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01.
Nature Medicine 2026-06-15

Blood signatures of cell type-specific aging forecast disease risk and resilience

作者: 未知作者

By measuring thousands of proteins in blood samples from over 60,000 people, we built molecular ‘clocks’ to estimate how fast cells age. Our analyses show that cell types age at different rates within the same person. Accelerated aging of specific cell types is associated with increased disease risk, whereas slower aging of others is linked to protection and improved survival.

02.
arXiv (CS.AI) 2026-06-12

Geometric and Quantum Kernel Methods for Predicting Skeletal Muscle Outcomes in chronic obstructive pulmonary disease

arXiv:2601.00921v3 Announce Type: replace-cross Abstract: Chronic obstructive pulmonary disease (COPD) affects hundreds of millions of people worldwide, and skeletal-muscle dysfunction is clinically important. Quantum machine learning is increasingly explored for biomedical prediction, but its value in small biomarker cohorts requires benchmarking against strong classical baselines. We analysed a cigarette-smoke COPD cohort of 213 animals with blood and bronchoalveolar-lavage biomarkers to predict tibialis anterior muscle weight, muscle quality, and force. We developed a kernel-geometric quantum hybrid method in which synthetic symmetric positive definite (SPD) references are mapped through a reproducing kernel Hilbert space, compressed using train-only random projection, normalised, and supplied to low-dimensional quantum regression circuits. We benchmarked this approach against classical ridge/kernel models, SPD relational representations, and quantum-kernel regression (QKR). All methods were evaluated using condition-stratified repeated cross-validation. The largest numerical improvement was observed for muscle weight, where the proposed method had the numerically lowest mean root mean squared error (RMSE), approximately 1.8% below the best classical comparator; paired fold-level testing did not establish statistically significant superiority after Holm adjustment, but the endpoint is biologically meaningful. The method also had the numerically lowest mean RMSE for muscle quality. For force, biomarker-only Ridge performed best, suggesting a more linear endpoint structure.

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

What Must Generalist Agents Remember?

arXiv:2606.18746v1 Announce Type: new Abstract: This paper develops a formal account of what generalist agents must store in memory in order to act near-optimally across multiple environments and goals. It shows that when two domains share an observational bottleneck but require incompatible optimal actions, any uniformly near-optimal policy must induce distinct memory distributions at that bottleneck. The result yields a separation theorem: sufficiently successful agents cannot rely only on current state observations, but must preserve domain-relevant information in memory. The paper further shows that if an agent's memory contains enough information to estimate values for related goals, then that memory can be used to approximately reconstruct the agent's local transition dynamics. Together, these results characterize memory as the substrate that supports domain disambiguation, transition-model reconstruction, and planning for generalist agents.

04.
arXiv (CS.AI) 2026-06-17

Prototype-Based Semantic Consistency Alignment for Domain Adaptive Retrieval

arXiv:2512.04524v4 Announce Type: replace-cross Abstract: Domain adaptive retrieval aims to transfer knowledge from a labeled source domain to an unlabeled target domain, enabling effective retrieval while mitigating domain discrepancies. However, existing methods encounter several fundamental limitations: 1) neglecting class-level semantic alignment and excessively pursuing pair-wise sample alignment; 2) lacking either pseudo-label reliability consideration or geometric guidance for assessing label correctness; 3) directly quantizing original features affected by domain shift, undermining the quality of learned hash codes. In view of these limitations, we propose Prototype-Based Semantic Consistency Alignment (PSCA), a two-stage framework for effective domain adaptive retrieval. In the first stage, a set of orthogonal prototypes directly establishes class-level semantic connections, maximizing inter-class separability while gathering intra-class samples. During the prototype learning, geometric proximity provides a reliability indicator for semantic consistency alignment through adaptive weighting of pseudo-label confidences. The resulting membership matrix and prototypes facilitate feature reconstruction, ensuring quantization on reconstructed rather than original features, thereby improving subsequent hash coding quality and seamlessly connecting both stages. In the second stage, domain-specific quantization functions process the reconstructed features under mutual approximation constraints, generating unified binary hash codes across domains. Extensive experiments validate PSCA's superior performance across multiple datasets.

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

A Unified Definition of Hallucination: It's The World Model, Stupid!

