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01.
bioRxiv (Bioinfo) 2026-06-10

Is level-1 blob reconstruction under the network multispecies coalescent easy?

作者:

Hybridization is an important evolutionary process, commonly modeled by the network multispecies coalescent. Reconstructing evolutionary histories under this model is notoriously costly, even for level-1 networks where hybridization events are isolated from each other. The widely used methods that combine speed with statistical guarantees rely on quartet concordance factors computed for all subsets of four species, resulting in an o(n^4k) bottleneck that severely limits scalability to large numbers of species (n) and genes (k). Among quartet-based methods, NANUQ+ is notable because it decomposes the problem into two steps: first reconstructing a tree of blobs, which compresses each non-treelike part of the network, called a blob, into a single vertex, and second reconstructing the internal structure of each level-1 blob, specifically its circular order and hybrid vertex. Here, we investigate whether level-1 blob reconstruction is difficult once the tree of blobs is known. We present a fast and statistically consistent algorithm, called NetCS, based on two simple primitives: majority voting and merge sort, circumventing the bottleneck of computing all quartet concordance factors. In simulations, NetCS achieved comparable accuracy to NANUQ+ and was dramatically faster, enabling analyses of 200 taxa and 1000 genes in only a few minutes. Both methods attained near-perfect accuracy when given the true tree of blobs; however, their performance degraded in end-to-end pipelines due to errors in tree of blobs reconstruction. Strikingly, even methods that reconstruct level-1 networks directly struggled to accurately predict hybrid ancestry. Our results suggest that reconstructing level-1 blobs is unexpectedly easy once the tree of blobs is known, and that a major challenge for phylogenetic network inference lies in accurate tree of blobs reconstruction.

02.
Nature (Science) 2026-06-16

Daily briefing: How many elementary particles are there?

作者:

Estimates range from 17 to 995.5. Plus, one man with paralysis is using a brain–computer interface at home and GLP-1 obesity drugs appear to boost testosterone and sperm quality. Estimates range from 17 to 995.5. Plus, one man with paralysis is using a brain–computer interface at home and GLP-1 obesity drugs appear to boost testosterone and sperm quality.

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

BindEdit: Taming Attention Leakage for Precise Multi-Object Image Editing

Real image editing enables precise manipulation of visual content, yet existing methods often fail in complex multi-object scenarios, causing semantic blending, object duplication, or incomplete edits. We attribute these failures to attention leakage, where signals across spatial regions and text tokens become entangled during the denoising process. Specifically, we identify two distinct forms of leakage: Edit-Token Leakage, where ambiguous token-region alignment leads to object blending, and Source Dominance Leakage, where tokens of unchanged source objects overwhelm the attention intended for target entities. To resolve these leakages, we propose BindEdit, which enforces attention-level constraints within a single diffusion trajectory. To suppress Edit-Token Leakage, BindEdit jointly regularizes cross- and self-attention so that each target token group is bound to its corresponding spatial region while maintaining instance-level separation. To suppress Source Dominance Leakage, a cross-attention re-balancing mechanism amplifies target token influence and attenuates residual source semantics within editable regions. Moreover, a region fidelity term ensures that each target concept is expressed coherently across the entire editing mask. Additionally, we propose a comprehensive multi-object benchmark encompassing diverse object counts and categories. Extensive experiments demonstrate that BindEdit consistently outperforms existing methods within a single diffusion trajectory, maintaining robust performance across both single- and multi-object editing scenarios.

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

Integrating Reasoning and Generalization in Text-to-SQL via Self-Enhanced Fine-Tuning

arXiv:2606.15598v1 Announce Type: new Abstract: Text-to-SQL aims to translate natural language questions into executable SQL queries over structured databases, enabling non-expert users to access data intuitively. While recent advances in large language models (LLMs) have shown promise in this task, existing LLM-based approaches often struggle to strike a balance between strong reasoning capabilities and robust generalization. To address these limitations, we propose CoTE-SQL to enhance the LLM-based text-to-SQL generation with three key innovations: (i) self-enhanced reasoning traces distilled from LLMs without human annotation, (ii) structured chain-of-thought (CoT) prompting with modular decomposition and examples retrieval, and (iii) error-aware revision based on SQL execution feedback. Extensive experiments on the Spider and Bird benchmarks demonstrate that CoTE-SQL achieves new state-of-the-art performance among methods built on open-source LLMs with comparable model sizes on Bird (53.39% EX / 59.02 VES) and strong results on Spider (79.60% EX / 77.19 VES), with especially significant gains on complex queries. Results highlight the effectiveness of combining self-enhancement, structured reasoning, and execution-time feedback within an LLM-based framework for text-to-SQL design.

