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02.
medRxiv (Medicine) 2026-06-18

AlphaGenome identifies a deep intronic variant in a family with PLA2G6-associated neurodegeneration: Closing the diagnostic gap in rare genetic diseases

A molecular diagnosis remains out of reach for a substantial subset of patients with clinically recognizable Mendelian disorders, even after comprehensive next-generation sequencing. Causal variants in non-coding regions are difficult to detect and interpret using standard pipelines. Deep intronic variants that disrupt splicing are a known but underexplored source of pathogenic alleles, and systematic tools to evaluate them at scale have only recently emerged. We aimed to resolve an incomplete genetic diagnosis in two siblings with early-onset parkinsonism, prominent neuropsychiatric features, and autonomic dysfunction consistent with PLA2G6-associated neurodegeneration (PLAN), an autosomal recessive condition. Prior clinical exome sequencing, genome sequencing, Multiplex Ligation-dependent Probe Amplification (MLPA), and long-read sequencing had identified only a single heterozygous PLA2G6 missense variant, c.2132C>G (p.Pro711Arg). We used AlphaGenome to score 91 non-coding variants shared among the affected siblings and their father within 1 megabase of the PLA2G6 locus. The deep-learning model identified an intronic variant (c.2034+355G>A) that was predicted to create a cryptic splice acceptor site that could result in inclusion of a 160-bp cryptic exon. Tissue-specific predictions indicated the aberrant splicing would be detectable in blood, confirmed by junction-spanning RNA-seq reads from an unrelated carrier. This analysis completed a compound heterozygous PLAN diagnosis nearly two decades after symptom onset and demonstrates the utility of sequence-to-function models. Systematic integration of tools like AlphaGenome into rare disease workflows offers a practical, low-barrier route to closing the diagnostic gap for patients with compelling Mendelian phenotypes and incomplete genetic diagnoses.

03.
arXiv (CS.AI) 2026-06-24

MOCHA: Multi-modal Objects-aware Cross-arcHitecture Alignment

arXiv:2509.14001v5 Announce Type: replace-cross Abstract: Personalized object detection aims to adapt a general-purpose detector to recognize user-specific instances from only a few examples. Lightweight models often struggle in this setting due to their weak semantic priors, while large vision-language models (VLMs) offer strong object-level understanding but are too computationally demanding for real-time or on-device applications. We introduce MOCHA (Multi-modal Objects-aware Cross-arcHitecture Alignment), a distillation framework that transfers multimodal region-level knowledge from a frozen VLM teacher into a lightweight vision-only detector. MOCHA extracts fused visual and textual teacher's embeddings and uses them to guide student training through a dual-objective loss that enforces accurate local alignment and global relational consistency across regions. This process enables efficient transfer of semantics without the need for teacher modifications or textual input at inference. MOCHA consistently outperforms prior baselines across four personalized detection benchmarks under strict few-shot regimes, yielding a +10.1 average improvement, with minimal inference cost.

04.
arXiv (math.PR) 2026-06-12

(Non)-hyperuniformity of perturbed lattices

arXiv:2405.19881v3 Announce Type: replace Abstract: We ask whether a stationary lattice in dimension $d$ whose points are shifted by identically distributed but possibly dependent perturbations remains hyperuniform. When $d = 1$ or $2$, we show that it is the case when the perturbations have a finite $d$-moment, and that this condition is sharp. When $d \geq 3$, we construct arbitrarily small perturbations such that the resulting point process is not hyperuniform. As a side remark of independent interest, we exhibit hyperuniform processes with arbitrarily slow decay of their number variance.

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

FinBalance: A Multi-Document Accounting Reconciliation Benchmark

Existing financial-NLP benchmarks mostly evaluate prepared artifacts such as filings, tables, or extracted values. Real accounting begins earlier: source documents must be reconciled into cited journal entries, aggregated into a balance sheet, and checked for contradictions. We introduce FinBalance, a multi-document accounting reconciliation benchmark built from source-document bundles across eight industries, three period types, and five difficulty levels. Human-authored business scenarios, accounting policies, tax/FX treatments, document schemas, distractors, and inconsistency templates are composed by a deterministic generator whose ledger produces journal entries,balance sheets, and 23 inconsistency-code labels. On a 710-record evaluation split, six contemporary LLMs reach at most 46% exact final-balance-sheet accuracy. Four models show a 26-41 pp gap between BS_exact, the model's reported balance sheet, and BS_recon, the balance sheet obtained by replaying its entries through our ledger. Models often recover numerically plausible entries but fail to bind them to supporting documents and aggregate them consistently. Citation-pressure prompting barely changes document-linking errors, while ledger-feedback ablations substantially improve reported balance sheets and expose inconsistency-detection trade-offs. Expert finance reviewers validate the benchmark design and labels.