Despite numerous attempts at mitigation since the inception of language models, hallucinations remain a persistent problem even in today's frontier LLMs. Why is this? We review existing definitions of hallucination and fold them into a single, unified definition wherein prior definitions are subsumed. We argue that hallucination can be unified by defining it as simply inaccurate (internal) world modeling, in a form where it is observable to the user. For example, stating a fact which contradicts a knowledge base OR producing a summary which contradicts the source. By varying the reference world model and conflict policy, our framework unifies prior definitions. We argue that this unified view is useful because it forces evaluations to clarify their assumed reference "world", distinguishes true hallucinations from planning or reward errors, and provides a common language for comparison across benchmarks and discussion of mitigation strategies. Building on this definition, we also connect our framework to HalluWorld, a complementary benchmark that instantiates fully specified reference world models for stress-testing model hallucinations.

06.
Nature (Science) 2026-06-10

Human migration has surged since 2000 — these maps reveal where people are going

Modelling with artificial-intelligence tools has filled gaps in migration data, revealing detailed global population movements from 1990 to 2023. Modelling with artificial-intelligence tools has filled gaps in migration data, revealing detailed global population movements from 1990 to 2023.

07.
arXiv (CS.CL) 2026-06-24

Do LLM Attribution Metrics Transfer? Auditing Retrieval-Augmented Generation Evaluation Across Datasets and Constructs

Practice often treats automatic metrics for attribution in LLM retrieval-augmented generation as interchangeable. We audit eight automatic scorers – lexical, embedding, and BERTScore baselines alongside entailment/grounding-trained models (clean and FEVER NLI, the checker MiniCheck) – across three evaluation constructs (provenance/topicality, generated-answer attribution, and fact-check entailment), asking whether any scorer transfers: stays within the 95% confidence interval of the best audited scorer on every dataset of a multi-dataset construct. In the construct with the most multi-dataset human-labeled coverage – generated-answer attribution (AttributionBench's four source datasets, n = 1,610, with independent HAGRID, n = 2,150) – none does: the per-dataset metric rankings invert (Kendall tau = -0.64, p = 0.031 on AttributedQA vs. LFQA), and an off-the-shelf NLI scorer that is best on short-claim AttributedQA (AUROC 0.90) collapses to AUROC 0.53 (chance) on long-form LFQA, where BERTScore wins (0.91); the flip is not a length or truncation artifact. This instability has a concrete decision cost: a naive "best-on-average" rule for choosing an evaluator fails leave-one-dataset-out (mean held-out regret 0.172 AUROC, worse than fixing one scorer), so metric choice must be validated on the target dataset rather than learned from others. A prompt-based LLM judge avoids the chance-level collapses the automatic scorers suffer (no LFQA collapse) but is not uniformly best, ~100x costlier, and non-deterministic – relocating, not removing, the validation burden.

08.
medRxiv (Medicine) 2026-06-22

Impact of Antidiabetic Medications on IgG and Plasma Protein N-Glycosylation in Type 2 Diabetes Patients

Introduction. Diabetes is a growing global health challenge, necessitating effective management strategies. Glycosylation, a highly regulated post-translational protein modification, has emerged as a pivotal factor in diabetes pathophysiology. However, the modulation of protein glycosylation by antidiabetic treatment is still largely unknown. This study explored the longitudinal effects of four distinct antidiabetic therapies - metformin, insulin, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and glucagon-like peptide-1 receptor agonists (GLP-1RA) - on plasma protein and immunoglobulin G (IgG) glycosylation in patients with type 2 diabetes (T2D). Research Design and Methods. Plasma protein and IgG N-glycans were enzymatically released, purified and chromatographically profiled in a cohort of 124 patients, examined at four time points, to assess therapy-induced glycan alterations. Linear mixed models adjusting for covariates and multiple testing (FDR

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

DrivingAgent: Design and Scheduling Agents for Autonomous Driving Systems

Many autonomous driving systems are increasingly incorporating foundation models to improve generalization and handle long-tail scenarios. However, this trend introduces two key challenges: (i) the manual and labor-intensive process of designing and integrating new models, and (ii) the lack of intelligent, dynamic scheduling mechanisms to meet strict real-time constraints. While Large Language Model (LLM)-based agents offer a promising avenue for automation, existing frameworks are ill-suited for autonomous driving. Specifically, they fail to distinguish between the fundamentally different requirements of system design and real-time scheduling, treat modules as opaque black boxes, and are not designed for continuous operation. To address these limitations, we propose DrivingAgent, a novel agent framework tailored to the dual challenges of autonomous driving system design and scheduling. In the design phase, DrivingAgent automates module development by interpreting system architecture, generating code, and validating modules via super-network training. In the scheduling phase, it employs a lightweight LLM trained with reinforcement learning to dynamically orchestrate system modules in real time, supported by a structured memory that integrates long-term storage with timestamped short-term context. Experimental results demonstrate that DrivingAgent achieves a superior speed–accuracy trade-off on both the nuScenes and Bench2Drive benchmarks.

