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01.
medRxiv (Medicine) 2026-06-15

Sociodemographic Disparities in Tafamidis Initiation and Clinical Outcomes in ATTR-CM Across the United States

BACKGROUND Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease. Sociodemographic factors may influence time to treatment initiation and resulting clinical outcomes, yet these relationships are poorly characterized. OBJECTIVE Assess the effects of sex and race on tafamidis initiation and subsequent outcomes and their interaction with factors such as ATTR-CM type and social deprivation measures. METHODS A retrospective cohort analysis was conducted using the US Komodo Healthcare Map (01/2016-06/2024) among patients with amyloidosis, identified by ICD-10-CM diagnosis codes. Cumulative incidence of treatment initiation and survival probabilities for cardiovascular-related hospitalization (CVH) or death were estimated by Kaplan-Meier, stratified by sex and race. Cox proportional hazards models were fitted for both endpoints to estimate hazard ratios, adjusting for demographics and clinical characteristics. RESULTS Of 11,311 patients identified, White and Black patients (n=9,223) were included in subsequent analyses. Within 12 months of diagnosis, White women had the lowest cumulative incidence of tafamidis initiation (11.4%), followed by Black women (22.0%), Black men (26.7%), and White men (31.0%). Event-free survival at 12 months was lowest in Black women (42.9%), followed by Black men (46.8%), White women (48.6%), and White men (54.4%). Median (95% CI) time to CVH or death was shortest for Black women (8.0 months [6.8-10.0]) followed by Black men (9.9 months [8.8-12.0]), White women (11.0 months [9.6-13.0]), and White men (15.0 months [14.0-16.0]). CONCLUSIONS In this large, real-world cohort of US patients with ATTR-CM, sex and race contributed to disparities in tafamidis initiation and survival, underscoring compounded disparities in both access and outcomes.

02.
arXiv (CS.CV) 2026-06-18

On-Manifold Variational Learning with Heat-Kernel Priors

Learning unsupervised representations of medical imaging cohorts can reveal clinically meaningful prototypes without expert labels, which are often noisy and fail to capture true pathological heterogeneity. However, existing deep latent-variable models estimate Gaussian mixture priors via Euclidean averaging, producing prototypes that drift off the curved data manifold and degenerate as the number of sub-populations grows. We propose a manifold-anchored variational framework built on a geometry-aware Expectation-Maximization (EM) algorithm, whose M-step selects each sub-population prototype as the graph medoid with the highest diffusion centrality on a heat-kernel-weighted latent graph, ensuring that every prototype remains on-manifold. A Dirichlet energy regularizer enforces geometric smoothness of the latent space, and a per-sub-population uncertainty score enables label-free quality assessment. \rev{The manifold-anchored EM is a general-purpose geometric tool that extends standard EM and applies readily to other latent-variable models beyond this setting.} On cardiac scar and brain MRI benchmarks, our framework attains the highest accuracy among all compared methods, produces the sharpest prototypes reported to date, and remains stable at large sub-population counts where all baselines degenerate.

03.
arXiv (CS.CL) 2026-06-16

A Survey on Agentic Security: Applications, Threats and Defenses

LLM-based agents are now used throughout cybersecurity. While these agents facilitate powerful and autonomous security applications, their autonomy opens up new attack surfaces, and the security community is actively building defenses to secure them. Yet the literature on this subject has grown quickly and unevenly. Existing surveys treat applications, threats, and defenses in isolation, leaving no unified account of how an agent's capabilities, vulnerabilities, and countermeasures interconnect. In this work we present the first holistic survey of the agentic security landscape, structuring the field around the fundamental pillars of Applications, Threats and Defenses. We provide a comprehensive taxonomy of over 260 papers, explaining how agents are used in downstream cybersecurity applications, inherent threats to agentic systems, and countermeasures designed to protect them. In addition, we provide detailed pillar-specific and cross-cutting analyses that show the security-lifecycle coverage of agentic applications, comparison between red-teaming and blue-teaming agents, and the adversarial use of red-teaming applications. On the threat side, we analyze the entry points and agent-loop stages that attacks target, their specificity to the agentic setting, and the threat models they assume. On the defense side, we analyze the prevailing defense strategies, their cost and security trade-offs, and where in the agent lifecycle they are deployed. We further map which defenses cover which attack classes and chart trends in agent architecture, backbone model usage, data modality coverage, and the growth of attack and defense research over time. Taken together, these findings indicate that agentic systems are structurally fragile by default and that securing them will require defenses that span the full agent lifecycle rather than single-layer fixes.