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

Hidden in Plain Sight: Benchmarking Agent Safety Against Decomposition Attacks with DECOMPBENCH

arXiv:2606.13994v1 Announce Type: cross Abstract: LLM-based Agents are becoming increasingly capable and widely deployed, creating growing incentives for adversarial misuse in the real-world. A key emerging threat is Decomposition Attacks [glukhov2024breach, jones2024adversaries] in which a harmful task is broken into simpler, benign subtasks that evade safety mechanisms when executed separately but cumulatively fulfill the malicious intent. Although recent benchmarks assess agent safety in multi-turn and multi-tool-use settings, they do not explicitly capture this form of decompositional misuse and may not represent realistic adversarial execution flows. To this end, we introduce DeCompBench, a benchmark designed specifically to evaluate agentic safety under decomposition attacks. DeCompBench is created with a decomposition-by-design principle using a graphical framework and enables harmful task decomposition into individually benign and executable subtasks with realistic workflows. Our experiments using a custom decomposer show that state-of-the-art agents exhibit high refusal rates on monolithic harmful tasks, but significantly lower refusal rates on their decomposed variants, while often inadvertently fulfilling the adversarial objectives. These findings underscore the need for safety evaluations against decomposition attacks and corresponding defenses. Our dataset is publicly available and can be found at https://huggingface.co/datasets/decompositionbench/DeCompBench.

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

Bidirectional Cross-Attention Fusion of High-Resolution RGB and Low-Resolution Hyperspectral Inputs for Multimodal Semantic Segmentation

Multimodal semantic segmentation with heterogeneous sensors must reconcile complementary information across modalities that differ in spatial resolution and channel dimensionality. In particular, high-resolution RGB imaging provides detailed spatial structure but often fails to distinguish visually similar materials, whereas hyperspectral imaging (HSI) provides discriminative spectral signatures but at lower spatial resolution. We present Bidirectional Cross-Attention Fusion (BCAF), which aligns high-resolution RGB with low-resolution HSI at their native grids via localized, bidirectional cross-attention, avoiding pre-upsampling or early spectral collapse. BCAF uses two independent backbones: a standard Swin Transformer for RGB and an HSI-adapted Swin backbone that preserves spectral structure through 3D tokenization with spectral self-attention. Although our evaluation targets RGB-HSI fusion, BCAF is modality-agnostic and applies to co-registered RGB with lower-resolution, high-channel auxiliary sensors. On the benchmark SpectralWaste dataset, BCAF delivers strong performance, achieving 75.4% at 55 images/s. We further evaluate a novel industrial dataset: K3I-Cycling (first RGB subset already released on Fordatis). On this dataset, BCAF reaches 62.3% mIoU for material segmentation (paper, metal, plastic, etc.) and 66.2% mIoU for plastic-type segmentation (PET, PP, HDPE, LDPE, PS, etc.). These results show that preserving native-grid spatial detail and spectral structure improves multimodal segmentation under real-time constraints. Code and model checkpoints are publicly available at https://github.com/jonasvilhofunk/BCAF_2026.

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

Scalable and Interpretable Representation Alignment with Ordinal Similarity

arXiv:2606.16379v1 Announce Type: new Abstract: Evaluating representation similarity is fundamental to representation learning. However, existing metrics suffer from significant limitations: they lack interpretability due to shifting baselines, lack robustness to outliers, and are computationally intractable for large datasets, forcing reliance on heuristic approximations. To address this, we develop an ordinal-similarity framework, instantiated by the Triplet (TSI) and Quadruplet (QSI) Similarity Indices, which measure alignment by quantifying the consistency of ordinal relationships. We theoretically demonstrate this formulation is inherently interpretable, robust to outliers, and computationally efficient. Finally, we establish a formal equivalence between TSI and local neighborhood alignment, measured by Mutual Nearest Neighbors. Empirically, we validate these properties and show that ordinal similarity offers a scalable approach to measuring alignment, enabling practitioners to better understand and design representations.