10.
arXiv (CS.CL) 2026-06-18

Want Better Synthetic Data? Steer It: Activation Steering for Low-Resource Language Generation

Large language models (LLMs) have become an effective tool for synthetic data generation, including for low-resource languages, where generated data can improve downstream task performance. Current best-performing approaches typically rely on few-shot prompting with target-language examples, which increases inference costs and may reduce diversity through lexical anchoring. In this work, we investigate activation steering as an alternative for low-resource synthetic data generation. We study two steering strategies: Language Steering, which targets the linguistic identity of a language, and Quality Steering, which captures well-formedness by contrasting human-written and backtranslated text representations. We evaluate these methods across four open-source LLMs, multiple layers, and 11 typologically diverse languages by generating sentiment and topic classification data and finetuning smaller classifiers. Steering is applied in both zero-shot and few-shot prompting settings and compared against non-steered counterparts. Our results show that steering on early layers consistently improves the diversity of generated data while often yielding stronger downstream model performance, particularly for low-resource languages.

11.
arXiv (CS.CL) 2026-06-24

Business as Rulesual: A Benchmark and Framework for Business Rule Flow Modeling with LLMs

Extracting structured procedural knowledge from unstructured business documents is a critical yet unresolved bottleneck in process automation. While prior work has focused on extracting linear action flows from instructional texts, such as recipes, it has insufficiently addressed the complex logical structures, including conditional branching and parallel execution, that are pervasive in real-world regulatory and administrative documents. Furthermore, existing benchmarks are limited by simplistic schemas and shallow logical dependencies, restricting progress toward logic-aware large language models.To bridge this Logic Gap, we introduce BREX, a carefully curated benchmark comprising 409 real-world business documents and 2,855 expert-annotated rules. Unlike prior datasets centered on narrow service scenarios, BREX spans over 30 vertical domains, covering scientific, industrial, administrative, and financial regulations. We further propose ExIde, a structure-aware reasoning framework that investigates five distinct prompting strategies, ranging from implicit semantic alignment to executable grounding via pseudo-code generation. This enables explicit modeling of rule dependencies and provides an out-of-the-box framework for different business customers without finetuning their own large language models. We benchmark ExIde using 13 state-of-the-art large language models. Our extensive evaluation reveals that executable grounding serves as a superior inductive bias, significantly outperforming standard prompts in rule extraction. In addition, reasoning-optimized models demonstrate a distinct advantage in tracing long-range and non-linear rule dependencies compared to standard instruction-tuned models.

12.
arXiv (CS.LG) 2026-06-18

RNN(p) for Power Consumption Forecasting

arXiv:2209.01378v3 Announce Type: replace Abstract: An elementary Recurrent Neural Network that operates on p time lags, called an RNN(p), is the natural generalisation of a linear autoregressive model ARX(p). It is a powerful forecasting tool for variables displaying inherent seasonal patterns across multiple time scales, as is often observed in energy, economic, and financial time series. The architecture of RNN(p) models, characterised by structured feedbacks across time lags, enables the design of efficient training strategies. We conduct a comparative study of learning algorithms for these models, providing a rigorous analysis of their computational complexity and training performance. We present two applications of RNN(p) models in power consumption forecasting, a key domain within the energy sector where accurate forecasts inform both operational and financial decisions. Experimental results show that RNN(p) models achieve excellent forecasting accuracy while maintaining a high degree of interpretability. These features make them well-suited for decision-making in energy markets and other fintech applications where reliable predictions play a significant economic role.

