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01.
arXiv (CS.CV) 2026-06-18

UniTemp: Unlocking Video Generation in Any Temporal Order via Bidirectional Distillation

Autoregressive video diffusion models have emerged as a promising approach for long video generation, achieving strong performance in streaming settings. However, existing methods are restricted to forward temporal generation, whereas practical video creation often requires flexible generation order, e.g., conditioning on future context to extend backward, or on both past and future context for inbetween generation. We bridge this gap by training an autoregressive model that supports generation in arbitrary temporal directions. A key technical challenge arises from the Causal 3D VAE widely used in video diffusion models, which encodes latents strictly conditioned on past context. While suited for forward generation, this causal structure causes inter-block discontinuities when generation proceeds backward. To address this, we introduce blockwise anchor latents, a set of auxiliary latents that restore the missing past context at block boundaries during backward generation. Built on this design, we propose UniTemp, a bidirectional distillation framework that trains a single autoregressive student model for any-direction video generation. At inference time, UniTemp conditions on arbitrary past and/or future frames, improving controllability for both bidirectional and inbetween generation. Experiments show that UniTemp maintains competitive performance on short and long video generation compared to forward-only methods, while enabling diverse workflows such as bidirectional video extension, inbetween generation, looping video generation, scene transition, and visual story generation. Project website: https://lzhangbj.github.io/projects/unitemp/

02.
arXiv (CS.CV) 2026-06-15

ADAPT: An Autonomous Forklift for Construction Site Operation

Efficient material logistics play a critical role in controlling costs and schedules in the construction industry. However, manual material handling remains prone to inefficiencies, delays, and safety risks. Autonomous forklifts offer a promising solution to streamline on-site logistics, reducing reliance on human operators and mitigating labor shortages. This paper presents the development and evaluation of ADAPT (Autonomous Dynamic All-terrain Pallet Transporter), a fully autonomous off-road forklift designed for construction environments. Unlike structured warehouse settings, construction sites pose significant challenges, including dynamic obstacles, unstructured terrain, and varying weather conditions. To address these challenges, our system integrates AI-driven perception techniques with traditional approaches for decision making, planning, and control, enabling reliable operation in complex environments. We validate the system through extensive real-world testing, comparing its continuous performance against an experienced human operator across various weather conditions. Our findings demonstrate that autonomous outdoor forklifts can operate near human-level performance, offering a viable path toward safer and more efficient construction logistics.

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

LLMs Struggle to Measure What Distinguishes Students of Different Proficiency Levels: A Study of Item Discrimination in Reading Comprehension Assessment

Item discrimination is a fundamental psychometric property of educational assessment, which measures whether an item meaningfully distinguishes students with higher proficiency from students with lower proficiency. While various existing works have explored whether large language models (LLMs) can estimate item difficulty, it remains unclear whether they can capture item discrimination. In this work, we evaluate 42 proprietary and open-weight LLMs in zero-shot settings using two complementary approaches: direct discrimination prediction, where models explicitly estimate an item's discrimination value from its content, and response-based Classical Test Theory (CTT) calibration, where LLM answers are treated as synthetic student responses to compute discrimination scores. Our results show that direct prediction yields weak alignment with human-calibrated discrimination: the best-performing model reaches only a Spearman correlation of 0.152. Response-based CTT calibration provides a stronger but still limited signal, with the all-persona synthetic respondent pool reaching a Spearman correlation of 0.241. These findings highlight item discrimination as an open challenge for LLM-based psychometric evaluation: current LLMs contain non-random discrimination-relevant signal, but they do not yet reliably capture how assessment items distinguish human students.