09.
arXiv (CS.AI) 2026-06-15

When Sample Selection Bias Precipitates Model Collapse

arXiv:2606.13732v1 Announce Type: new Abstract: The proliferation of recursive training on synthetic data can alleviate data scarcity but risks model collapse, where repeated training erodes distributional tails and homogenizes outputs. Data selection is widely viewed as a remedy, yet its reliability depends critically on the reference distribution used by the verifier. We show that in low-resource verification regimes, where each verifier observes only a small, fragmented, and biased slice of the target manifold, selection itself becomes biased. This situation naturally arises in low-resource data silos such as healthcare consortia or proprietary financial institutions, where raw data cannot be pooled and local references are inherently incomplete. As a result, selection preferentially retains samples aligned with the local manifold while pruning globally relevant tail modes, turning from a safeguard against collapse into a mechanism that precipitates it. We theoretically prove that such siloed selection accelerates collapse and induces power-law diversity decay. As an initial mitigation, we construct Wasserstein proxy references from multiple silos without sharing raw data. Empirical results confirm that local-reference selection fails on skewed distributions, whereas collaborative proxy references mitigate diversity degradation, suggesting that recursive synthetic-data pipelines require particular caution when real-data coverage is fragmented or scarce.

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

Cross-Dataset, Age, and Gender Generalization: A Comprehensive Analysis of Fine-Tuning Strategies for Low-Resource Children's ASR

arXiv:2606.19791v1 Announce Type: cross Abstract: The challenge associated with recognizing dysarthric speech primarily arises from pronounced acoustic variability attributed to impaired articulatory precision. Past research has demonstrated improved recognition through the use of hybrid DNN/HMM sequence discriminative training. This paper presents a comprehensive investigation of various combinations of acoustic features tailored to different Acoustic Models, offering suitable feature selections for each. The incorporation of Pitch features notably improved recognition performance, especially for sentence recognition tasks involving dysarthric speech. Through a systematic examination of the TORGO database, we have demonstrated the potential to enhance the performance of the state-of-the-art Factorized Time Delay Neural Network (F-TDNN) model for recognizing dysarthric speech. Our methods, implemented with the F-TDNN model, resulted in a 4.65\% relative improvement in isolated word recognition and a 4.63\% relative improvement in sentence recognition for dysarthric speech, compared to previous research. This improvement effectively compensates for speech variability, attributable to our deliberate selection of the number of overlapping frames between consecutive training example chunks.

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

SceneConductor: 3D Scene Generation from a Single Image with Multi-Agent Orchestration

Generating complete 3D scenes from a single image requires inferring globally consistent geometry, object relationships, and environmental context from inherently ambiguous visual evidence. Despite recent progress in joint layout-and-mesh generation, existing methods often rely on holistic or weakly decomposed pipelines that entangle many factors at once and demand extensive scene-level supervision, limiting their generalization to complex real-world environments. We propose a multi-agent orchestration framework that decomposes single-image 3D scene generation into three structured stages: scene initialization, environment construction, and multi-agent refinement. The initialization stage extracts image-derived object masks, builds object-level 3D representations, and predicts an initial spatial layout to form a coarse 3D scene. The environment-construction stage then leverages this initialization together with point-map geometry to build an environmental scaffold of supporting surfaces, room boundaries, materials, and illumination. Finally, in the refinement stage, a planner agent identifies structural and visual inconsistencies, applies simple corrections directly, and dispatches specialist agents for complex localized revisions that are reintegrated into the global scene. To provide reliable structural initialization while reducing reliance on scene-level annotations, we further introduce a geometry-aware layout predictor supervised by sparse geometric priors derived from point maps. Unlike fully supervised layout generators, the predictor can be trained from segmentation-level data and generalizes robustly to diverse real-world scenes. Extensive experiments on benchmark datasets show that our method consistently outperforms prior approaches in geometric accuracy, spatial consistency, and perceptual realism.