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

MAMVI: 3D Test-Time Adaptation via Masked Multi-View Point Clouds

3D point cloud models suffer significant performance degradation under distribution shifts caused by sensor noise, occlusions, and environmental changes. Test-time adaptation (TTA) has emerged as a practical paradigm for mitigating this issue during inference. Recently, leveraging multi-view augmentation has shown promise in improving 3D TTA performance. However, existing multi-view approaches are often constrained by sequential optimization that treats each view independently. This sequential optimization leads to substantial inference latency due to repetitive optimization steps, making real-time adaptation impractical. To address this, we propose Masked Multi-View Test-Time Adaptation (MAMVI), which replaces sequential optimization with a unified single-step adaptation. Specifically, MAMVI utilizes a hybrid masking strategy that combines fixed ratios for stability with Beta-distributed sampling for diversity. By aggregating losses across multiple views, MAMVI performs adaptation through a single backward pass based on multi-view consensus. Additionally, a confidence-based adaptive learning rate is used to dynamically adjust the adaptation intensity for each sample. Extensive experiments on ModelNet-40C, ShapeNet-C, and ScanObjectNN-C demonstrate that MAMVI achieves state-of-the-art accuracy on ShapeNet-C and ScanObjectNN-C. Moreover, it remains competitive on ModelNet-40C while delivering 4.9-8.9 times faster inference, making it highly suitable for real-time applications. Our code is available at https://github.com/Inseok-kong/MAMVI

14.
arXiv (CS.LG) 2026-06-12

Estimating Individualized Treatment Effects in Acute Ischemic Stroke with Causal Transformation Models (TRAM-DAG): A Multi-Centre Observational Study with External RCT Validation

arXiv:2606.12623v1 Announce Type: cross Abstract: Personalized medicine in acute ischemic stroke requires moving beyond average treatment effects (ATE) to individualized treatment effect (ITE) estimates to support treatment decisions. In acute ischemic stroke, mechanical thrombectomy has been shown to be more effective on average than lysis in randomized controlled trials (RCTs), such as the MR CLEAN study. We aim to identify which individual patients benefit most from mechanical thrombectomy compared to lysis. The outcome of interest is the modified Rankin Scale (mRS) at three months, an ordinal measure of functional disability (0: no symptoms, 6: death). We demonstrate that causal transformation models on directed acyclic graphs (TRAM-DAG) can be used for ITE estimation after being fitted on observational MAGIC multi-center stroke patient data. To ensure comparability with the MR CLEAN population, which we use for validation, we train the TRAM-DAG on a MAGIC sub-population with NIHSS at admission >= 6, corresponding to one inclusion criterion of MR CLEAN. The fitted model is then used to estimate ITEs for stroke patients in the MR CLEAN population. While these ITE estimates cannot be confirmed experimentally, we show that their average is consistent with the trial's reported ATE. Furthermore, the ITE estimates correctly rank trial patients by their observed frequency of a good outcome (mRS at three months

15.
arXiv (CS.LG) 2026-06-18

Robust and Interpretable Adaptation of Equivariant Materials Foundation Models via Sparsity-promoting Fine-tuning

arXiv:2606.18691v1 Announce Type: new Abstract: Pre-trained materials foundation models, or machine learning interatomic potentials, leverage general physicochemical knowledge to effectively approximate potential energy surfaces. However, they often require domain-specific calibration due to physicochemical diversity as well as mismatches between practical computational settings and those used in constructing the pre-training data. To address this, we propose a sparsity-promoting fine-tuning method that selectively updates model parameters by exploiting the structural properties of E(3)-equivariant materials foundation models. On energy and force prediction tasks across molecular and crystalline benchmarks, our method matches or surpasses full fine-tuning and equivariant low-rank adaptation while updating only $\sim$3~\% of parameters, and in some cases as little as $\sim$0.5~\%. Beyond energy and force calibration, we further demonstrate task generalizability by applying our method to magnetic moment prediction and magnetism-aware total energy modeling. Finally, analysis of sparsity patterns reveals physically interpretable signatures, such as enhanced $d$-orbital contributions in transition metal systems. Overall, our results establish sparsity-promoting fine-tuning as a flexible and interpretable method for domain specialization of equivariant materials foundation models.