04.
arXiv (math.PR) 2026-06-18

Finite free perpetuities

arXiv:2606.19115v1 Announce Type: new Abstract: We introduce and study finite free perpetuities, defined as monic polynomial solutions of degree $n$ to the affine fixed-point equation \[ p(z) = \mathbb{E}\!\left[ A^{n}\,p\!\left(\frac{z-B}{A}\right)\mathbf{1}_{\{A\neq0\}} \right] + \mathbb{E}\!\left[ (z-B)^n\mathbf{1}_{\{A=0\}} \right], \] where $A$ and $B$ are complex-valued random variables with finite moments up to order $n$. Equivalently, if $p(z)=\mathbb{E}[(z-X)^n]$, then $p$ encodes a truncated moment version of the classical perpetuity equation $X\stackrel{d}{=}AX+B$ with $X$ and $(A,B)$ independent. This places finite free perpetuities between classical perpetuities and free-probabilistic fixed-point laws. We prove existence and uniqueness under weak conditions, and we identify a broad class of admissible pairs $(A,B)$ for which the resulting polynomial has only real, nonnegative zeros. Our approach uses finite free additive and multiplicative convolutions together with a probabilistic representation via the $U$-transform. As a motivating example, we exhibit an explicit family of finite free perpetuities expressed in terms of Jacobi polynomials and show that their empirical root distributions converge to a free-beta-prime law. More generally, for admissible sequences of parameters, we prove weak convergence of the empirical root distributions of finite free perpetuities to the law of a free perpetuity characterized by the corresponding free fixed-point equation. This yields a finite-degree polynomial model approximating free perpetuities and clarifies the connection between classical affine recursions, finite free convolutions, and free probability.

05.
arXiv (CS.CL) 2026-06-19

Trustworthy Multi-Agent Systems: Mitigating Semantic Drift with the Argent Signaling Protocol

When multi-agent LLM systems produce bad answers, not all failures are equal: some answers are grounded in the right material but incomplete, while others are simply ungrounded and should be stopped. Current retry strategies treat both cases identically (try again and hope for the best), leaving human supervisors unable to tell whether a retry was warranted or whether the system should have halted instead. We introduce the Argent Signaling Protocol (ASP), a compact machine-readable header that accompanies every AI-generated response with structured quality signals: certainty (@C), grounding (@G), stochasticity (@S), and an assumption index that classifies the evidentiary basis of each claim. These signals enable a controller to distinguish repairable failures from containment failures and route each case differently. We evaluate ASP in two modes. In standalone mode, a 27-question document-grounded QA benchmark over the Array BioPharma/Ono license agreement compares baseline prompts against ASP-instrumented controller actions across three local GGUF models. On Qwen~(0.8B), ASP improves pass rate from 11.1% to 33.3% and mean term coverage from 36.7% to 65.4%; on Dobby~(8B), ASP produces 4 fail-to-pass recoveries, raising pass rate from 33.3% to 44.4%; on SmolLM3~(3B), ASP alternates between repair and containment per question. Aggregate improvement is meaningful (12/81 to 21/81 passes). In multi-agent mode, an ASP sidecar sits between a retrieval agent and a downstream decision agent; the sidecar blocks 100% of ungrounded upstream outputs from reaching the downstream agent (24/27 blocked, 0 ungrounded propagations).

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

MA-DLE: Speech-based Automatic Depression Level Estimation via Memory Augmentation

Speech-based automatic estimation of depression levels is essential for enabling early detection and timely intervention, particularly in resource-constrained mental health settings. In recent years, deep learning has demonstrated impressive success across various domains, including affective computing and mental health assessment. Most existing approaches rely on RNN-based architectures (such as LSTM and GRU) to model temporal information for depression estimation. However, the extracted features often emphasize only a few adjacent speech segments, limiting their ability to capture long-range dependencies. To overcome this limitation, we introduce a memory-based feature augmentation method that enhances the representational capacity of GRU-extracted features. Rather than indiscriminately incorporating historical data, our memory bank is designed to selectively integrate two types of components in order to reduce redundancy and irrelevance: (1) historical temporal features that closely resemble the current GRU output, offering complementary contextual information; and (2) dynamic memory features identified based on feature variability, which capture behavioral and emotional fluctuations indicative of depressive symptoms. To effectively fuse the memory-augmented features with GRU outputs, we further design a Hierarchical Attention Fusion (HAF) module. Our method is evaluated on the widely used DAIC-WOZ and E-DAIC datasets, achieving state-of-the-art performance.

