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01.
arXiv (CS.CL) 2026-06-19

When Lower Privileges Suffice: Investigating Over-Privileged Tool Selection in LLM Agents

As LLM agents increasingly select tools autonomously, their choices among tools with different privileges become safety-relevant. However, prior tool-selection studies focus on safety-agnostic metadata preferences, leaving privilege-sensitive choices underexplored. To address this gap, we study over-privileged tool selection, in which an agent selects or escalates to a higher-privilege tool despite a sufficient lower-privilege alternative. We introduce ToolPrivBench to evaluate whether agents choose higher-privilege tools despite sufficient lower-privilege alternatives, measuring both initial selection and escalation after transient tool failures. Across eight domains and five recurring risk patterns, we find that over-privileged tool selection is common among mainstream LLM agents and is further amplified by transient failures. We further find that general safety alignment does not reliably transfer to least-privilege tool choice, while prompt-level controls provide only limited mitigation under transient failures. We therefore introduce a privilege-aware post-training defense that teaches agents to prefer sufficient lower-privilege tools and escalate only when necessary. Our mitigation experiments show that this defense substantially reduces unnecessary high-privilege tool use while preserving general capabilities.

02.
arXiv (CS.CL) 2026-06-16

The Dark Regulome: Disentangling Predictability from Regulation in Genomic Foundation Models

High-grade gliomas integrate into neural circuits through functional synapses with neurons, raising the question of which noncoding elements shape synaptogenic gene expression in tumor cells. The regulatory program written across the dark genome, what we call the $dark regulome$, is the natural substrate to probe, and sequence foundation models offer a zero-shot route through in-silico mutagenesis (ISM); yet likelihood-based scoring is tautologically coupled to local sequence predictability, leaving the regulatory interpretation underdetermined. Across three architecturally distinct foundation models (Caduceus-Ph, HyenaDNA, Enformer) and 30,448 dark genome elements at 92 glioma-relevant loci, we introduce a residualization-and-permutation diagnostic that separates predictability-driven from regulation-driven RIS variance. A sharp 10kb proximal-regulatory horizon survives every control we apply, but the LM-derived element-class hierarchy does not: a six-feature linear baseline matches Caduceus top-decile membership at AUC $= 0.985$. Cross-architecture decomposition cleanly separates a sequence-predictability layer (the two language models co-rank long well-predicted transposable elements) from a regulatory-output layer (Enformer alone retains residual cCRE-discriminative signal), with literally zero overlap between the two top-100 lists. Conservation, brain cis-eQTL, and STRING-PPI cross-checks then anchor what biology survives: top-100 elements across all three models are $3.3\times$ enriched per model for matching brain eQTLs ($p_\mathrm{emp} < 5\times 10^{-3}$), while a tempting transposable-element regulatory layer and a striking NRXN1+NLGN1 protein-pair convergence both fail proper permutation tests once those tests are constructed. We deliver the diagnostic as a general methodological tool for any ISM-based regulatory study.

03.
arXiv (quant-ph) 2026-06-15

Experimental violation of a Bell-like inequality for causal order

arXiv:2506.20516v2 Announce Type: replace Abstract: Quantum mechanics is compatible with scenarios where physical processes happen in an indefinite order. In theory, this feature could be detected through violations of inequalities on the observed correlations, analogous to Bell inequalities. However, experimental demonstrations of such violations have been missing until recently due to the complexity of the required setup. Here we report an experimental violation of a Bell-like inequality involving the correlations of four parties, one of which is spacelike separated from the others. Our demonstration employs 3 km fiber spools to simulate spacelike separation, and achieves high-speed operations in photonic time-bin encoding, nanosecond synchronization, and accurate temperature stabilization. These experimental advances enable a violation by 5.7 standard deviations and open a path towards a certification of indefinite order in conditions that guarantee spacelike separation with existing state-of-the-art devices. However, the certification is not device-independent, as it relies on knowledge about the setup to exclude bidirectional signaling–a loophole inherent to implementations in classical acyclic spacetimes, which may be resolved in future quantum-spacetime tests.