04.
bioRxiv (Bioinfo) 2026-06-11

Tumour evolution as ground truth for cancer whole-genome sequencing

Cancer genomes are shaped by evolutionary processes that couple mutagenesis, clonal selection, chromosomal instability, spatial growth and treatment response into structured genomic patterns, yet current benchmarking strategies largely ignore this evolutionary dependency. Here, we present SCOUT, a large-scale synthetic whole-genome sequencing resource of over 200 samples, designed for systematic benchmarking of tumour genomic analysis and evolutionary inference under controlled evolutionary ground truth. Unlike conventional task-specific simulations, SCOUT models tumour evolution as a latent generative process that simultaneously shapes mutations, copy-number alterations, variant allele frequencies, mutational signatures and clonal architectures. SCOUT recapitulates key features of solid and haematological malignancies, including driver mutations, chromosomal instability, intratumour heterogeneity, spatial sampling and treatment-associated evolutionary dynamics in tumour and matched-normal longitudinal and multi-region sequencing designs. Using SCOUT, we benchmarked widely used methods for somatic variant detection, copy-number analysis, mutational signature inference and tumour evolutionary reconstruction. Across analytical tasks, performance deteriorated in low-purity, highly subclonal and structurally complex tumours, while spatial sampling bias and hypermutation generated spurious evolutionary signals that confounded tumour interpretation across multiple inference layers. Evolutionary simulations further distinguished lineage-restricted genetic bottlenecks from multi-lineage resistance dynamics associated with tumour plasticity. Tumour purity consistently exerted a stronger effect on inference accuracy than sequencing depth. Together, our results establish evolutionary ground truth as a prerequisite for reproducible benchmarking and biologically interpretable analysis of cancer whole-genome sequencing data.

05.
arXiv (CS.CL) 2026-06-15

Is ChatGPT Fair for Recommendation? Evaluating Fairness in Large Language Model Recommendation

The remarkable achievements of Large Language Models (LLMs) have led to the emergence of a novel recommendation paradigm – Recommendation via LLM (RecLLM). Nevertheless, it is important to note that LLMs may contain social prejudices, and therefore, the fairness of recommendations made by RecLLM requires further investigation. To avoid the potential risks of RecLLM, it is imperative to evaluate the fairness of RecLLM with respect to various sensitive attributes on the user side. Due to the differences between the RecLLM paradigm and the traditional recommendation paradigm, it is problematic to directly use the fairness benchmark of traditional recommendation. To address the dilemma, we propose a novel benchmark called Fairness of Recommendation via LLM (FaiRLLM). This benchmark comprises carefully crafted metrics and a dataset that accounts for eight sensitive attributes1 in two recommendation scenarios: music and movies. By utilizing our FaiRLLM benchmark, we conducted an evaluation of ChatGPT and discovered that it still exhibits unfairness to some sensitive attributes when generating recommendations. Our code and dataset can be found at https://github.com/jizhi-zhang/FaiRLLM.

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

Red-Teaming Agent Execution Contexts: Open-World Security Evaluation on OpenClaw

arXiv:2605.11047v2 Announce Type: replace-cross Abstract: Agentic language-model systems increasingly rely on mutable execution contexts, including files, memory, tools, skills, and auxiliary artifacts, creating security risks beyond explicit user prompts. This paper presents DeepTrap, an automated framework for discovering contextual vulnerabilities in OpenClaw. DeepTrap formulates adversarial context manipulation as a black-box trajectory-level optimization problem that balances risk realization, benign-task preservation, and stealth. It combines risk-conditioned evaluation, multi-objective trajectory scoring, reward-guided beam search, and reflection-based deep probing to identify high-value compromised contexts. We construct a 42-case benchmark spanning six vulnerability classes and seven operational scenarios, and evaluate nine target models using attack and utility grading scores. Results show that contextual compromise can induce substantial unsafe behavior while preserving user-facing task completion, demonstrating that final-response evaluation is insufficient. The findings highlight the need for execution-centric security evaluation of agentic AI systems. Our code is released at: https://github.com/ZJUICSR/DeepTrap

07.
Nature (Science) 2026-06-10

Molecular glue degraders of HuR suppress BRAF-mutant colorectal cancer

作者:

BRAF gain-of-function mutations, particularly BRAF(V600E), affect roughly 10% of all patients with colorectal cancer (CRC), and portend poor prognosis with limited therapeutic interventions. BRAF inhibitors such as encorafenib are ineffective due to MAPK pathway reactivation driven by BRAF dimerization. Combined inhibition of BRAF and EGFR, although approved therapies, results in short survival benefits and frequent treatment resistance and relapse1–3. Here, through rational chemical library design coupled with parallel proteomic screening, we identified dHuR as a molecular glue degrader of human antigen R (HuR), an RNA-binding protein that drives tumour growth, invasion and therapy resistance. dHuR binds to the CRBN ubiquitin ligase to create a unique benzofuran-tethered composite surface to recruit HuR as a neosubstrate by engaging its β-hairpin G-loop degron, as revealed by the cryo-electron microscopy structure of the ternary complex. dHuR abrogated BRAF expression by inducing its exon 18 skipping, and demonstrated superior suppression of BRAF-mutant CRC tumours including those gaining resistance to BRAF inhibitors. Finally, we performed kinome library CRISPR screening and revealed that inactivation of EGFR or MEK enhanced dHuR cytotoxicity, thus establishing a combinatorial strategy to treat patients with refractory BRAF-mutant CRC. Molecular glue degraders of the RNA-binding protein HuR have therapeutic potential for BRAF-mutant cancers.

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

Scaling LLM Reasoning from Minimal Labels: A Semi-Supervised Framework with a Lightweight Verifier

For the development of Large language models (LLMs), recent approaches to generating pseudo intermediate reasoning have shown remarkable progress. But they typically rely on large numbers of correctly annotated answers to assess reasoning quality. This paper presents a semi-supervised framework that scales reasoning learning from minimal supervision, turning reasoning verification itself into a data creation mechanism. We train a lightweight reasoning-correctness classifier on only a few labeled samples, which judges whether intermediate reasoning traces generated by an LLM are valid. Furthermore, an entropy-based confidence threshold filters out unreliable samples, and the remaining high-confidence reasoning traces are used to fine-tune the model. Experiments on Verifiable Math Problems (Orca-Math subset) and Question Answering on Image Scene Graphs (GQA) with Visual Programming show that our method achieves accuracy comparable to using 10-15x more labeled data. Ablation analyses confirm that both the classifier and entropy filtering are essential for scalable and noise-resistant pseudo-labeling. By replacing expensive answer-level supervision with lightweight reasoning verification, our method provides a practical path toward constructing large-scale reasoning resources and paves the way for future autonomous reasoning systems that learn from minimal human input.

09.
medRxiv (Medicine) 2026-06-17

The interaction between chronic hepatitis B (CHB) and Metabolic dysfunction-associated steatotic liver disease (MASLD) in a diverse central London population

Introduction: The overlap between chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global health challenge. We investigated the impact of MASLD and metabolic comorbidity in a diverse London viral hepatitis clinic. Methods: This retrospective cross-sectional study (May 2018-Feb 2024) included adults with CHB having controlled attenuation parameter (CAP) measurements. MASLD was defined as CAP >264 dB/m plus [≥]1 cardiometabolic factor (CMF). We used univariable and multivariable models to examine MASLD's relationship with liver stiffness and hepatitis B viral load (HBV VL). Results: Among 323 individuals (67% male, median age 36), most were from Black (35%) or non-white British/Irish (29%) backgrounds. Overall, 64% had [≥]1 CMF, and 20% had MASLD. The CHB/MASLD group was significantly older (median 43 vs 35 years, p

10.
medRxiv (Medicine) 2026-06-18

Web-based education on Metabolism and Obesity is associated with improved lifestyle and health behaviours among Brazilian school teachers

Background: Obesity is a major global public health challenge, and teachers play a critical role in school-based health promotion. This study examined the perceived impact of a web-based educational program on metabolism and obesity delivered to Brazilian school teachers. Methods: This analytical cross-sectional study included 217 teachers who responded to the evaluation questionnaire after attending the course between 2017 and 2022. Statistical analyses included logistic regression and chi-square tests. Findings: Course completion rate was 81.98%, substantially exceeding the 5-15% typical of global MOOCs. However, ethnic disparities were observed: White respondents were 4.95 times more likely to complete the course than Black respondents (p=0.00097) and Brown respondents were 3.05 times more likely (p=0.0268) than Black respondents. Among non-completers, lack of time (64.7%) was the primary barrier. Participation was concentrated in Sao Paulo (77%), with no respondents from three northern states. Perceived difficulty showed a non-significant trend (p=0.0893) where by Black respondents had the lowest predicted difficulty; the most challenging course material was Scientific Content/Reading papers (50%). Completion was strongly associated with applying learned activities in teaching (p