07.
arXiv (CS.CV) 2026-06-16

EmoZone-Talker: Regional Semantic Control of Audio-Driven 3DGS Talking Heads via Facial Action Units

3D Gaussian Splatting (3DGS) has shown strong potential for high-fidelity talking head synthesis. However, enabling fine-grained, interpretable, and editable facial expression control remains fundamentally challenging due to intrinsic conflicts between speech-driven facial dynamics and explicit expression signals. Existing methods rely on implicit multimodal fusion, leading to spatial entanglement and temporal instability. We present EmoZone-Talker, a novel framework that reformulates audio-driven facial animation as a structured spatial-temporal coordination problem under cross-modal conflicts. Our approach introduces an explicit spatial disentanglement and temporal dynamics modeling of facial motion. Specifically, we propose Synergy Zones with Prioritized Attention Bias (SZ-PAB) to explicitly decouple modality contributions via region-wise constraints guided by anatomical priors, and a Channel-Independent Temporal AU Encoder (CIT-AE) to model temporally coherent AU dynamics. By integrating these representations into 3D Gaussian deformation, EmoZone-Talker enables precise and interpretable control over facial expressions. Extensive experiments demonstrate that our method improves expression controllability and realism, with notable gains in upper-face accuracy and temporal coherence, while preserving high rendering quality and accurate lip synchronization. Code will be publicly released to facilitate reproducibility and further research.

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

Automated ultrasound doppler angle estimation using deep learning

arXiv:2508.04243v2 Announce Type: replace-cross Abstract: Angle estimation is an important step in the Doppler ultrasound clinical workflow to measure blood velocity. It is widely recognized that incorrect angle estimation is a leading cause of error in Doppler-based blood velocity measurements. In this paper, we propose a deep learning-based approach for automated Doppler angle estimation. The approach was developed using 2100 human carotid ultrasound images including image augmentation. Five pre-trained models were used to extract images features, and these features were passed to a custom shallow network for Doppler angle estimation. Independently, measurements were obtained by a human observer reviewing the images for comparison. The mean absolute error (MAE) between the automated and manual angle estimates ranged from 3.9{\deg} to 9.4{\deg} for the models evaluated. Furthermore, the MAE for the best performing model was less than the acceptable clinical Doppler angle error threshold thus avoiding misclassification of normal velocity values as a stenosis. The results demonstrate potential for applying a deep-learning based technique for automated ultrasound Doppler angle estimation. Such a technique could potentially be implemented within the imaging software on commercial ultrasound scanners.

09.
bioRxiv (Bioinfo) 2026-06-18

Benchmarking attention-based methods for vision transformers' interpretability in retinal fundus imaging

Deep learning models based on Vision Transformers (ViTs) have shown strong performance in retinal fundus imaging, but their interpretability remains poorly understood. In particular, attention-based attribution methods are widely used to explain ViT predictions, despite limited evaluation of their faithfulness and biological relevance in medical imaging. Here, we systematically benchmark four attention-based interpretability methods for RETFound, a retinal ViT-based foundation model, that we previously fine-tuned to predict 17 retinal vascular phenotypes from UK Biobank fundus images1. We compare raw attention, attention rollout, gradient-weighted attention rollout, and Chefer's hybrid relevance-based method using both qualitative visualisation and quantitative evaluation frameworks. To assess attribution faithfulness, we perform perturbation-based deletion and insertion experiments, quantifying changes in model predictions as highly attended image regions are progressively removed or restored. To evaluate biological specificity, we run structure-aware analyses combining attribution maps with vessel segmentation and artery-vein labels through the Relative ratio of Attention Intensity (RAI) metric. Across models, attribution maps differed substantially depending on the selected interpretability method, highlighting the need for rigorous quantitative evaluation. Among the evaluated approaches, gradient-weighted attention rollout consistently achieved the strongest perturbation performance and produced attribution maps most closely aligned with the anatomical definition of the predicted retinal traits. Furthermore, vessel-type specific models systematically concentrate attention on the corresponding vascular structures despite being trained using only a single scalar value per image as supervision. These findings demonstrate that attention-based attribution methods capture biologically meaningful vascular representations, while also revealing method-dependent variability in attribution behaviour. This work provides a quantitative framework for evaluating interpretability methods in medical imaging with annotated segmentation and contributes toward more transparent and biologically grounded medical AI systems.