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

State-Grounded Multi-Agent Synthetic Data Generation for Tool-Augmented LLMs

Training tool-augmented LLM agents requires large corpora of multi-turn, tool-grounded conversational data that is expensive to annotate, privacy-constrained in production settings, and largely absent from public datasets. We present StateGen, a synthetic data generation platform that produces scored, reasoning-trace-rich training conversations by orchestrating a four-role LLM loop: a persona-conditioned user simulator, an agent under test, a state-grounded tool simulator, and a multi-axis LLM judge. The key architectural contribution is an authoritative state manager that maintains a structured world-state object across turns, enforcing a backend-is-truth invariant that eliminates the dominant class of tool-call hallucinations by construction. StateGen extends naturally to hierarchical multi-agent settings by declaring sub-agents as tools, all sharing a single state object. We report results on 64,698 evaluated conversations across three production corpora: tool-call hallucination scores reach 9.66/10, the system supports persona-driven variation via a 23-dimensional trait vector, and a cleanly separated train and golden evaluation set split confirms the data is not memorization bait (per-criterion gap analysis). Comparison with eight external systems shows that no single publicly available platform combines multi-turn generation, state-grounded tool simulation, hierarchical multi-agent support, and built-in judge scoring.

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

A Quantum Encoding of Traveling Salesperson Tours via Route Generation, Cost Phases, and a Reversible Valid-Permutation Oracle

arXiv:2603.21283v3 Announce Type: replace Abstract: For a traveling salesperson problem (TSP) of n cities, we present a compact quantum encoding based on a time-register representation of tours. A candidate route is represented as a sequence of n-1 city labels over discrete time steps, with one fixed start city and the remaining cities encoded in binary registers. We describe three ingredients of the construction: uniform route generation over the route register, a reversible validity oracle, and a phase oracle that encodes the total tour cost. The validity oracle checks both that the non-start city labels form a permutation and, for incomplete graphs, that every directed edge used by the route exists. The cost oracle then accumulates the start-edge, intermediate-transition, and return-edge costs into a tour-dependent phase for valid routes. This yields a coherent superposition of candidate routes with feasibility and tour-length information embedded directly in the quantum state. The complete construction uses O(n log n) qubits, while a naive implementation has worst-case elementary-gate complexity O(n^3 log n). The encoding is compatible with amplitude amplification or spectral filtering techniques such as the quantum singular value transform (QSVT) or Grover's algorithm. However, due to the exponentially small fraction of valid tours, the overall complexity remains exponential even when combined with amplitude amplification.

07.
arXiv (CS.CV) 2026-06-12

MaskWAM: Unifying Mask Prompting and Prediction for World-Action Models

World Action Models (WAMs) present a promising paradigm for robotic control via video prediction. However, current WAMs suffer from fundamental spatial bottlenecks: standard text inputs introduce referential ambiguity in cluttered scenes, while unstructured RGB predictions lack semantic grounding and remain biased by task-irrelevant backgrounds. To overcome these limitations, we introduce MaskWAM, an object-centric world-action model. By jointly integrating masks as both explicit inputs and predictions via a unified Mixture of Transformers (MoT), MaskWAM unlocks robust policy generalization. This design provides two key benefits: (1) predicting future masks yields object-centric semantic supervision that suppresses visual noise, significantly enhancing even standard text-conditioned WAMs; and (2) coupling this predictive supervision with first-frame visual prompts, such as target object masks, establishes a precise spatial anchor that substantially reduces language ambiguity. Crucially, as WAMs are inherently vision-driven architectures, direct mask conditioning yields substantially stronger guidance than text alone, establishing a precise and robust paradigm for manipulating unseen objects. Evaluations on LIBERO, RoboTwin, and real-world tasks demonstrate that MaskWAM significantly outperforms baselines in both language-clear and language-ambiguous tasks.