11.
arXiv (CS.LG) 2026-06-17

A Bayesian Boolean Matrix Factorization with Application to Copy Number Analysis in Cancer

arXiv:2606.17491v1 Announce Type: cross Abstract: Binary data factorization is common, but real-valued methods ignore discreteness and yield hard-to-interpret factors. Boolean Matrix Factorization (BooMF) instead decomposes a binary matrix into two lower-rank binary matrices via logical AND and OR, expressing the data as a Boolean disjunction of interpretable patterns. In cancer genomics, BooMF can reveal coordinated feature changes that may drive tumor evolution, unlike rotational or additive decompositions. Most existing BooMF methods are heuristic, greedy, sensitive to initialization, prone to local optima, and do not support principled model selection or uncertainty quantification. We introduce Bayesian Boolean Matrix Factorization (BBMF), a fully conjugate generative model with sparsity-inducing priors. It enforces Boolean constraints, yields interpretable latent factors with coherent uncertainty quantification, and admits Gibbs sampling with closed-form full conditionals. Because cancer evolution often involves widespread, near-simultaneous chromosome-number changes (e.g., whole-genome duplication followed by instability and selection), Boolean factorizations capture these patterns more naturally than additive models. Applied to arm-level copy-number alteration data in multiple myeloma, where entries indicate presence/absence of chromosomal-arm amplifications, BBMF finds a small set of interpretable bicliques linking patient subsets to recurrently co-altered chromosomal arms, providing a compact, biologically meaningful summary of tumor heterogeneity and demonstrating BBMF's utility for uncovering discrete latent structure in complex binary data.

12.
arXiv (CS.AI) 2026-06-16

FlowState: Sampling-Rate-Equivariant Time-Series Forecasting

arXiv:2508.05287v3 Announce Type: replace-cross Abstract: Existing time series foundation models (TSFMs), often based on transformer variants, lack adaptability to different sampling rates, struggle with generalization across varying context and target lengths, and are computationally inefficient. We introduce FlowState, a novel TSFM architecture that achieves sampling-rate-equivariant forecasting through a unified design that pairs a state space model (SSM) encoder with a functional basis decoder (FBD). This design enables continuous-time modeling and dynamic time-scale adjustment, allowing FlowState to inherently generalize across all possible temporal resolutions, and dynamically adjust the forecasting horizons without retraining. We further propose an efficient pretraining strategy that improves robustness and accelerates training. Despite being one of the smallest TSFMs, FlowState achieves state-of-the-art results on the widely used GIFT-Eval benchmark, while demonstrating superior adaptability to unseen sampling rates. Our detailed analyses confirm the effectiveness of its components, and we demonstrate its unique ability to adapt to varying input sampling rates.

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

VGGHeads: 3D Multi Head Alignment with a Large-Scale Synthetic Dataset

Human head detection, keypoint estimation, and 3D head model fitting are essential tasks with many applications. However, traditional real-world datasets often suffer from bias, privacy, and ethical concerns, and they have been recorded in laboratory environments, which makes it difficult for trained models to generalize. Here, we introduce \method – a large-scale synthetic dataset generated with diffusion models for human head detection and 3D mesh estimation. Our dataset comprises over 1 million high-resolution images, each annotated with detailed 3D head meshes, facial landmarks, and bounding boxes. Using this dataset, we introduce a new model architecture capable of simultaneous head detection and head mesh reconstruction from a single image in a single step. Through extensive experimental evaluations, we demonstrate that models trained on our synthetic data achieve strong performance on real images. Furthermore, the versatility of our dataset makes it applicable across a broad spectrum of tasks, offering a general and comprehensive representation of human heads.