10.
arXiv (CS.AI) 2026-06-19

Structuring and Tokenizing Distributed User Interest Context for Generative Recommendation

arXiv:2606.20554v1 Announce Type: cross Abstract: Generative recommendation is an emerging paradigm that has shown promise in industrial recommendation systems, aiming to predict users' next interactions from their historical behaviors. At the core of generative recommendation lies item tokenization, which bridges item semantics and recommendation models. However, existing methods often struggle to effectively organize and inject complex user-behavioral and item-semantic contexts into recommendation models simultaneously. On the one hand, existing graph-based integration methods, such as graph serialization and graph neural networks, either suffer from scalability issues or exploit only local graph information. On the other hand, existing semantic tokenization methods typically rely on heuristics and lack explicit supervision signals, which may lead to inaccurate or suboptimal semantic representations. To address these limitations in user interest context modeling, we propose G2Rec, a scalable framework that unifies holistic graph-based user co-engagement modeling with semantic tokenization for industrial-scale generative recommendation. Overall, G2Rec enables recommendation models to capture holistic and semantically grounded user interest prototypes without requiring ground-truth user interests, thereby providing more comprehensive and accurate modeling of user behavior contexts in industrial sequential recommendation. Online deployment across product surfaces and extensive experiments on public datasets demonstrate the superiority of G2Rec over existing methods.

11.
Nature Biotechnology 2026-06-05

Structural motif search across the protein universe with Folddisco

作者:

Detecting similar protein structural motifs in large structure collections is computationally expensive. We developed Folddisco, a fast structural motif search tool that uses an index of position-independent geometric features, including side-chain orientation, combined with a rarity-based scoring system. Folddisco is 20-fold faster in querying and fourfold more storage-efficient than existing methods while improving accuracy. Folddisco is freely available online ( https://folddisco.foldseek.com ), along with a webserver ( https://search.foldseek.com/folddisco ). Folddisco enables protein structural motif search in million scale databases.

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

Nonslop: A Gamified Experiment in Human-AI Collaborative Writing

arXiv:2606.12350v1 Announce Type: new Abstract: The rapid proliferation of large language models (LLMs) raises critical questions about human creativity and individual expression in an era of AI-assisted creation. When do humans adopt AI suggestions, and what are the implications for individual voice? This study examines these questions through a gamified writing exercise where 74 participants (214 responses) replied to prompts while AI-generated word suggestions were available as they wrote. The game simulates a dystopian future in which an AI is attempting to learn from what remains of human individuality, and disincentivizes AI-like writing. In doing so, it attempts to create conditions that reveal authentic user preferences rather than default behaviors, such as accepting a readily available AI-generated suggestion. Note that this is a deliberate inversion of the "helpful assistant" design pattern; the system is explicitly forbidding you from accepting AI suggestions. We analyze user behavior patterns across different task types, user behaviors, and response characteristics to understand the factors influencing human-AI interaction in creative tasks. The study focuses on when users choose to maintain creative autonomy versus violating the rules of the game and accepting AI assistance. It also explores how these choices relate to response patterns, task characteristics, and user behavior. This gamified approach offers both a framework for studying authentic human-AI interaction and a provocative lens for understanding the tension between efficiency and authenticity in AI-augmented creativity.