08.
arXiv (CS.CV) 2026-06-12

Emerging Flexible Designs for Geospatial Multimodal Foundation Models

Foundation models are rapidly transforming Earth observation by enabling scalable pretraining across diverse unlabeled geospatial modalities. However, their architectural diversity ranging from encoder-only to encoder-decoder and masked autoencoding paradigms makes it challenging to assess performance trade offs in a consistent manner. In this work, we present an apples-to-apples comparison of leading FM architectures designed for geospatial multimodal reasoning, with a particular focus on flexibility across varied spectral band configurations. We standardize pretraining using identical self supervised learning objectives and training datasets, and evaluate all models under consistent parameterization on the GEOBench benchmark across classification and segmentation tasks. Our results offer new insights into the design trade-offs between model flexibility, modality alignment, and downstream task performance. By highlighting architectural strengths and limitations under controlled conditions, this study provides practical guidance for building next generation geospatial foundation models capable of robust multimodal reasoning.

10.
arXiv (CS.LG) 2026-06-17

Eigen-Spike Emergence and Quadratic Equivalents for Conjugate Kernels on Nonlinearly Separable Data

arXiv:2605.29669v2 Announce Type: replace-cross Abstract: Recent work in random matrix theory (RMT) has developed the notion of deterministic equivalents: typically linear surrogate models that approximate the spectral behavior of large nonlinear random matrices, such as nonlinear feature maps in neural networks (NNs). Such equivalents make theoretical predictions tractable by reducing a complex model to a simpler one with properties that fall under the umbrella of classical RMT tools. However, this leaves open the question of whether this idealized linear equivalence remains meaningful for classification of high-dimensional nonlinearly separable data. Motivated by this, we consider the conjugate kernel (CK), which is the nonlinear feature map of a one-layer feedforward NN, under a canonical nonlinearly separable dataset for the XOR problem; and we use the study of informative outlier eigenvalues in the CK and whether their corresponding eigenvectors asymptotically align with XOR labels as a proxy for nonlinear learnability. We develop a robust quadratic equivalent of the CK matrix that enables a precise analysis of emergent informative spikes, as one modifies various knobs common in ML practice: sample complexity, signal-to-noise ratio (SNR), nonlinear activation choice, and pretrained features. We identify regimes in which these knobs move the CK beyond the linear equivalent and produce BBP-type transitions to label-aligned outlier eigenspaces. Our analysis helps bring deterministic-equivalence tools from RMT to bear on problems of practical relevance in ML.

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

Privacy from Symmetry: Orthogonally Equivariant Transformers for LLM Inference

arXiv:2606.16461v1 Announce Type: new Abstract: Running large language models locally is often impractical, pushing inference on sensitive text to third-party providers. Split inference partially mitigates this by keeping tokens on the client and sending only hidden representations, but these representations can still be recovered via nearest-neighbor search against the public embedding table. We propose an orthogonal obfuscation procedure in which the client multiplies embeddings by a secret orthogonal matrix before transmission. To enable correct inference under arbitrary rotations, we introduce ConjFormer, a transformer variant that is exactly $\mathrm{O}(d)$-equivariant via a lightweight normalization change (scalar RMSNorm) together with blockwise orthogonal conjugation of all linear weights. As a result, the server performs the full forward pass entirely in the rotated basis and never observes unrotated hidden states. Experiments on GPT-2 and Llama 3.2 1B models fine-tuned on PubMed show that orthogonal obfuscation eliminates direct cosine nearest-neighbor inversion and reduces token recovery from over 35% top-10 to at most 1.3%, while increasing perplexity by only 0.4% after fine-tuning. These results indicate that enforcing symmetry at the architectural level can provide a practical defense for privacy-preserving LLM inference without noise injection or heavy cryptographic machinery.