14.
arXiv (CS.AI) 2026-06-18

Veriphi: Attack-Guided Neural Network Verification with Dataset-Dependent Training Methods

arXiv:2606.18454v1 Announce Type: cross Abstract: We present Veriphi, a GPU-accelerated neural network verification system that combines fast adversarial attacks with formal bound certification using alpha,beta-CROWN methods. Through systematic experiments on MNIST and CIFAR-10 using three training methodologies (standard, adversarial, certified), we demonstrate that training method effectiveness is fundamentally dataset-dependent. Interval Bound Propagation (IBP) achieves 78% certified accuracy on simple MNIST (784 dimensions) but provides negligible certification performance on the more complex CIFAR-10 dataset, where PGD adversarial training dominates with 94% certification at small perturbations. We achieve 5x verification speedup through attack-guided falsification and scale our approach to production-size models (105.8M parameters) for real-world aerospace logistics optimization. Our results challenge the assumption that certified training universally outperforms adversarial training, showing context matters critically for verification strategy selection.

15.
arXiv (CS.CV) 2026-06-12

OpenMedQ: Broad Open Pretraining for Medical Vision-Language Models

We present OpenMedQ, a medical vision-language model pretrained on the broadest fully-open medical mix to date: 14 datasets totaling ~3.35M pretraining samples spanning pathology, radiology, microscopy, and text-only clinical QA. OpenMedQ reaches state-of-the-art BLEU-1 on PathVQA (75.9), beating Med-PaLM M variants up to 562B parameters (~80x larger), and matches the best reported VQA-MED BLEU-1 (64.5). Its vision encoder, transferred to 8 unseen medical classification benchmarks under an identical downstream recipe, obtains the highest average macro-F1 (0.757) among BiomedCLIP (0.745), PMC-CLIP (0.745), PubMedCLIP (0.746), and a from-scratch baseline (0.616). We release our code and an interactive demo is publicly available as a reproducible baseline for the community.

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

CrossEarth-Gate: Fisher-Guided Adaptive Tuning Engine for Efficient Adaptation of Cross-Domain Remote Sensing Semantic Segmentation

In Remote Sensing (RS), Parameter-Efficient Fine-Tuning (PEFT) has emerged as a key approach to activate the generalizable representation ability of foundation models for downstream tasks. However, existing specialized PEFT methods often fail when applied to large-scale Earth observation tasks, as they are unable to fully handle the multifaceted and unpredictable domain gaps (e.g., spatial, semantic, and frequency shifts) inherent in RS data. To overcome this, we propose CrossEarth-Gate, which introduces two primary contributions. First, we establish a comprehensive RS module toolbox to address multifaceted domain gaps, comprising spatial, semantic, and frequency modules. Second, we develop a Fisher-guided adaptive selection mechanism that operates on this toolbox. This selection is guided by Fisher Information to quantify each module's importance by measuring its contribution to the task-specific gradient flow. It dynamically activates only the most critical modules at the appropriate layers, guiding the gradient flow to maximize adaptation effectiveness and efficiency. Comprehensive experiments validate the efficacy and generalizability of our method, where CrossEarth-Gate achieves state-of-the-art performance on 16 out of 18 cross-domain benchmarks for RS semantic segmentation.

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

CHILLGuard: Towards Fine-Grained Chinese LLM Safety Guardrail with Scalable Data Construction and Model-aware Preference Alignment

Malicious content generated from large language models (LLMs) could pose severe safety risks and ethical concerns. While existing LLM safety guardrails excel in English or multilingual settings, they lack adaptation to Chinese-specific regulatory policies, cultural context and linguistic nuances, failing to support fine-grained risk classification for diverse deployment needs. In this paper, we introduce a 5-macro, 31-micro category fine-grained risk taxonomy for Chinese scenarios, and build CHILLGuard: a dedicated Chinese LLM content safety guardrail. To address the critical scarcity of high-quality annotated Chinese safety data, we propose a scalable multi-stage data construction pipeline: we expand multi-source corpus via retrieval-augmented generation, generate implicit harmful samples through prompt engineering rewriting, and refine high-quality data via multi-model voting-based label calibration. Based on this, we build CHILLGuardTrain, a large-scale training set with 405,007 samples, and CHILLGuardTest, a rigorously curated annotated test set with 51,745 samples. We then train CHILLGuard on CHILLGuardTrain under a generator-classifier collaborative framework via Model-aware Direct Preference Optimization. Extensive experiments under multiple settings demonstrate the state-of-the-art performance of CHILLGuard, e.g., a 15.92% improvement of F1 score over Qwen3Guard-8B-Strict on our benchmark. We will release our resources at https://github.com/cswbyu/CHILLGuard.