13.
arXiv (CS.AI) 2026-06-18

TRIDENT: Breaking the Hybrid-Safety-Physics Coupling for Provably Safe Multi-Agent Reinforcement Learning

arXiv:2606.18308v1 Announce Type: cross Abstract: Safe coordination in networked cyber-physical systems forces learning algorithms to simultaneously handle hybrid discrete-continuous actions, hard training-time safety constraints, and physics-governed dynamics. We show that these three features form a directed cycle of biases that defeats any naive composition of off-the-shelf modules, and formalize this as a three-way coupling lemma. We then introduce TRIDENT, the first MARL framework whose three components are co-designed to cancel each leak: a Richardson-Romberg gradient correction reducing Gumbel-Softmax bias from O(tau) to O(tau^2), a Lyapunov-constrained sequential trust-region update enforcing per-iterate feasibility, and a physics-informed residual critic that decomposes value rather than reward. We prove an O~(1/sqrt(K)) convergence rate to a constrained Nash equilibrium and an O(sqrt(K)) cumulative-violation bound. On multi-UAV mobile-edge computing, autonomous intersection management, and a hybrid SMAC variant, TRIDENT cuts training-time violations by 95.5% over MADDPG and 76.3% over MACPO, while improving reward by 13.5% over the strongest unconstrained baseline.

14.
arXiv (CS.CV) 2026-06-15

Catching magnetic resonance imaging outliers in artificial intelligence-supported radiotherapy workflows: unsupervised detection and localization of image anomalies using deep learning

Artificial intelligence is increasingly integrated into radiotherapy workflows, yet such pipelines remain vulnerable to out-of-distribution image data that may introduce unexpected behavior in clinical tasks. Deep learning-based anomaly detection for pelvic magnetic resonance imaging (MRI) remains largely unexplored, and transparent evaluation of its feasibility for full automation is limited. We developed and evaluated a fully automated, unsupervised anomaly-detection framework for pelvic and brain MRI. A two-stage framework was trained on reference images from public datasets: LUND-PROBE for pelvic MRI, and IXI, fastMRI, and fastMRI+ for brain MRI. In the first stage, MRI slices were compressed into discrete tokens; in the second, the distribution of normal tokens was modeled. Anomaly evidence was estimated by combining perceptual image differences with token-surprisal scores based on negative log-likelihood. Automated detection was evaluated on pelvic MRI with synthetic global and real clinical anomalies, and on brain MRI with clinically annotated fastMRI+ abnormalities. Sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and false-positive behavior in held-out normal cases were assessed. The framework achieved robust detection across hidden evaluation cohorts, with AUCs of 0.97 (95% CI, 0.95-0.98) and 0.81 (95% CI, 0.74-0.87) for pelvic and brain MRI, respectively. Heatmap analysis showed strong spatial agreement between detected anomalies and ground-truth locations, supporting localization accuracy and interpretability. These results support the potential of unsupervised anomaly detection as an automated MRI quality-control layer for radiotherapy workflows, with transparent visualization of image regions likely to compromise downstream AI-based tasks.

15.
medRxiv (Medicine) 2026-06-16

Language fMRI lateralization success and head motion in pediatric epilepsy patients with ADHD, and improvements based on fMRI task training

Introduction Language functional MRI (fMRI) is a valuable tool for presurgical planning in epilepsy. Functional MRI can be challenging in children, and head motion can compromise its utility. The candidacy of patients with ADHD for fMRI is sometimes queried regarding concerns about possible head motion. In 2020, we implemented an fMRI task training program, via telehealth and/or mock MRI. We aimed to determine whether training increased language lateralisation success and/or reduced head motion in all patients, and in those with ADHD. We also aimed to determine whether patients with ADHD exhibited more head motion during fMRI than those without ADHD. Methods We retrospectively identified 223 epilepsy (85%) and other neurosurgery patients, (241 scans including repeats) with language fMRI at Royal Children's Hospital, Melbourne, Australia, 2016-2024. There were 24 individuals with ADHD listed in the Electronic Medical Record, five of whom had diagnoses of both ADHD and autism; and nine with autism. Language lateralisation success was determined by clinician description recorded as left/right/bilateral in the medical record. 99 patients were provided the training including fMRI task practise. Head motion was quantified by maximum Framewise Displacement (FDmax; mm). Results ADHD was associated with lower language lateralisation success. Training was associated with greater language lateralisation success, across all patients, and in those with ADHD. Regarding ADHD and head motion, outliers in FDmax were seen in 5 young patients with ADHD. Data were trimmed to allow separate investigation of FDmax for the sample with and without extremes of head motion. In untrimmed data, FDmax was significantly higher in patients with ADHD than in those without. In trimmed data, FDmax was on average lower in patients with ADHD than those without, however this was not statistically supported. Regarding training and head motion, across all patients, FDmax was significantly lower for scans with training than without. In patients with ADHD, FDmax was on average lower for scans with training, however training was not associated with FDmax. Conclusions Language fMRI training was associated with higher language lateralization success, particularly in patients with ADHD. Training was associated with reduced head motion across all patients. Although some young patients with ADHD had substantial head motion, most in our sample did not move more than those without ADHD. We conclude that the training program increases success of language fMRI, and that an ADHD diagnosis should not be a contraindication to language fMRI.