04.
medRxiv (Medicine) 2026-06-15

Anti-Platelet Factor 4 Antibody Clonal Heterogeneity and MGUS Status in HIT

Background Monoclonal gammopathy of thrombotic significance (MGTS) is a recently described chronic prothrombotic condition characterized by monoclonal anti-PF4 antibodies that are detected above the polyclonal antibody background in patient sera (i.e. present as monoclonal gammopathy of undetermined significance, MGUS). Due to conflicting data in the published literature on antibody clonality in heparin-induced thrombocytopenia (HIT), we evaluated clonality and abundance of anti-PF4 antibodies in HIT, including investigating whether an MGUS, if present in HIT, represents the causative anti-PF4 antibody. Methods Blood samples from 15 patients with HIT were subject to Platelet Factor 4-dependent antigen-based and functional tests. The unmanipulated serum antibody repertoire and isolated anti-PF4 antibodies were subjected to mass spectrometric evaluation. Results Two of the 15 HIT patients had an IgG MGUS. Notably, anti-PF4 antibodies were not synonymous with the MGUS antibody in either of the two patients. Eight of the 15 patients demonstrated monoclonal anti-PF4 antibodies, however, none of the anti-PF4 antibodies were detectable as an MGUS upon evaluation of the entire serum antibody repertoire, reflecting their low abundance. In the seven patients with multiple anti-PF4 antibodies, non-monoclonality was confirmed by analysis of deglycosylated antibody heavy chains. Conclusions Anti-PF4 HIT antibodies are monoclonal in approximately 50% of HIT patients, however, antibody abundance is low such that they are not detectable over the polyclonal IgG background (i.e. are MGUS-negative), differentiating HIT from MGTS. This observation helps explain the transient nature of HIT relative to the persistent prothrombotic state seen in MGTS.

05.
arXiv (math.PR) 2026-06-19

Towards practical PDMP sampling: Metropolis adjustments, locally adaptive step-sizes, and NUTS-based time lengths

arXiv:2503.11479v2 Announce Type: replace-cross Abstract: Piecewise-Deterministic Markov Processes (PDMPs) hold significant promise for sampling from complex probability distributions. However, their practical implementation is hindered by the need to compute model-specific bounds. Conversely, while Hamiltonian Monte Carlo (HMC) offers a generally efficient approach to sampling, its inability to adaptively tune step sizes impedes its performance when sampling complex distributions like funnels. To address these limitations, we introduce three innovative concepts: (a) a Metropolis-adjusted approximation for PDMP simulation that eliminates the need for explicit bounds without compromising the invariant measure, (b) an adaptive step size mechanism compatible with the Metropolis correction, and (c) a No U-Turn Sampler (NUTS)-inspired scheme for dynamically selecting path lengths in PDMPs. These three ideas can be seamlessly integrated into a single, `doubly-adaptive' PDMP sampler with favourable robustness and efficiency properties.

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

Phenotyping TPF via Self-Supervised Learning: A Label-Agnostic Framework with Expert Validation

The full potential of artificial intelligence in tibial plateau fracture characterisation remains unrealised, constrained by a fundamental dependency on labelled datasets whose consistency cannot be guaranteed: conventional classification schemes such as Schatzker and AO/OTA suffer from inter-observer variability, causing supervised models to learn human disagreement rather than stable fracture morphology. We design, implement, and validate a label-agnostic framework that eliminates this constraint by learning fracture representations directly from imaging data without observer-assigned labels. A RadImageNet-pretrained ResNet-50 encoder is fine-tuned on 154 cleaned knee radiographs using the SimCLR contrastive objective, preceded by a data cleaning protocol and followed by UMAP dimensionality reduction and k-means clustering to discover four imaging-derived phenotypes. Phenotype validity is assessed through a blinded expert review protocol administered to two independent clinicians. The four phenotypes demonstrate robust stability (bootstrap ARI = 0.319 +/- 0.041), strong internal cohesion (silhouette = 0.511), and coherence ratings of 3-5/5 from both reviewers under blinded conditions; one phenotype was unanimously identified as exhibiting comminution – a high-complexity feature isolated without any supervisory signal. Inter-partition comparison against Schatzker labels yields ARI = 0.013, confirming orthogonality to conventional classification boundaries. Notably, expert reviewers anchored to established classification vocabularies perceived imaging-derived groups as heterogeneous precisely where Schatzker alignment was lowest, suggesting that Schatzker-trained perception and label-agnostic embedding geometry measure orthogonal dimensions. These findings establish label-agnostic SSL phenotyping as a reproducible and clinically interpretable complement to conventional classification.