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

REACH: Interpretability-Driven Feature Identification and Architecture Compression for Multi-Channel Vehicular Channel Estimation

arXiv:2606.11857v1 Announce Type: cross Abstract: Multi-channel mixed-SNR training improves out-of-distribution (OOD) generalisation of deep learning channel estimators for IEEE 802.11p vehicular communications, yet the internal mechanism responsible for this remains unexplained. This work presents REACH (Relevance-based Explanation and Architectural Compression for cHannel estimators), a gradient-based interpretability framework that operates at two levels. Input-level attribution identifies a subset of time-frequency features consistently relevant across all evaluated channel conditions, enabling input dimensionality reduction with minimal performance loss. Filter-level attribution reveals a near-universal internal representation, providing a representational account of the observed OOD generalisation. Guided by the resulting filter taxonomy, relevance-guided architecture compression substantially reduces both the number of parameters and the number of floating-point operations (FLOPs) with sub-1 dB normalised mean square error (NMSE) degradation, and OOD generalisation degrades more slowly than within-distribution accuracy under increasing compression.

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

Learning to Annotate Delayed and False AEB Events: A Practical System for Extreme Class Imbalance and Asymmetric Label Noise

arXiv:2606.19186v1 Announce Type: cross Abstract: Autonomous Emergency Braking (AEB) optimization relies on accurately annotated real-world trigger events, particularly rare but critical delayed and false AEB triggers that expose system deficiencies. However, these minority samples comprise less than 5% of thousands of daily triggers, making manual annotation prohibitively expensive at scale. We present the first automated AEB annotation framework to address this problem. During development, we identified two fundamental challenges that severely impair delayed/false trigger annotation accuracy: (1) Extreme class imbalance where delayed/false triggers are overwhelmed by true triggers; (2) Asymmetric label noise where mislabeled majority samples (true triggers) suppress minority samples (delayed/false triggers) learning. To overcome these challenges, we propose two key innovations: (1) Specific data augmentation that synthesizes realistic samples by manipulating focal target attributes, transplanting ego-vehicle dynamics, and masking non-focal agents; (2) noise suppression using stable hardness estimation and probe-guided adaptive threshold to clean mislabeled true trigger samples. Crucially, we deploy our model as a practical annotation system with full-stack architecture, efficiently identifying critical delayed/false triggers from thousands of daily AEB events. Production results demonstrate 80% improvement in recall of delayed/false triggers and 50% reduction in manual workload. Beyond immediate gains, the system enables continuous self-improvement through accumulated high-quality annotations, establishing a necessary data foundation for on-vehicle AEB system optimization

14.
medRxiv (Medicine) 2026-06-15

Poly-Social Risk for Hypertension Among Black and Latina Women

Background: Hypertension is a leading modifiable cardiovascular risk factor prominently influenced by health-related social needs (HRSN). Whether detailed information on HRSN can improve identification of hypertension among minoritized women is unknown. Methods: Black and Latina women aged 18-65 years completed the Centers for Medicare and Medicaid Services Accountable Health Communities Screening Tool, assessing 13 HRSN domains. Hypertension was ascertained by a validated EHR-based algorithm or self-report of hypertension. Logistic regression tested associations of HRSN with hypertension. LASSO regression with 10-fold cross-validation was used to derive a poly-social risk score in the training set (random 70%) and tested in the validation set (30%) against a sociodemographic model (age, race, income, education). Results: Among 1302 participants (mean [SD] age 40.1 [11.3] years, 70.4% Black, 44.3% Latina), higher cumulative burden of HRSN was associated with increased odds of hypertension (adjusted odds ratio [aOR] for each additional domain of HRSN: 1.07 [95% CI 1.01-1.14], P=0.02). Food insecurity (aOR 2.30 [1.37-3.87], P= 0.002), lapse in utilities (aOR 1.44 [1.04-1.96], P=0.02), poor concentration (aOR 1.57 [1.13-2.17], P=0.007), and social isolation (aOR 1.77 [1.14-2.73], P=0.01) were associated with hypertension. In the validation set, the poly-social risk score did not improve discrimination for hypertension vs. the sociodemographic model (AUC 0.76 [95% CI 0.71-0.81] vs. AUC 0.80 [0.75-0.85]). Conclusion: In this cross-sectional analysis of Black and Latina women, greater cumulative social disadvantage was associated with hypertension. While inclusion of HRSN did not improve hypertension prediction beyond conventional sociodemographic indices, findings may inform targeted interventions among minorities at cardiometabolic risk.