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

Beyond a Single Explanation of the Adam–SGD Gap

arXiv:2606.14259v1 Announce Type: new Abstract: Prior work has identified several factors that can contribute to the performance gap between Adam and SGD, spanning data aspects, architecture design, and optimization properties. Yet these explanations are often studied in isolation, leaving their relative importance unclear. In this work, we revisit these hypotheses through a controlled empirical study across vision, language, genomics, and graph tasks, spanning modern and classical architectures, and carefully designed training setups. Our results suggest that no single factor consistently explains the Adam–SGD gap. For instance, the Adam advantage can (1) persist under a uniform vocabulary distribution yet nearly disappear under a heavy-tailed one; (2) reverse in favor of SGD in softmax-attention models; and (3) become larger under soft architectural modifications, e.g., when ReLU is replaced by a GeLU nonlinearity. This suggests that the gap arises from nontrivial data and architecture interactions, rather than from a single common factor. Yet, we observe a pattern across our settings: a crossover batch size at which the relative advantage shifts from SGD to Adam as the batch size scales. These empirical results are captured by our theoretical gap model, which predicts this batch-size-dependent crossover. Our perspective helps reconcile several existing hypotheses while offering practical insights across domains.

17.
arXiv (CS.CV) 2026-06-15

Overhead Wildlife Locator (OWL): Benchmarking Weakly Supervised Learning for Aerial Wildlife Surveys

Automated aerial wildlife surveys increasingly rely on deep learning, yet standard object detectors require bounding-box annotations, reported to be up to seven times slower and three times more expensive to produce than point-level labels. To address this bottleneck, we introduce the Overhead Wildlife Locator (OWL), a weakly supervised density-estimation framework with three variants: OWL-C, a fully convolutional model for high-throughput screening; OWL-T, a Swin-augmented hybrid for heterogeneous, cluttered scenes; and OWL-D, built on a frozen DINOv3 ViT-H+/16 encoder with a DPT-style fusion decoder. We benchmark all three against POLO, YOLOv11n, and YOLOv11l across five public aerial datasets, from sparse fixed-wing savanna surveys to dense UAV paddock imagery, and against the published HerdNet baseline on its native Delplanque split. OWL-D sets a new state of the art on Delplanque (0.934 AP vs. HerdNet's 0.840) and records the highest AP on four of the five datasets. Performance is regime-dependent: on the extreme-density SheepCounter UAV dataset the hybrid OWL-T leads (0.978 AP) and the convolutional variants attain the lowest counting error, whereas the foundation-based OWL-D degrades, indicating which variant suits which survey type. We further validate operational readiness on the Alaska Department of Fish and Game's 2022 Central Arctic Caribou census: under cross-herd and cross-temporal transfer, OWL-C fine-tuned on the 2017 Porcupine Caribou Herd split attains F1 = 0.965 on a held-out patch test set, with a signed count error of +3.1% aggregated across the released test patches. We release the OWL code, model weights, and the annotated Porcupine Caribou Herd 2017 (PCH) and Central Arctic Herd 2022 (CAH) patches, the first open patch-level datasets for large-scale caribou aerial surveys, at https://github.com/microsoft/MegaDetector-Overhead.

18.
arXiv (CS.CV) 2026-06-16

RealityBridge: Bridging Editable 3D Gaussian Splatting Driving Simulations and Real-World Videos

Long-tail hazardous scenarios are essential for safety-oriented autonomous driving, yet they are difficult to collect and reproduce at scale. Editable 3D Gaussian Splatting (3DGS) simulation offers a promising alternative by reconstructing real driving scenes and supporting controllable scene editing. However, edited 3DGS-rendered videos still suffer from a significant Sim-to-Real gap, including rendering artifacts, degraded foreground assets, inconsistent illumination, and temporal flickering. Existing restoration and video generation methods are insufficient for this task, as they often fail to jointly repair 3DGS-specific artifacts, improve visual realism, and ensure temporal consistency. To fill this gap, we propose RealityBridge, a structure-preserving and asset-aware Sim-to-Real framework for edited 3DGS driving videos. RealityBridge uses multimodal controls, including rendered videos, foreground masks, edge maps, and semantic masks, together with a lightweight GateNet for adaptive condition allocation across backbone layers. We further construct targeted training data and introduce autoregressive long-video training with reward-guided post-training to improve restoration quality, temporal stability, and hallucination suppression. Extensive experiments on internal and public driving datasets show that RealityBridge outperforms existing methods in artifact removal, illumination harmonization, and long-sequence temporal consistency.