07.
arXiv (quant-ph) 2026-06-16

Efficient Implementation of a Single-Qutrit Gate Set via Coherent Control

arXiv:2507.06860v2 Announce Type: replace Abstract: Qutrits offer the potential for enhanced quantum computation by exploiting an enlarged Hilbert space. However, the synthesis of high-fidelity and fast qutrit gates, particularly for single qutrits, remains an ongoing challenge, as it involves overcoming intrinsic constraints in quantum platforms. Here, we develop a novel framework for the efficient implementation of a single-qutrit gate set via coherent control, leveraging SU(3) dynamics while obviating platform-specific constraints such as those arising from the selection rule. As a proof-of-principle demonstration, we realize 35-ns qutrit Hadamard and X gates using a superconducting transmon, achieving an average fidelity of 99.5\%, as verified by randomized benchmarking. We further demonstrate two paradigmatic quantum circuits, which can be naturally extended to scalable qudit algorithms for phase estimation and parity check. In addition, we propose an SU(3)-based decomposition strategy for an arbitrary single-qutrit gate and numerically demonstrate its substantial efficiency improvement over conventional SU(2)-based protocols. By addressing the challenge of efficiently implementing single-qutrit gates, our protocol paves the way for realizing high-performance qutrit processors in diverse quantum platforms.

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

EMS: Multi-Agent Voting via Efficient Majority-then-Stopping

arXiv:2604.02863v2 Announce Type: replace Abstract: Majority voting is the standard for aggregating multi-agent responses into a final decision. However, traditional methods typically require all agents to complete their reasoning before aggregation begins, leading to significant computational overhead, as many responses become redundant once a majority consensus is achieved. In this work, we formulate efficient multi-agent voting as a reliability-aware agent scheduling problem and propose Efficient Majority-then-Stopping (EMS) to improve reasoning efficiency. EMS first estimates a Task-Conditioned Reliability Ordering (TCRO) for each agent by retrieving its historical consensus evidence on semantically similar queries, and then invoking agents in descending reliability order. Next, Adaptive Incremental Voting (AIV) terminates the process once the current leading answer cannot be overturned by any possible votes from the remaining agents, and returns this answer. Finally, Reliability History Updating (RHU) updates only the invoked agents according to their consensus with the final decision. Extensive evaluations across five benchmarks show that EMS preserves the accuracy of Majority Voting while reducing the average number of invoked agents by 35% and token consumption by 44%, respectively. The code is available at https://github.com/fuyu66/EMS.

09.
arXiv (CS.CV) 2026-06-16

VisualClaw: A Real-Time, Personalized Agent for the Physical World

Vision language models are serving as general-purpose interfaces for complex multimodal tasks. However, deployment still faces three gaps: VLMs typically incur high latency and cost when processing dense video frames and long prompts, the agent scaffold remains static after deployment, and standard video-QA benchmarks do not test whether agents can use visual evidence inside tool-using workspaces. We present VisualClaw, a self-evolving multimodal agent built around two principles. First, hybrid encoding reduces deployment cost by filtering less informative streaming frames with a cascaded gate and compressing the text skill bank through hot/cold top-k injection. Second, skill evolution lets the agent learn from failures: retrieved memories condition an evolver as direct concatenated context or as guided evidence, producing skill-bank updates that help future questions. Across 4 video-QA benchmarks with 2 VLMs, VisualClaw cuts per-question API cost by an average -98% versus full-frame upload and by -25.9% over the offline uniform 8 frame baseline, while boosting accuracy in most settings, e.g., an average +3.85% and a peak +15.80% on EgoSchema with Gemini 3 Flash. To address the gap, we curate VisualClawArena, a 200-scenario multimodal agentic benchmark built through a strict five-stage pipeline; models must use video evidence, documents, dynamic updates, and executable checks inside a workspace. On VisualClawArena, the same framework with computer-use agent backends improves macro accuracy by +2.9% for Codex (GPT-5.5) and +3.2% for Claude Code (Sonnet 4.6) over no-evolution baselines, with a -9.5% cost reduction compared to the uniform-sampled baseline. These properties make VisualClaw a natural fit for edge applications, where the cascade reduces a 1-hour streaming session from ~3,600 API uploads down to only 5-20 calls and the self-evolution makes it a perfect personalized assistant.