18.
arXiv (quant-ph) 2026-06-17

Quantum mechanics in configuration space in context

arXiv:2606.17622v1 Announce Type: new Abstract: To enhance the way in which wave-particle duality is implemented in the modelling of quantum mechanical systems, Bukhari et al. [New J. Phys. 27, 084501 (2025)] recently introduced an alternative approach to quantum mechanics, namely quantum mechanics in configuration space. This formalism is based on a physically motivated quantisation of Newtonian mechanics and promotes the classical position-velocity states (x,v) to pairwise distinguishable quantum states. The resulting |x,v> states form the basis of the Hilbert space of individual quantum mechanical particles and evolve along classical trajectories. In this paper, we consider the modelling of a mechanical particle in free space and put quantum mechanics in configuration space into context. It is shown that this formalism increases the continuity between quantum and classical mechanics by avoiding a conceptual inconsistency associated with the definition of momentum in canonical quantisation. In addition, we emphasise that standard quantum mechanics and quantum mechanics in configuration space are based on two distinct formulations of classical mechanics.

19.
arXiv (CS.AI) 2026-06-11

Rule Taxonomy and Evolution in AI IDEs: A Mining and Survey Study

arXiv:2606.12231v1 Announce Type: cross Abstract: The adoption of AI-powered Integrated Development Environments (AI IDEs) has introduced "Rules" as a novel software artifact, allowing developers to persistently inject project-specific constraints and architectural guidelines into the context of Large Language Models (LLMs). Despite their role in aligning AI behavior with developer intent, the taxonomy, evolution, and practical impact of these rules remain largely unexplored. To bridge this gap, we conducted a mixed-methods empirical study on AI IDE rules. By mining 83 open-source projects and extracting 7,310 rules, we established a comprehensive taxonomy comprising 5 primary and 25 secondary categories. We then triangulated these artifacts with survey responses from 99 practitioners. Our analysis identified a contrast between developer priorities and actual configurations: while practitioners rate architectural constraints as highly important, rule files in repositories primarily consist of low-level workflow and code formatting constraints. Furthermore, our analysis of 1,540 rule evolution events revealed that rules are updated frequently. Repository data further indicate that rule evolution is primarily driven by constructive context expansions (29.17%) and enrichments (26.59%). In contrast, surveyed developers reported modifying rules primarily to correct AI errors (77.78%), typically by adding new negative constraints rather than editing existing ones. Finally, an artifact compliance assessment of 160 rule evolution events revealed that updating rules significantly improves the adherence of software artifacts, with the average artifact compliance rate increasing by 22.99% (from 49.14% to 72.13%) following an update. Our study provides empirical insights that can help developers optimize prompting strategies and guide tool builders in designing automated conflict-detection and context-management mechanisms for AI IDEs.

20.
arXiv (CS.CV) 2026-06-17

MODE-RAG: Manifold Outlier Diagnosis and Energy-based Retrieval-Augmented Generation Evaluation

While Multimodal Retrieval-Augmented Generation (M-RAG) enhances Large Vision-Language Models, it remains highly susceptible to cross-modal hallucinations, causal fabrications, and sycophancy. Furthermore, existing mitigation pipelines often face an intervention paradox: static rules tend to unnecessarily disrupt accurate generations, whereas leaving the multi-modal reasoning completely unguided allows existing mismatches to cascade into severe logical fabrications. To quantify and mitigate these hallucinations, we propose a Multi-Agent system, MODE-RAG, driven by Variational Free Energy (VFE) and internal attention states to dynamically gate interventions. High-risk queries are routed to five stage-specific agents, integrating Monte Carlo Tree Search (MCTS) for rigorous causal derivation and logit perturbations to penalize sycophancy. Dedicated Correction and Overseer agents ensure formatting stability and perform post-hoc factual verification. To objectively evaluate our approach, we introduce ModeVent, a challenging subset derived from the MultiVent dataset. Extensive experiments indicate that our system effectively reduces hallucination rates and logical fabrication, significantly improving the robustness of M-RAG systems.