19.
arXiv (math.PR) 2026-06-11

Hilbert space embeddings of independence tests and interaction measures of several variables

arXiv:2411.08653v2 Announce Type: replace-cross Abstract: We present a unified theoretical framework for kernel-based measures of dependence on product spaces. Building on the ideas underlying distance covariance, distance multivariance, and the Hilbert-Schmidt Independence Criterion (HSIC), we define a new family of kernels on an $n$-fold Cartesian product, termed positive definite independent of order $k$ (PDI$_{k}$ kernels). These kernels extend the concepts of positive definite and conditionally negative definite kernels to higher orders and provide the foundation for generalized independence and interaction tests, such as the generalized Lancaster interaction of order $k$ ($\Lambda_{k}^{n}$), and the Streitberg interaction ($\Sigma$). Our analysis focuses on the continuous setting, where we prove a Kernel Mean Embedding Theorem for PDI$_{k}$ kernels and establish the corresponding integrability restrictions. Based on these results, we characterize how the Kronecker products of PDI kernels behave.

20.
arXiv (CS.CL) 2026-06-11

Unstable Features, Reproducible Subspaces: Understanding Seed Dependence in Sparse Autoencoders

Sparse autoencoders (SAEs) are widely used to interpret neural network representations, but their utility depends on whether the learned features are reproducible across training runs. We study this question through feature stability: for each SAE feature, we estimate the probability that a similar feature reappears in an independently trained SAE. This yields a scalable per-feature signal that separates stable from unstable features. In a large-scale study across seeds, models, layers, dictionary sizes, and SAE variants, we find a pronounced functional asymmetry: stable features carry most of the reconstruction- and prediction-relevant signal, while unstable features have weak marginal impact and are dominated by low-frequency surface-form triggers in both activation statistics and automatic explanations. Geometrically, unstable features are individually non-reproducible but concentrate in reproducible lower-rank subspaces, suggesting that seed dependence often reflects basis ambiguity within a shared region of activation space rather than pure noise. A controlled synthetic model makes this mechanism explicit, showing that low-rank ground-truth features can be recovered at the subspace level while remaining non-identifiable as individual SAE latents across seeds. Finally, by pooling unique cross-seed features, we construct more stable SAEs while preserving explained variance in this setting. Together, these results show that unstable features are not merely failed or noisy latents: they have weak individual functional impact, but reflect reproducible low-dimensional structure that standard SAEs resolve differently across seeds.

22.
medRxiv (Medicine) 2026-06-10

Gendered pathways to adolescent mental health: An empirical assessment of a new conceptual framework

Introduction Gender norms and roles are important determinants of physical and mental health in the key period of adolescence. Yet, the gendered pathways to mental health in adolescents are not fully understood. Using a conceptual framework for global adolescent mental health that we developed based on a Delphi process, we empirically investigated the associations between six gender-related constructs and adolescent mental health. Methods We used cross-sectional Gender and Adolescence: Global Evidence (GAGE) data from Ethiopia (2020) to explore the associations between sex, gender norms, psychological competencies, gender attitudes, gender roles, with the latter two also serving as mediators, and psychological distress (GHQ-12), using Structural Equation Modelling (SEM). Results The SEM model contained measurements from 1,584 adolescents, including 843 girls and 741 boys, with a median age of 13 years. Out of 14 pathways tested, we found statistically significant associations between psychological competencies and psychological distress; sex and gender attitudes; and between gender norms and psychological competencies, gender attitudes, and gender roles. Hence, the gender-related constructs were mostly associated with each other, rather than with psychological distress. Conclusion The gender-related constructs are strongly interrelated, thereby attenuating their individual effects on psychological distress. The interplay of gender-related constructs should be considered when developing interventions to promote mental health in adolescents.

23.
medRxiv (Medicine) 2026-06-22

Multisite Real-World Validation of an Electronic Health Record-Integrated Generative Artificial Intelligence Tool for Venous Thromboembolism Risk Stratification