12.
arXiv (CS.AI) 2026-06-17

Reversal Q-Learning

arXiv:2606.17551v1 Announce Type: cross Abstract: Iterative generative modeling techniques, such as flow matching, provide powerful tools to model complex behaviors for effective offline reinforcement learning (RL). In this work, we propose a new off-policy RL algorithm that trains a flow policy based on prior data. Our idea starts from the "expanded" Markov decision process (MDP) framework, which treats individual flow refinement steps as separate actions in an MDP. To enable off-policy RL within this framework, we apply two techniques: we generate virtual on-policy trajectories (by "reversing" flows) to make this framework compatible with prior data, and we apply a bias-and-variance reduction technique to mitigate the curse of horizon in off-policy RL. We call the resulting algorithm Reversal Q-learning (RQL). RQL has several advantages over previous flow-based RL methods: it does not suffer from backpropagation through time, makes better use of the learned value function, and directly trains the full, expressive flow policy. Through our experiments on 50 challenging simulated robotic tasks, we show that RQL leads to the best average offline RL performance compared to state-of-the-art flow-based offline RL algorithms.

13.
arXiv (CS.LG) 2026-06-16

HAPI-EP: Towards Hybrid, Adaptive, and Predictive Digital Twins of Cardiac Electrophysiology

arXiv:2606.15637v1 Announce Type: new Abstract: A digital twin (DT) of a patient-specific heart offers significant potential in personalized medicine. However, its rapid and dynamic adaptation to an individual's live data and its predictive capability after adaptation remains central challenges. We examine this challenge from its two building blocks: DT formulation where mechanistic and data-driven models show competing merits and limitations, and DT optimization strategies that are largely driven by a reconstruction objective leading to un-identifiable models. We address both bottlenecks via HAPI – an AI framework for building hybrid, adaptive, and predictive DTs with three key enablers. First, HAPI constructs a physics-integrated gray-box model in which an interpretable mechanistic backbone is augmented by a neural component that models its residual to the observed data. Second, rather than attempting to pre-encode all possible variations in a static hybrid model, HAPI enables rapid on-the-fly adaptation of the hybrid model to few-shot live data, achieved by feedforward meta-learners realizing amortized inference of both mechanistic and neural parameters of the hybrid model trained with predictive objectives. Finally, we show that this adaptivity corresponds to the construction of a conditional generative model (i.e., the hybrid DT) that endows it with theoretical identifiability and thus strong performance in predictive scenarios. We demonstrate the proof-of-concept of HAPI in cardiac electrophysiology using a hybrid monodomain model with mechanistic reaction kinetics and neural graph diffusion. Across synthetic and real-data studies, we show that HAPI's mechanistic-neural hybridization and predictive adaptation are critical for obtaining identifiable DTs with strong predictive and out-of-distribution capabilities.

14.
arXiv (CS.AI) 2026-06-24

IV-CoT: Implicit Visual Chain-of-Thought for Structure-Aware Text-to-Image Generation

arXiv:2606.24849v1 Announce Type: cross Abstract: Unified multi-modal large language models (MLLMs) have achieved strong text-to-image generation quality, but still struggle with structure-aware prompt following, where object counts, spatial relations, attribute bindings, and coarse layouts must be preserved. We attribute this limitation in part to the entanglement of structural planning and appearance rendering within a single conditioning stream. To address this issue, we propose Implicit Visual Chain-of-Thought (IV-CoT), a latent visual reasoning framework for query-conditioned image generation. IV-CoT decomposes the visual conditioning queries into a structural-to-semantic cascade, where structural queries first form a latent visual plan and semantic queries then render appearance conditioned on this plan. To guide the structural queries, we introduce training-only sketch supervision, which encourages them to capture structure from sketches without requiring sketch extraction or intermediate decoding at inference time. IV-CoT performs implicit CoT reasoning in a single forward pass and achieves superior results on GenEval and T2I-CompBench. Visualizations and analyses demonstrate that the learned structural and semantic queries play complementary roles in structure-aware generation.

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

Latent Space Reinforcement Learning for Inverse Material Estimation in Food Fracture Simulation