21.
medRxiv (Medicine) 2026-06-16

Adherence to Red Reflex and Vision Screening Recommendations: A Deep Dive into Primary Care Implementation Gaps

Introduction: Early childhood vision screening is critical for detecting amblyopia and other vision-threatening conditions. Despite screening recommendations during well-child visits, rates remain low. Red reflex assessment is recommended to identify serious ocular pathology, yet its use in primary care is not well described. We examined rates and drivers of vision screening in pediatric primary care. Methods: We conducted a retrospective review of electronic health records for children 3 to 5 years attending well-child visits in 2022 in one of three representative primary care clinics within a university health system. Outcomes were documented red reflex and functional vision tests. We evaluated associations with patient demographics and clinic site using multivariable logistic regression Results: Among 1,003 visits, 21.1% (n=212) had a documented red reflex assessment, and 60.8% (n=610) a functional vision test. Younger children (ages 3 and 4 vs. 5 years) had higher odds of red reflex assessment [adjusted odds ratio (aOR) 9.00 and 8.64], and lower odds of a functional vision (aOR 0.47 and 0.59) test. Females had higher odds of red reflex assessment (aOR 1.53). Other/Multiracial children had lower odds of red reflex assessment than Non-Hispanic White children (aOR 0.48). Screening rates varied significantly by clinic site Conclusions: Visual function and red reflex assessment are inconsistently performed in pediatric primary care, with particularly low rates of red reflex documentation. Screening rates varied between clinics and were affected by age. These findings highlight missed opportunities for early detection of vision-threatening conditions and identify targets for improving adherence to pediatric vision screening recommendations

22.
arXiv (CS.CV) 2026-06-15

Context-aware Modality-Topology Co-Alignment for Multimodal Attributed Graphs

Multimodal Attributed Graphs (MAGs) model real-world entities by coupling graph topology with heterogeneous attributes such as text and images. They support graph-centric tasks requiring structural and class-discriminative representations, and modality-centric tasks requiring fine-grained cross-modal correspondence. However, existing MAG methods often rely on fixed graph contexts or uniformly fused representations, causing task-agnostic propagation and over-compressed fusion that hinder diverse task requirements and modality-specific evidence preservation. To address this, we propose CoMAG, a unified MAG backbone that learns task-adaptive reliable contexts and modality-preserving alignment within them. CoMAG first conducts Reliable Context Learning by estimating edge reliability from multimodal semantic consistency, complementing raw topology with semantic neighbors, and selecting context components through a task-aware gate. It then performs Modality-preserving Hop-token Alignment by maintaining modality-specific multi-hop trajectories, matching modality-hop tokens across modalities, and decoupling shared and private representations. Thus, CoMAG produces graph and modality representations from one forward pass while retaining modality-specific cues. We further analyze stable propagation, over-smoothing mitigation, and modality-collapse control. Experiments on nine OpenMAG datasets compare CoMAG with feature-only, graph-only, multimodal, and unified MAG baselines across graph-level prediction, modality matching, and graph-conditioned generation. Results show that CoMAG achieves the best reported performance, demonstrating that task-adaptive reliable contexts and modality-preserving alignment improve structural prediction, cross-modal matching, and graph-conditioned generation while retaining sparse edge-linear complexity.

23.
Nature (Science) 2026-06-17

Towards autonomous medical artificial intelligence agents

作者:

Large language models (LLMs) show great potential for clinical decision-making, yet most applications remain narrow, task-specific chat tools rather than systems integrated into clinical workflows1,2. However, building physician copilots will require models that operate within the electronic health record (EHR), with governed access to patient data and the ability to initiate permitted EHR actions within defined safety constraints. Yet it remains unproven whether such a system can manage patient cases with physician-level performance. Here we show that MIRA (Medical Intelligence for Reasoning and Action), an autonomous artificial intelligence agent operating in a sandboxed EHR environment, can navigate a large clinical action space to obtain patient histories; order and interpret laboratory, imaging and microbiology tests; generate differential diagnoses; and formulate treatment plans such as prescribing medications, scheduling surgical procedures and planning admissions. In simulations on real patient cases spanning multiple diagnoses, MIRA outperformed physicians in diagnostic accuracy and made guideline-concordant, medication-safe and appropriate admission decisions. Compared with previous LLM applications that addressed isolated subtasks or provided free-text advice, these results suggest that an EHR-integrated artificial intelligence agent can turn clinical intent into structured, actionable EHR operations, possibly making it a more effective decision-support partner for physicians. Further work is needed to establish generalization, safety and governance through prospective, real-world studies. A large language model artificial intelligence agent operating in a sandboxed electronic health record system can autonomously take patient histories, order tests, interpret findings, diagnose conditions and propose treatments, outperforming experienced clinicians while adhering to safety standards and clinical guidelines.