10.
arXiv (math.PR) 2026-06-18

A simple approach to the L{\o}kka-Zervos dichotomy for absolutely continuous dividend strategies

arXiv:2604.13302v3 Announce Type: replace-cross Abstract: We revisit the optimization problem solved in L{\o}kka & Zervos (2008), i.e., the maximization of dividends, in a Brownian risk model, with the possibility (not the obligation) of making capital injections. Following the approach introduced in Alvarez & Shepp (1998), Renaud & Simard (2021), Renaud et al. (2023), we consider instead absolutely continuous (AC) dividend strategies with an affine bound on the payment rates, while singular capital injections are still allowed. In addition, we incorporate a parameter for the cost of ruin or, said differently, a penalty at ruin in the performance function. We show that the solution is a so-called L{\o}kka-Zervos dichotomy: the surplus is never ruined by making bail-out payments, or no capital is injected and bankruptcy can occur; in either case, dividends are paid at full rate when the surplus is above a threshold. Our framework allows us to provide explicit conditions to express the dichotomy, either using the cost of capital injections or the cost of ruin as a criterion, which also exposes the underlying structure of the solution. In particular, for some values of the parameters, we show that it is optimal to liquidate. Moreover, we perform a numerical analysis highlighting the range of values generated under this AC affine-bound structure.

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

Semantic Editing with Coupled Stochastic Differential Equations

Editing the content of an image with a pretrained text-to-image model remains challenging. Existing methods often distort fine details or introduce unintended artifacts. We propose using coupled stochastic differential equations (coupled SDEs) to guide the sampling process of any pre-trained generative model that can be sampled by solving an SDE, including diffusion and rectified flow models. By driving both the source image and the edited image with the same correlated noise, our approach steers new samples toward the desired semantics while preserving visual similarity to the source. The method works out-of-the-box, without retraining or auxiliary networks, and achieves high prompt fidelity along with near-pixel-level consistency. These results position coupled SDEs as a simple yet powerful tool for controlled generative AI. Project page: https://z-jianxin.github.io/syncSDE-release/. Code: https://github.com/Z-Jianxin/syncSDE-release.

12.
arXiv (math.PR) 2026-06-11

On the $d$-rigidity phase transition in random graphs

作者:

arXiv:2605.25711v2 Announce Type: replace-cross Abstract: We study generic $d$-dimensional rigidity in sparse random graphs. Our main result is that for every $d\ge 2$, the Erdős–Rényi random graph $G\sim G(n,c/n)$ undergoes a $d$-rigidity phase transition at the known, explicit, $d$-orientability threshold $c_d$: If $cc_d$, then $G$ is a.a.s. not independent in the generic $d$-rigidity matroid, and we give a sharp asymptotic estimate for its rank. In addition, the $d$-rigidity closure of $G$ has a giant clique of linear size, which contains all but at most $o(n)$ vertices of the $((d+1)+d)$-core of the graph. More generally, we compute, up to a $1+o(1)$ factor, the generic $d$-rigidity rank of random graphs with a given degree distribution. For example, we show that the uniform $n$-vertex $k$-regular graph a.a.s. has rank $\min(k/2,d)n+o(n).$ Our approach is to estimate the rigidity rank of a random graph from its Galton–Watson local weak limit, using a parameter that we call local flexibility.

13.
arXiv (CS.AI) 2026-06-11

FreeBridge: Variational Schrödinger Bridges for Cellular Transition Dynamics

arXiv:2606.11286v1 Announce Type: cross Abstract: High-content imaging assays quantify cellular responses to chemical and genetic perturbations, yet continuous trajectories of individual cells are unobservable because cells are chemically fixed at acquisition. Perturbation modeling therefore reduces to inferring stochastic transport between control and treated populations observed only as separate marginals. While recent generative models achieve strong end-point alignment, boundary consistency does not determine intermediate evolution: multiple stochastic processes may connect identical marginals while traversing regions unsupported by observed single-cell morphologies. We introduce FreeBridge, a Schrödinger Bridge formulation for single-cell transition modeling under endpoint-only supervision. FreeBridge defines atomic states as instance-segmented single-cell representations, establishing a fixed cellular manifold, and learns stochastic transport constrained within this geometry via empirical latent support regularization. Across BBBC021, RxRx1, and JUMP, FreeBridge maintains competitive or improved endpoint fidelity and mechanism-of-action retention under a unified evaluation protocol; on BBBC021, it further reduces intermediate support violations. These findings highlight the importance of geometric grounding for biologically interpretable perturbation dynamics. Project page: https://y-research-sbu.github.io/FreeBridge/.