Realistic visual simulation of food manipulation requires accurate material parameters, yet these are difficult to measure directly and vary across the heterogeneous regions of a single food item. We address the inverse problem of estimating material parameters from a target description of fracture behavior in a non-differentiable continuum damage mechanics simulator. Using orange peeling as a test case, we train a neural surrogate on 2,000 forward simulations and compare Covariance Matrix Adaptation Evolution Strategy (CMA-ES, a gradient-free evolutionary optimizer) with Proximal Policy Optimization (PPO, a reinforcement learning algorithm) across the original 9-dimensional parameter space and two learned 4-dimensional latent representations. Since different oranges have different material properties, a practical inverse system must handle arbitrary targets without retraining. We train a goal-conditioned PPO policy that learns a general inverse mapping: given any target description of peeling behavior, the policy produces a material parameter estimate in a single forward pass (8 surrogate evaluations, approximately 10ms). Operating in a normalizing flow latent space with a shared surrogate evaluator, the goal-conditioned policy achieves 0.642 actual recovery when validated through the simulator, outperforming the original parameter space by 23%. A warm-start extension that initializes CMA-ES refinement from the policy's output further improves recovery to 0.828 with 540 evaluations. These findings provide a practical framework for inverse food physics and lay groundwork for vision-driven material identification from video observations of food manipulation.

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

Exploiting Search in Symbolic Numeric Planning with Patterns

arXiv:2606.16329v1 Announce Type: new Abstract: In this paper, we present a procedure for numeric planning based on Symbolic Pattern Planning (SPP). Given a numeric planning problem $\Pi$, a pattern $\prec$ is a sequence of actions used to define a formula encoding the subsequences of $\prec$ executable from a starting state $S$. Cardellini, Giunchiglia, and Maratea (2024a) follow the Planning as Satisfiability approach by defining, at each step $n \ge 0$, a formula $\Pi^\prec_n$ in which $(i)$ the pattern $\prec$ is computed only for $n=0$ in the initial state $I$ of $\Pi$, and then exploited at each step $n$, $(ii)$ the starting state $S$ is set to $I$, and $(iii)$ the set $G$ of goals is required to hold in the last state that can be reached by one of the subsequences of $\prec$ concatenated $n$ times. The procedure begins with $n=0$, terminates as soon as $\Pi^\prec_n$ is satisfiable, and otherwise proceeds by incrementing $n$. In this paper, possibly at each step, $(i)$ we symbolically search for an intermediate state $P$ reachable from $I$, closer to a goal state, $(ii)$ dynamically recompute the pattern $\prec_h$ – to be used in the next step – in $P$, $(iii)$ refine the pattern $\prec_g$ used to reach $P$, and $(iv)$ start the new search from the state $S$ which can be either the initial state $I$ or the last computed intermediate state $P$, exploiting the computed patterns $\prec_g$ and $\prec_h$ to define the pattern $\prec$ to be used in the search. In particular, at each step, we define a formula $\Pi^{\prec}_{S,P}$ encoding the existence of a state $P'$ closer than $P$ to a goal state, with $P'$ reachable from the starting state $S$ when using the pattern $\prec$. We present different techniques for producing such formulas, each corresponding to a different strategy for exploring the search space. We prove their correctness and completeness, the latter under certain conditions.

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

FlowDec: Temporal Conditional Flow Decorruptor for Robust Continuous Vision-Language Navigation

Vision-and-Language Navigation in Continuous Environments (VLN-CE) requires agents to follow natural-language instructions in unseen scenes. While Large Models (LMs) have advanced VLN-CE, their performance remains severely degraded by real-world visual corruptions, a critical yet underexplored domain constraint. We introduce Temporal Conditional Flow Decorruptor (FlowDec), a novel image restoration framework tailored for LM-based VLN-CE. FlowDec integrates a hybrid temporal conditioning strategy to align the generative flow path with historical context and employs action-centroid guided filtering to dynamically assess and integrate outputs. Extensive experiments demonstrate that FlowDec outperforms state-of-the-art decorruption methods in both navigation accuracy and generation latency. Our approach establishes a robust, efficient paradigm for resilient embodied navigation in unpredictable real-world conditions.

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

3-Key-Input: Exploring the Theoretical Minimum Keys for Text Entry

作者:

How far can we reduce the number of physical keys if we endow an ambiguous keyboard with modern language models? Fewer keys increase hardware design freedom in constrained settings such as assistive devices and mobile form factors. This paper systematically evaluates text entry systems using 2-5 physical keys combined with language-model-based disambiguation. On a 300-sentence English corpus (100 sentences each for Business / Conversational / Technical), we compare key counts (2-5), letter-to-key mappings (layout-based / frequency-based / intentionally worst-case), and decoders (Trie-only, GPT-2 beam search, GPT-4o selection). We find that 3 keys + GPT-4o achieves character error rate (CER) 9.46% and word error rate (WER) 12.20%, reducing CER by 59% relative to 2 keys (CER 23.3%). At 3 keys, the key-stream entropy is 1.54 bits/char; while increasing to 5 keys improves accuracy (CER 5.4%), the marginal gains diminish. Mapping choice has a small impact under standard designs ({\Delta}CER < 0.5 pp), and even an intentionally worst mapping degrades CER by only +0.5 pp, whereas Technical sentences yield roughly twice the error rate of Business. These results suggest that, in our evaluated offline setting under a strong LM prior, 3 keys are a practical minimum for general English.