16.
arXiv (quant-ph) 2026-06-19

Arrival times of an atomic Bose-Einstein condensate

arXiv:2606.20281v1 Announce Type: cross Abstract: The times of flight of an atomic Bose-Einstein condensate are theoretically investigated in the experimentally unexplored regime corresponding to detection close to the trap of the condensate. In this regime, there is no consensus on how to calculate the distribution of times of arrival onto the detector. For non-interacting particles, distinct theoretical predictions have been made in the past. This work analyses how these predictions are modified for an interacting Bose-Einstein condensate. For this purpose, a time-dependent Gross-Pitaevskii equation is solved analytically and numerically.

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

AgenticRec: A Recommendation-Oriented Agentic Framework with Progressive Tool-Integrated Reasoning Optimization

arXiv:2603.21613v2 Announce Type: replace-cross Abstract: Recommender agents built on Large Language Models offer a promising paradigm for personalized recommendation. However, existing agents typically suffer from a misalignment between their tool-integrated reasoning trajectories and recommendation feedback, limiting their ability to distinguish fine-grained user preferences. To address these challenges, we propose AgenticRec, an agentic recommendation framework that formulates recommendation as a tool-integrated reasoning process over a recommendation-oriented tool suite. Built upon this framework, we further develop a dedicated two-stage training paradigm tailored for recommender agents. In the first stage, we introduce Recommendation-Oriented Trajectory Activation, optimize the agentic recommendation ability under implicit feedback. In the second stage, Progressive Preference Refinement further refines the agent through bidirectional preference reasoning over self-bootstrapped hard pairs, progressively sharpening preference boundaries. Theoretical analysis and extensive experiments demonstrate the effectiveness of AgenticRec. Our code is available at https://anonymous.4open.science/r/AgenticRec-FB16.

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

Model soups need only one ingredient

arXiv:2602.09689v2 Announce Type: replace Abstract: Fine-tuning large pre-trained models on a target distribution often improves in-distribution (ID) accuracy, but at the cost of out-of-distribution (OOD) robustness as representations specialize to the fine-tuning data. Weight-space ensembling methods, such as Model Soups, mitigate this effect by averaging multiple checkpoints, but they are computationally prohibitive, requiring the training and storage of dozens of fine-tuned models. In this paper, we introduce MonoSoup, a simple, data-free, hyperparameter-free, post-hoc method that achieves a strong ID-OOD balance using only a single checkpoint. Our method applies Singular Value Decomposition (SVD) to each layer's update and decomposes it into high-energy directions that capture task-specific adaptation and low-energy directions that introduce noise but may still encode residual signals useful for robustness. MonoSoup then uses entropy-based effective rank to automatically re-weigh these components with layer-wise coefficients that account for the spectral and geometric structure of the model. Experiments on CLIP models fine-tuned on ImageNet and evaluated under natural distribution shifts, as well as on Qwen language models tested on mathematical reasoning and multiple-choice benchmarks, show that this plug-and-play approach is a practical and effective alternative to multi-checkpoint methods, retaining much of their benefits without their computational overhead.

19.
medRxiv (Medicine) 2026-06-22

Histologically validated diffusion MRI signatures of neuroinflammation and neurodegeneration in Alzheimer disease

Noninvasive neuroinflammation measurement remains a major barrier for Alzheimer disease (AD) therapeutics. We present generalized diffusion basis spectrum imaging (g-DBSI), a diffusion MRI framework that decomposes the tissue signal into biologically interpretable microstructural compartments. In postmortem Knight ADRC brains, g-DBSI-derived restricted isotropic fraction (RIF) and restricted anisotropic fraction (RAF) mapped cellularity and neurofilament density, while their ratio (RIF/RAF) tracked inflammatory cell density and peri-plaque amyloid-beta with higher specificity and regional consistency than RIF alone. In 112 living Knight ADRC participants stratified by PET amyloid, g-DBSI metrics showed amyloid-dependent trajectories: in low-amyloid individuals, RIF and RAF rose together with amyloid, consistent with early neuropil expansion and glial elaboration, whereas in high-amyloid individuals, RIF/RAF increased, and RAF declined, indicating established neuroinflammatory remodeling and neurofilament loss. CSF proteomics linked RIF/RAF to glia-enriched immune and vascular pathways, supporting g-DBSI as a clinically compatible MRI biomarker of neuroinflammation and neurodegeneration in AD.