14.
medRxiv (Medicine) 2026-06-11

PCRAgent: A Multi-Agent Framework for Transforming Noisy clinical conversations into Structured Pre-Consultation Medical Records and Reusable Clinical Data Resources

In primary care and outpatient settings, clinically important patient information is often embedded in fragmented, ambiguous, repetitive, and noisy communication between physicians and patients. This limits physicians ability to obtain a clear preconsultation overview of symptoms, history of present illness, and visit intent, while also preventing real world clinical dialogues from being reused in hospital information systems and medical artificial intelligence applications. To address this challenge, we developed PCRAgent, a centrally coordinated multi agent framework for preconsultation clinical information organization. Guided by physician inquiry logic, PCRAgent identifies, extracts, corrects, and standardizes patient-reported information from noisy consultations. Its coordinated modules including error detection, semantic editing, output control, contextual memory, and intent recognition enable robust parallel handling of spelling errors, repetitions, grammatical inconsistencies, medical ambiguities, and non-medical interference. A traceable edit list records intermediate corrections and context, allowing iterative refinement without redundant modifications. PCRAgent generates two complementary outputs. One is a PreConsultation Clinical Report for rapid physician review. The other is a Structured Clinical Conversation Dataset for hospital data construction and downstream AI applications. In evaluations using 220000 strongly perturbed consultations, PCRAgent maintained high robustness, achieving a clinical information accuracy of 4.99 out of 5 and key element completeness of 5 out of 5, outperforming GPT4o. Expert review of Chinese and English dialogues confirmed high clinical accuracy of 4.85 out of 5 and high safety of 4.79 out of 5. Multicenter validation in real-world outpatient workflows further demonstrated practical utility. These findings indicate that PCRAgent can efficiently transform noisy and unstructured consultations into physician ready reports and AI ready structured data, improving outpatient efficiency, reducing cognitive burden, ensuring information completeness, supporting precise decision-making, and enabling high-quality reuse of clinical data.

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

Differential Privacy of Gaussian Process Posterior Sampling

arXiv:2606.17995v1 Announce Type: cross Abstract: We study the privacy of releasing posterior sample paths from a Gaussian process (GP) when the entire training set including covariates and responses is private. Unlike standard differential-privacy (DP) mechanisms that add external noise, posterior sampling is random by construction. We show that this intrinsic randomness yields DP guarantees by deriving explicit Rényi-DP bounds for GP posterior sample-path release. The bounds separate posterior-mean leakage from data-dependent posterior-covariance leakage showing that meaningful privacy depends sharply on effective ridge regularisation. We apply membership-inference attacks to show that empirical leakage follows the predicted dependence on regularisation, posterior variance and the number of released posterior sample-paths. Utility experiments on downstream posterior-sampling tasks identify noisy-observation regimes where privacy-compatible regularisation preserves useful decisions with modest utility loss. When stronger privacy is needed, the intrinsic guarantee can be sharpened by adding calibrated GP noise, providing an explicit additional privacy knob.

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

ISE: An Execution-Grounded Recipe for Multi-Turn OS-Agent Trajectories

Training capable OS agents requires data that simultaneously captures structured user intents, multi-turn task delegation, and grounded tool execution–properties absent from existing datasets. We propose ISE (Intent -> Simulate -> Execute), a three-stage synthesis paradigm that addresses these gaps jointly. Stage 1 constructs roughly 50000 structured intents via a 4D framework (Persona x Domain x Task x Complexity); after deduplication the pool contains 43956 unique intents and attains a Vendi Score of 61.57 over the entire pool on mpnet-base-v2 embeddings (cosine kernel, q=1). Stage 2 drives multi-turn user-agent interaction through a role-locked user simulator that grounds each user turn in actual execution outcomes, producing 23132 complete trajectories averaging 8.12 user turns and 68.24 total dialogue turns. Stage 3 runs every tool call inside a live, isolated OS workspace, generating authentic failure-recovery dynamics instead of simulated responses. Fine-tuning on ISETrace improves ClawEval pass@1 from 19.3 to 37.7 using Qwen3-8B on agent tool-use tasks with a standard protocol. This result outperforms zero-shot GPT-4o and the larger Qwen3-32B base model which is four times bigger. An ablation on Stage 2 proves multi-turn simulation brings a large portion of the performance gain. We release all source code and dataset at https://github.com/Valiere01/ISE-Trace.