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

WorldLines: Benchmarking and Modeling Long-Horizon Stateful Embodied Agents

arXiv:2606.18847v1 Announce Type: new Abstract: To assist humans over extended periods in real homes, embodied agents must remember user routines, world states, and past interactions. Existing long-term memory benchmarks mainly evaluate language-centric retrieval and question answering, while embodied benchmarks often focus on short-horizon task execution without testing long-term memory use in dynamic environments. We introduce WorldLines, a project-driven benchmark for long-horizon embodied household assistance. It constructs temporally extended household traces with dialogues, actions, execution feedback, object and device state changes, and converts them into evidence-linked samples for Memory QA and Embodied Task Planning. We further propose ObsMem, an observer-grounded memory framework that maintains visibility-aware memories and action-native state trails for state-aware decisions. Experiments reveal persistent challenges in partial observability, overwritten world states, and translating long-term memory into embodied plans, while ObsMem offers a stronger reference architecture for this setting.

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

Organize then Retrieve: Hierarchical Memory Navigation for Efficient Agents

Large language model (LLM) agents struggle with long-horizon tasks due to their inherent statelessness, requiring all task-relevant information to be encoded in growing input contexts. The resulting degraded reasoning quality, increased inference cost, and higher latency necessitate efficient working memory mechanisms. However, existing approaches either rely on lossy compression or similarity-based retrieval, which often fail to capture temporal structure and causal dependencies required for multi-step agentic tasks. In this work, we present HORMA, a Hierarchical Organize-and-Retrieve Memory Agent that organizes experience into a file-system-like hierarchical structure, where summarized entities are linked to the corresponding raw trajectories, enabling efficient access without losing detailed information. HORMA decomposes working memory into two stages: structured memory construction and navigation-based retrieval. The construction module iteratively refines how experiences are structured by distinguishing between failures caused by missing information and those caused by misleading or overloaded context. The navigation module retrieves task-relevant context by traversing the hierarchy using a lightweight agent trained with reinforcement learning to select minimal yet sufficient context, thereby reducing latency along the critical execution path. Across ALFWorld, LoCoMo, and LongMemEval, HORMA improves task performance under constrained context budgets while requiring at most 22.17% of the baseline token usage in long conversation tasks. Compared to existing methods, it consistently achieves better efficiency-performance trade-offs and generalizes effectively to unseen tasks.

21.
medRxiv (Medicine) 2026-06-10

Impact of Early Treatment on Symptom Improvement and Procedural Events among Men with BPH and Bothersome Lower Urinary Tract Symptoms: A Contemporary Analysis of the American Urological Association Quality (AQUA) Registry

PURPOSE: As the armamentarium of BPH therapies continues to expand, it remains imperative to maximize patient satisfaction and minimize decisional regret. We sought to determine the impact of time from BPH diagnosis to index treatment on symptom improvement and subsequent procedural events. MATERIALS AND METHODS: We queried the American Urological Association Quality Registry for men [&ge;] 40 years old with BPH, available IPSS data, and no receipt of prior BPH treatment. Index treatment included medication, surgery, or minimally invasive surgical therapy (MIST). Outcomes included IPSS over 3 years of follow-up, change in percentage of mild lower urinary tract symptoms (LUTS) by 3 months, and time to procedural event. Patients were stratified by time from index diagnosis to treatment by 3 years. Outcomes were compared across time-to-treatment cohorts with appropriate statistical tests with p < 0.05 as significant. RESULTS: 43,919 patients met criteria with 19,642 pursuing treatments. Patients pursued treatment at comparably lower baseline IPSS compared to prior prospective series. Patients undergoing surgery and MIST had significantly higher baseline IPSS, while medical comorbidities were significantly more common among men initiating pharmacotherapy. Early surgery and MIST were associated with significant improvement in IPSS within 6-12 months and an increase in mild LUTS by 3 months. All forms of early treatment were associated with delayed time to procedural events, including catheterization and fulguration. CONCLUSIONS: Early procedural intervention for BPH is associated with early symptom improvement and delayed time to procedural events among real-world, contemporary practice.

