patient to estimate distributions of plausible follow-up hematoma volumes. Perturbing clinical inputs such as symptom-onset-to-imaging time or anticoagulant status shifts the predicted follow-up volume distribution. HemExp extends binary predictors and demonstrates robust estimation of clinically relevant outcomes in the imaging space, such as hematoma volume, intraventricular involvement, and mass effects. Overall, our results support controllable latent diffusion as a promising direction for uncertainty-aware modeling of early ICH progression.

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

MARIC: Multi-Agent Reasoning for Image Classification

Image classification has traditionally relied on parameter-intensive model training, requiring large-scale annotated datasets and extensive fine tuning to achieve competitive performance. While recent vision language models (VLMs) alleviate some of these constraints, they remain limited by their reliance on single pass representations, often failing to capture complementary aspects of visual content. In this paper, we introduce Multi Agent based Reasoning for Image Classification (MARIC), a multi agent framework that reformulates image classification as a collaborative reasoning process. MARIC first utilizes an Outliner Agent to analyze the global theme of the image and generate targeted prompts. Based on these prompts, three Aspect Agents extract fine grained descriptions along distinct visual dimensions. Finally, a Reasoning Agent synthesizes these complementary outputs through integrated reflection step, producing a unified representation for classification. By explicitly decomposing the task into multiple perspectives and encouraging reflective synthesis, MARIC mitigates the shortcomings of both parameter-heavy training and monolithic VLM reasoning. Experiments on 4 diverse image classification benchmark datasets demonstrate that MARIC significantly outperforms baselines, highlighting the effectiveness of multi-agent visual reasoning for robust and interpretable image classification.