20.
medRxiv (Medicine) 2026-06-15

GLLaucoMed: A Secure LLM-Powered Agentic Workflow for Automated Medication Extraction from Free-Text Glaucoma Clinical Notes

Purpose: To evaluate the efficacy of large language models (LLMs) in extracting medication-related information from glaucoma clinical notes in the electronic health record (EHR). Design: Cross-sectional. Subjects: 1,250 subjects in the Bascom Palmer Ophthalmic Repository. Methods: Extracted clinical notes from glaucoma-related encounters between 2014 and 2024 were labeled by two glaucoma specialists with a third serving as an adjudicator. Graders were asked to label current topical medications (CTM), proposed changes to topical medications ({Delta}TM), current oral medications (COM), and proposed changes to oral medications ({Delta}OM) in a structured fashion. The dataset was split into development (10%), validation (10%), and test (80%) sets stratified by clinician. Development and validation sets were used to engineer and refine prompts, and the held-out test set was used for model assessment. Five LLMs (Claude Opus 4.6, DeepSeek-V3.2, GPT 5.2, Grok 4.1, and Qwen3.6-35B-A3B) were accessed via Microsoft Azure AI Foundry within a HIPAA-compliant environment. Inter-grader agreement was assessed with Gwet AC1. LLM performance was initially assessed in a binary fashion with F1 scores, and the degree of text match among positive cases was evaluated using exact match accuracy and Jaccard Index (JI). Main Outcome Measures: F1 score, exact match accuracy, JI. Results: Gwet AC1 for intergrader agreement was 0.799, 0.888, 0.985, and 0.988 for CTM, {Delta}TM, COM, and {Delta}OM, respectively. F1 scores for CTM were 0.985, 0.971, 0.978, 0.968, and 0.970 for Claude, Deepseek, GPT, Grok, and Qwen, respectively; for {Delta}TM: 0.905, 0.826, 0.897, 0.842, 0.855, respectively; for COM: 0.923, 0.887, 0.899, 0.906, 0.894, respectively; for {Delta}OM: 0.958, 0.815, 0.937, 0.835, 0.940, respectively. Among positive cases, range of exact match accuracies for CTM (N=1354) was 0.730- 0.882 and range of JIs was 0.809-0.918. For {Delta}TM (N=404), exact match accuracy range was 0.619-0.780 and JI range was 0.668-0.827. For COM (N=47), exact match accuracy range was 0.766-0.872 and JI range was 0.765-0.870. For {Delta}OM (N=25), exact match accuracy range was 0.583-0.920 and JI range was 0.583-0.922. Conclusions: The GLLaucoMed pipeline demonstrated high performance in extracting and standardizing medication data from unstructured clinical notes, including both current medications and proposed changes. Claude and GPT exhibited the strongest performance.

21.
arXiv (CS.AI) 2026-06-18

Towards an Agent-First Web: Redesigning the Web for AI Agents

arXiv:2606.19116v1 Announce Type: new Abstract: The World Wide Web was built on an assumption held for three decades: the primary consumer of web content is a human being. This permeates every layer; its access model presumes human visitors, its economics rest on human attention, and its content targets human perception. The rapid emergence of AI agents as intermediaries between humans and web content invalidates this assumption. Yet the web resists agents through blanket blocking, CAPTCHA-based exclusion, and economic models that treat agent access as extraction rather than legitimate interaction. This paper proposes a principled redesign across three layers. At the access layer, agents acting for humans should inherit equivalent access rights, governed by rate limiting and agent identification metadata in HTTP requests, analogous to browser headers, alongside a dual-layer architecture serving human-readable and agent-optimized content from the same domain. At the economic layer, we propose an intent-based tier framework grounded in the agent-as-human-proxy principle: an agent's economic obligation mirrors that of the human it represents. A token-based subscription model meters content in tokens rather than pageviews, alongside a commissioned content economy anchoring AI content production in human intentionality. At the content layer, we identify epistemic recursion, the self-referential loop in which AI-generated content is consumed by agents to produce further content, progressively detaching web knowledge from human ground truth. We propose the Agent Text Markup Language (ATML), a four-level human supervision tier model, and a cryptographic provenance chain to counter this threat. Together these constitute ten design principles for an agent-first internet, one in which agents are first-class citizens whose integration requires renegotiating the web's foundational social contract across access, economics, and content.