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

RGFVR: Reference-Guided Face Video Restoration with Flow Matching

Face video restoration from degraded observations is challenging, as it requires simultaneously recovering visual fidelity, temporal consistency, and subject identity. Existing approaches are often either reference-free, which can lead to identity loss when person-specific facial details are lost, or subject-specific, which limits generalization to unseen identities. We propose a subject-agnostic, reference-guided framework for identity-preserving face video restoration. Our method introduces bimodal perceptual-descriptive identity conditioning into a pretrained flow-based text-to-video generator and employs a two-stage training strategy to strengthen identity guidance during restoration. Experiments show that our approach improves restoration fidelity, temporal consistency, and identity preservation, achieving superior performance under challenging video degradations, including downsampling, blur, noise, and compression artifacts. The code is available under: https://github.com/batuhanntosun/RG-FVR.

17.
medRxiv (Medicine) 2026-06-10

Development of a Novel Blood-Based Assay for Brain-Derived Tau and Its Validation in Traumatic Brain Injury

Brain-derived tau (BD-tau) is an emerging blood-based biomarker for neurodegeneration, yet there are currently limited well validated BD-tau assays available for research and clinical use. To enhance access to this vital biomarker for neurological disorders including traumatic brain injury (TBI), we developed a novel blood-based immunoassay for BD-tau on the ultra-sensitive Quanterix HD-X platform using Single Molecule Array technology. Analytical validation assessed dilution linearity, specificity, precision, detection limits, and spike recovery, each recording robust metrics in agreement with international expert recommendations. The assay demonstrated robust validation metrics, achieving between-run stability of 95% when analyzing aliquots from six independent plasma and serum samples across five analytical runs. It also showed strong dilution linearity when diluted four-fold and achieved over 90% recovery when spiked with cerebrospinal fluid. Next, we evaluated the clinical utility of the assay in cohorts of individuals with traumatic brain injury (TBI), where strong performances were recorded whether using the 2-step or 3-step assay formats ({rho}= 0.94; p < 0.0001). Furthermore, plasma BD-tau distinguished samples from TBI patients based on time from injury and severity (AUC=0.93). Plasma BD-tau differentiated between favorable and unfavorable functional outcomes in the acute-severe group. Our findings underscore the significant potential of the BD-tau assay as a biomarker for TBI in the severe phase.

18.
arXiv (math.PR) 2026-06-16

Universality in the target arrival statistics of non-conservative search processes

arXiv:2606.16025v1 Announce Type: cross Abstract: Stochastic search processes in which searchers are continuously introduced to and removed from a target search domain are fundamental to a wide class of physical and artificial systems. The theory of such non-conservative search processes is, however, much less developed than for search processes with a fixed number of particles. Here we exploit a natural mapping between non-conservative stochastic search and queueing theory to derive the full time-dependent distribution of target arrivals under minimal assumptions on the underlying search process. Remarkably, we find that the steady-state inter-arrival time distribution is exactly exponential, regardless of the details of the search process, showing a robust universality that emerges directly from the queueing framework. Thus, counterintuitively, the arrival statistics of a non-conservative search process are much simpler than sequential search-and-capture processes involving a fixed number of searchers. This has major implications for target resource accumulation, where the delivery of resources is counter-balanced by their downstream consumption.

19.
arXiv (CS.LG) 2026-06-16

Incentives and Evidence in Learned Service Orchestration

arXiv:2606.16555v1 Announce Type: cross Abstract: Reinforcement learning for service orchestration has been the subject of sustained research for over a decade, yet it is not used in production at scale. The usual explanation is that learned controllers degrade under delayed and noisy telemetry, workload shifts, and uncontrolled tenants. We test whether existing evidence supports that explanation. We evaluate three highly influential RL-based orchestration systems spanning resource allocation, DAG scheduling, and autoscaling, using pre-registered predictions about comparative degradation under production-relevant perturbations and paired inference with family-wise error correction. Across the tests, most predicted performance reversals do not occur. Diagnostic analyses show that these outcomes often reflect comparator collapse, artefact limitations, or evaluation choices rather than evidence that learned controllers tolerate the perturbations. One apparent advantage under observation lag is roughly fortyfold compared to a Kubernetes HPA-equivalent controller. Another widely cited result cannot be reconstructed from its released artefact, and the strongest reproducible margin is far smaller than the published results. Conclusions also reverse under changes in perturbation magnitude and evaluation mode. Based on these results and broader patterns in the literature, we identify an institutional problem. Publication and review incentives favour benchmark gains against convenient comparators, even when those gains provide little evidence of deployment performance. We argue that the problem is not solely technical. Rather, it is institutional, so learned orchestration needs production-grade comparators, registered perturbation models, separate operational metrics, and publication criteria that reward reproducible operational evidence. Without these changes, the literature can grow without establishing whether learning improves orchestration.