Background: Guiding risk-appropriate inpatient thromboprophylaxis requires venous thromboembolism (VTE) risk stratification; however, reliable risk determination remains inconsistent in routine care. Health systems increasingly pilot artificial intelligence (AI) tools, yet few studies demonstrate rigorous evaluation in the context of a learning health system (LHS). We evaluated the performance of a pilot electronic health record (EHR)-integrated generative AI (GenAI) system, inHealth General Reasoner (iHGR), for VTE risk stratification versus clinician order set classifications and physician-adjudicated chart review. Methods: This multisite retrospective validation study included adult inpatient admissions at Johns Hopkins Medicine between June 21, 2025, and Dec 18, 2025 (checklist-based order set from June 21, 2025 - November 19, 2025, and clinician judgement-based order set from November 29 - December 18, 2025). From 758 eligible admissions, we randomly sampled 500 balanced by site and order set periods. iHGR and clinician-selected order set classifications were compared with the reference standard (RS). Primary outcomes were iHGR sensitivity and specificity. Secondary analyses compared the order sets with the same RS to evaluate workflow comparators and error patterns. Results: iHGR achieved 81.8% sensitivity (95% CI 77.3-85.6) and 70.9% specificity (63.6-77.3). The checklist-based order set had 61.3% sensitivity (53.7-68.5) and 86.2% specificity (77.4-91.9). The clinician judgement-based order set had 78.1% sensitivity (71.3-83.7) and 65.4% specificity (54.3-75.0). False-negative iHGR classifications were associated with missed narrative risk factors. Conclusion: iHGR showed higher sensitivity for VTE risk than checklist-based order sets and clinician judgement without introducing systematic bias. In silico evaluation of pilot AI systems within LHSs can identify clinically important performance trade-offs and implementation targets before operational scale-up. Narrative clinical data abstraction remained a key limitation, supporting the use of GenAI to support rather than supplant clinician judgement.

24.
arXiv (CS.AI) 2026-06-17

A Unified Framework for Context-Aware and Relation-Aware Graph Retrieval-Augmented Generation

arXiv:2606.18075v1 Announce Type: new Abstract: Retrieval-Augmented Generation (RAG) has emerged as a paradigm for enhancing large language models (LLMs) with external knowledge, yet existing graph-based methods face a fundamental limitation: entity-centric and chunk-centric approaches operate on representations anchored to original text without true knowledge fusion. While entity-centric methods connect logically related content and chunk-centric methods preserve context, both retrieve information separately through similarity search, missing emergent understanding from their synthesis. In this paper, we propose HyGRAG, a hierarchical graph RAG framework that transcends source documents by addressing three core challenges: constructing summaries that genuinely integrate contextual and relational information, leveraging these synthesized representations to access emergent knowledge during retrieval, and efficiently updating hierarchical structures for dynamic corpora. Specifically, we design hierarchical index structures over hybrid graphs with both chunk and entity nodes, then iteratively cluster them and generate LLM-based summaries. Then, we design context and relation-aware retrieval that searches across all abstraction levels while expanding through community membership. Moreover, we enable dynamic knowledge update through attachment-based algorithms with only local re-summarization. Experimental results show that HyGRAG improves the average accuracy of multi-hop reasoning tasks by 9.7%, while maintaining reasonable efficiency.

25.
arXiv (CS.CL) 2026-06-16

Control-Plane Placement Shapes Forgetting: An Architectural Study of Agent Memory Across Thirteen System Configurations

作者:

Where an LLM sits in an agent memory pipeline – between the recall plane that retrieves stored facts (extensively benchmarked) and the control plane that mutates them via supersede, release, purge (largely untested) – shapes which forgetting failure modes the system recovers. Comparing thirteen system configurations on a 385-case adversarial surface, we observe three placement regimes with partly complementary coverage: deterministic primitives suffice for lexical/temporal categories but fail canonicalization (5% on identifier-obfuscation, 0% on cross-lingual); inscribe-time LLM recovers canonicalization (100%) but cannot help intent-aware deletion (0% on prefix-collision and compound-fact); a mutation-time hook recovers intent-aware deletion (78-85%) and brightens nearly all categories simultaneously (91.7-93.2% overall, $0.17 per 385-case run, 2.3s/case mutation latency vs. 64-191ms/case deterministic, recall path unchanged). We expose the trade-off via ForgetEval, a 1000-case templated suite plus a 385-case adversarial layer (132 hand-crafted + 253 LLM-drafted oracle-validated) scored by deterministic substring match, paired with a six-method Adapter Protocol with honest N/A scoring that lets heterogeneous memory stores enter in 130 lines. Admission is corroborated by 10-annotator IAA (Fleiss' kappa = 0.958) and a 77-case external-authored subset (four blind contributors) that replicates the canonicalization asymmetry and amplifies the joint-placement lift (+27.8 pt). Production failures are predominantly forgetting failures rather than recall failures, yet existing benchmarks measure only recall. ForgetEval and all adapters are released under MIT.