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

Fermions are fundamentally more nonlocal than Bosons

arXiv:2606.12363v1 Announce Type: new Abstract: Bell's theorem shows that entangled quantum particles can exhibit correlations that classical particles cannot reproduce without an additional nonlocal resource, such as communication. In this sense, quantum particles are fundamentally more nonlocal than classical ones, and entanglement becomes unavoidable in physics. Here we prove the analogous result within quantum theory itself: indistinguishable fermions transmitted through a quantum network can generate correlations that distinguishable particles or indistinguishable bosons cannot reproduce without additional communication. In the same sense, fermions are fundamentally more nonlocal than bosons or distinguishable particles, motivating fermionic anticommutation and indistinguishability as unavoidable operational resources. Our result further implies that fermions can strictly surpass all qubit-based protocols for certain distributed computing tasks, demonstrating that a complete understanding of information processing requires going beyond qubits to fermionic information carriers - febits.

23.
arXiv (CS.AI) 2026-06-16

Probing Low Frame Rate Degradation in Neural Audio Codecs

arXiv:2606.16969v1 Announce Type: cross Abstract: Low frame rates in neural audio codecs are attractive for autoregressive speech synthesis, where the generation cost scales linearly with the sequence length. Recent work has demonstrated that codecs can operate at 12.5 Hz and below, but the mechanisms underlying low frame rate degradation remain insufficiently understood. We investigate these mechanisms through a controlled frame rate ablation. We reproduce a quality cliff at 6.25 Hz reported in previous works and evaluate candidate explanations: phonemic collisions and codebook saturation, neither of which shows evidence of a fundamental barrier. The cliff is instead caused by suboptimal training configuration: fixed clip duration during training yields too few tokens at low frame rates, starving the decoder of inter-token context. Once corrected, WER degrades smoothly with phonemic load down to 3.1 Hz and 1.6 Hz, suggesting the inference-time efficiency gains of low frame rate codecs are more accessible than previously assumed.

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

The Range Shrinks, the Threat Remains: Re-evaluating LLM Package Hallucinations on the 2026 Frontier-Model Cohort

arXiv:2605.17062v2 Announce Type: replace-cross Abstract: Spracklen et al. (USENIX Security '25) showed that code-generating large language models hallucinate package names that do not exist on PyPI or npm at rates ranging from 5.2% on commercial models to 21.7% on open-source models, creating an attack surface for slopsquatting – the registration of malicious packages under hallucinated names. We replicate their methodology on five frontier code-capable LLMs released between October 2025 and March 2026: Claude Sonnet 4.6, Claude Haiku 4.5, GPT-5.4-mini, Gemini 2.5 Pro, and DeepSeek V3.2. Across 199,845 paired Python and JavaScript prompts validated against PyPI and npm master lists, we measure overall hallucination rates between 4.62% (Claude Haiku 4.5) and 6.10% (GPT-5.4-mini) – an order-of-magnitude compression of the inter-model spread observed by Spracklen, but not a retirement of the threat. Beyond replication, we identify a set of 127 package names (109 on PyPI, 18 on npm) that all five evaluated models invent identically; following coordinated disclosure with PyPI Security and Socket.dev, 53 of these (41 on PyPI, 12 on npm) remain registrable by an attacker after each registry's existing defenses, constituting a model-agnostic supply-chain attack surface that no single-model study can reveal. We further document a Python-over-JavaScript hallucination asymmetry that inverts Spracklen's 2024 finding, identify a Haiku-below-Sonnet inversion within the Anthropic family, and observe a Jaccard-similarity peak between DeepSeek V3.2 and GPT-5.4-mini (J = 0.343) suggestive of shared training-data origins.