20.
PLOS Medicine 2026-06-01

The NIH 2025 Public Access Policy: Immediate access, unequal costs

by Caitlin R. Ryus, Caroline Raymond King, Edward R. Melnick The NIH 2025 Public Access Policy eliminates embargo periods for federally funded research, expanding who can read science. Yet without addressing article processing charges and market concentration, the policy risks creating new barriers to who can afford to perform and publish their science. In this Perspective, Caitlin Ryus and colleagues discuss the NIH 2025 Public Access Policy, highlighting that while expanding who can read science, the policy risks creating new barriers to who can afford to perform and publish their science.

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

KGEdit: Ambiguity-Aware Knowledge Graphs for Training-Free Precise Video Generation and Editing

In recent years, training-free video generation has progressed remarkably. However, when handling complex textual instructions, existing methods still suffer from semantic ambiguity, incorrect concept binding, and cross-frame inconsistency. To address these issues, we propose KGEdit, a structured semantic control framework for text-to-video (T2V) diffusion models. Specifically, we first construct an ambiguity-aware knowledge graph (AAKG) to disentangle and disambiguate the input prompt, converting it into four types of structured semantics: identity, relation, attribute, and negative constraints. We then design a structured semantic injection module (SSIM) to inject these semantic signals into key layers of the diffusion Transformer, enabling fine-grained semantic control. In addition, we introduce a temporal-aware semantic control (TASC) module that dynamically schedules semantic objectives according to the stage-wise characteristics of the denoising process, further improving semantic alignment and temporal consistency. Experiments show that KGEdit outperforms existing methods in editing precision and temporal stability, while offering higher efficiency and controllability in text-driven interaction scenarios.

22.
arXiv (quant-ph) 2026-06-17

Effects of Josephson Junction Non-idealities on Adiabatic Quantum Flux Parametron Circuits

arXiv:2606.17338v1 Announce Type: new Abstract: Adiabatic quantum flux parametron (AQFP) gate is a promising approach to scale up the cryogenic microwave electronics for superconducting qubit multiplexed control. However, the performance of these circuits depends on the quality of the Josephson junctions which are ideally superconductor-insulator-superconductor (SIS) type following the ideal sinusoidal relation between current and quantum phase. We demonstrate how the non-sinusoidal current-phase relation in Superconductor-Normal metal-Superconductor (SNS) and weak link (WL) junctions affects the speed, delay, and margin of the AQFP gates. The JJ models are defined in the Keysight ADS simulator using symbolically defined device (SDD) method.

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

AVA-VLA: Improving Vision-Language-Action models with Active Visual Attention

Vision-Language-Action (VLA) models have shown remarkable progress in embodied tasks recently, but most methods process visual observations independently at each timestep. This history-agnostic design treats robot manipulation as a Markov Decision Process, even though real-world robotic control is inherently partially observable and requires reasoning over past interactions. To address this mismatch, we reformulate VLA policy learning from a Partially Observable Markov Decision Process perspective and propose AVA-VLA, a framework that conditions action generation on a recurrent state that serves as a neural approximation to the agent's belief over task history. Built on this recurrent state, we introduce Active Visual Attention (AVA), which dynamically reweights visual tokens in the current observation to focus on regions most relevant given both the instruction and execution history. Extensive experiments show that AVA-VLA achieves state-of-the-art performance on standard robotic benchmarks, including LIBERO and CALVIN, and transfers effectively to real-world dual-arm manipulation tasks. These results demonstrate the effectiveness of temporally grounded active visual processing for improving VLA performance in robotic sequential decision-making. The project page is available at https://liauto-dsr.github.io/AVA-VLA-Page.

24.
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.