24.
medRxiv (Medicine) 2026-06-22

COVID-19 containment policies and hyperglycemia in pregnancy: correlation with the Stringency Index in a nationwide Belgian cohort

Background During the COVID-19 pandemic, gestational diabetes (GD) prevalence showed variable changes across regions, with most reporting increases and others decreases; however, its association with perinatal outcomes in Belgium remains unknown. We aimed to compare the prevalence of hyperglycemia in pregnancy (HIP) in 2020 versus 2019 and examined the correlation between HIP prevalence and pandemic-related restrictions measured by the Stringency Index (SI) and evaluate neonatal weight percentiles changes. Methods: We included all singleton live births in Belgium in 2019 and 2020 from Belgian birth registry data. We compared monthly proportions of HIP prevalence and Small for gestational age (SGA) and Large for gestional age (LGA) newborns in 2019 and 2020. Crude and adjusted odds ratios (ORs, aORs) were estimated with logistic and multinomial regression. The Spearman correlation coefficient was used to assess the correlation between the monthly average SI and the monthly aORs of HIP. Results: For deliveries from January to June 2020, no significant differences in HIP prevalence were observed compared with 2019. From July to December 2020, there was a significant increase in HIP, with peaks in July (GD screening in April) (aOR 1.41, 1.26-1.58) and November (GD screening in August) (aOR 1.33, 95% CI 1.18-1.49). There was no significant change in neonatal weight percentiles. The Spearman correlation coefficient between the SI and HIP aORs was 0.86 (p = 0.02). Conclusion During the pandemic, we observed an increase in the prevalence of HIP, compared to 2019, without a measurable impact on LGA or SGA newborns. The aOR of HIP in a given month was strongly correlated with the corresponding SI.

25.
medRxiv (Medicine) 2026-06-15

Neural Correlates of Human Food Memory link to Microbial, Homeostatic, and Hedonic Signals: Evidence from a Prebiotic Randomized Clinical Trial

Background Homeostatic and hedonic brain circuits regulate eating behavior but also shape how food memories are encoded and retrieved. Objective We examined neural correlates during food memory encoding and retrieval during functional MRI before and after a 14-day prebiotic intervention in a preregistered, double-blind crossover trial (NCT03829189). Design 55 healthy adults with overweight (19 females, age 28{+/-}6.5, BMI 25-30 kg/m2) underwent 3 Tesla task-based functional MRI before and after dietary intervention of prebiotic (30g inulin/day) or equicaloric placebo for 14 days. Peripheral metabolic, short-chain fatty acids (SCFA), and microbial markers using 16S rRNA analysis were assessed in fasting blood and feces. Results Food memory was enhanced by assigned reward value and engaged brain activity in hedonic regions, including the nucleus accumbens, orbitofrontal cortex, caudate, cingulate, dorsomedial prefrontal cortex, and ventral tegmental area, as well as homeostatic and memory-related such as the hypothalamus and the hippocampus. Higher neural activations during food encoding were related to higher Actinobacteriota abundance, fecal SCFA acetate, and creatinine levels, and lower ghrelin levels. Activations in reward-related and homeostatic brain areas partially correlated with insulin, glucagon-like peptide-1, leptin, and thyroid-stimulating hormone levels. Neural activations related to food memory decreased after prebiotic intervention. The prebiotic supplementation induced decrease of hippocampal activity during food encoding related to changes in gut microbiota Firmicutes abundance. Conclusions This study indicates that neuronal food-related memory processes depend on homeostatic and hedonic brain signals modulated by the gut-brain axis. Our findings raise implications for the treatment of obesity and substance use disorder.