22.
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&nbsp;take patient histories, order tests, interpret findings, diagnose conditions and propose treatments, outperforming experienced clinicians while adhering to safety standards and clinical guidelines.

23.
arXiv (CS.AI) 2026-06-11

"That's AI Slop, You Bot!" Studying Accusations, Evidence, and Credibility in Online Discourse Towards LLM-Generated Comments

arXiv:2606.12073v1 Announce Type: cross Abstract: Generative AI has made fluent prose cheap to produce, breaking the old promise to readers that good writing meant real thinking. How have readers responded, and what can this tell us about changing anti-AI attitudes? We analyzed 25 million comments from Hacker News and Reddit (2023-2026), combining LLM judgment on 7,500 sampled accusations of AI use, sentiment trajectories, speech-act coding of 300 confirmed accusations of AI use, and a matched-control test of accused versus non-accused parent comments. We found that the pejorative-label share of accusations rose more than tenfold on both platforms while a placebo vocabulary of pre-2022 inauthenticity terms (shill, astroturf) did not. This shift reflected a fast-growing trend of branding any suspicious or seemingly inauthentic prose as "AI slop". The slop frame now constitutes 94 percent of pejorative mentions, with the dominant comments shifting in tone from mockery toward gatekeeping and structural protest. The key surprise comes from a matched-control test which found that prose features that statistically distinguish AI from human text do not predict which human text gets accused as AI. The new accusations work as social gatekeeping of perceived authenticity without actually screening for AI. This research extends signaling theory by showing that substitute signals used socially can grow even when inaccurate if the underlying detection problem cannot be solved at the non-expert level. It shows that AI's effects on writing from the reader side are distinct from those on the production (writer) side. Detection technology cannot resolve this dynamic because the social function of accusations is increasingly to perform social gatekeeping and in-group signaling as opposed to identifying AI-generated writing.

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

GUI vs. CLI: Execution Bottlenecks in Screen-Only and Skill-Mediated Computer-Use Agents

arXiv:2606.24551v1 Announce Type: new Abstract: Computer-use agents can execute software tasks through either graphical interfaces or programmatic command interfaces, but existing evaluations confound interaction modality with differences in tasks, initial states, verifiers, and permitted actions. We introduce a matched execution-layer benchmark of 440 desktop tasks across 18 applications and 12 workflow categories, where screen-only GUI agents and skill-mediated CLI agents receive identical goals, states, and final-state verifiers while being restricted to modality-native actions. In this controlled setting, the strongest GUI agent reaches a 59.1% full pass rate, outperforming the strongest original-skill CLI agent at 48.2%; however, verifier-guided skill augmentation raises CLI success to 69.3%, showing that much of the CLI deficit comes from incomplete skill coverage rather than model capability alone. These results suggest that GUI and CLI expose different execution bottlenecks: GUI agents are limited by reliable grounded interaction over long-horizon workflows, whereas CLI agents are limited by the coverage and scalability of their skill interfaces.

25.
arXiv (CS.LG) 2026-06-18

A Guide to Estimating Conditional Average Treatment Effects in Competing Risks Settings

arXiv:2606.18281v1 Announce Type: cross Abstract: Conditional average treatment effects (CATEs) are central to treatment decision-making in personalized medicine. In competing risks settings, estimating CATEs from survival data allows for patient-specific assessments of treatment effectiveness for a specific event of interest while properly accounting for alternative event types. This distinction is essential in the presence of comorbidities, where competing causes of death may otherwise confound the therapeutic benefit. Focusing on right-censored survival times with binary treatment, we examine CATEs defined as covariate-conditional differences in the absolute risk for the event of interest at a fixed time. To this end, we study meta-learners which adapt machine learning algorithms for CATE estimation in competing risks scenarios. We systematically compare six meta-learners, combining Cox regression or random survival forests for risk modeling with elastic net regression or random forests for direct CATE modeling. To provide practical guidance on model selection, we evaluate their performance in multiple simulation settings, that differ in hazard complexity, treatment heterogeneity, treatment assignment, event type distribution and censoring. To facilitate applied use, we provide the R package, crsurvlearners, which implements all considered approaches.