17.
arXiv (CS.LG) 2026-06-19

Judging to Improve: A De-biased VLM-as-3D-Judge Protocol for Single-Image 3D Generation

arXiv:2606.20364v1 Announce Type: new Abstract: A companion study established a de-biased, cross-model VLM-as-3D-judge that reliably ranks single-image-to-3D mesh quality where cheap geometry and CLIP proxies fall short. This paper asks: can that judge's preferences specialize a strong open generator, TRELLIS, on one asset class (furniture), cheaply and without human labels? Taking the judge from ranking to optimization is where the work lives. Pushing a VLM judge into the training and evaluation loop exposes failure modes ranking never triggered, so our contribution is an optimization-grade hardening of the judge: a training judge (Qwen2.5-VL-7B) held distinct from an evaluation judge (InternVL3-8B) to break circularity; position-bias correction; and fixes for three failure modes (image overload, geometry-hiding splat renders, and reference-free judging that rewards clean-but-wrong outputs), with calibration evidence (clear-gap win-rate 0.83-1.0; base-vs-base ~0.5). Using this protocol as an independent evaluator, and working only from public models and data with lightweight parameter-efficient adaptation, we find our methods match the strong base rather than exceed it. Independent base samples carry essentially no learnable preference (0.94 order-flip rate), so signal must be engineered by quality-contrastive construction. Across six adaptation methods, two input regimes, and a severity sweep, the most targeted - conditioner repair under severe degradation - reaches parity (0.50) with the base, while no method clears the >=65% win-rate target. The result is mechanistic: clean inputs saturate the judge, flow-DIT fine-tuning washes out through the sampler, and conditioning repair is the locus that moves geometry. Win-rates are directional at n=8 objects. Matching a strong public-data base with cheap adaptation is itself informative: exceeding it needs more than lightweight PEFT on public data, and the judge protocol is reusable.

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

Null-Space Diffusion Distillation Unlocks Speed, Fidelity and Realism in Lensless Imaging

Lensless imaging reconstructs scenes from highly multiplexed measurements, resulting in a severely ill-posed inverse problem. In this work, we identify a fundamental trade-off between measurement consistency, perceptual quality, and inference speed across lensless reconstruction paradigms. Traditional methods favor consistency but produce perceptually degraded results, supervised approaches achieve high-quality reconstructions with fast inference but may violate physical constraints, and diffusion-prior methods achieve high perceptual quality and consistency–particularly when structured constraints such as range-null decomposition are used–but remain slow due to iterative sampling. Motivated by this observation, we propose Null-Space Diffusion Distillation (NSDD), a single-pass reconstruction model that distills structured diffusion-prior inference into an efficient feed-forward network. NSDD learns to produce high-quality reconstructions that preserve measurement consistency while avoiding costly iterative sampling. Experimental results demonstrate that NSDD achieves perceptual quality and consistency competitive with diffusion-prior methods, while providing significantly faster inference and offering a favorable balance across all three objectives. Furthermore, ablation experiments show that distilling the range–null decomposition improves reconstruction quality and robustness over unstructured full-reconstruction distillation, including on unseen real scenes. These results highlight the potential of structure-aware distillation for efficient lensless imaging. Code is available at github.com/JRCSAVSN/NullSpaceDiffusionDistillation.

20.
medRxiv (Medicine) 2026-06-15

ICD-10 Code Ambiguity Obscures Treatment-Eligible Adults with Spinal Muscular Atrophy: A Single-Center Chart Review and Patient Outreach Study

Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.

21.
PLOS Medicine 2026-05-21

Novel symptoms associated with eclampsia could improve detection and save lives

by Alice Beardmore-Gray, Andrew Shennan Eclampsia is a life-threatening complication of pre-eclampsia, yet remains difficult to predict. In this Perspective, Alice Beardmore-Gray and Andrew Shennan highlight a recent study that identifies 10 novel prodromal symptoms of eclampsia, with potential to better predict which women are at risk and therefore reduce delays in intervention.

22.
arXiv (math.PR) 2026-06-11

On the structure of the sandpile identity element on Sierpinski gasket graphs

arXiv:2603.12006v2 Announce Type: replace-cross Abstract: We consider the identity of the abelian sandpile group of finite approximation graphs of the Sierpinski gasket, and we show that the second-order term in the scaling limit converges to the path distance to the nearest corner on the Sierpinski gasket. The proof relies on a decomposition of the identity of the sandpile group into the sum of a constant function and the Laplacian of the graph distance on the approximating graphs.

23.
arXiv (CS.CV) 2026-06-17

Blended Chart Surfaces: A Seamless Explicit Representation for Smooth Surface Fitting

A surface representation suitable for geometry processing should be compact and explicit, provide global smoothness guarantees, support a wide range of surface topologies, and offer reliable access to differential quantities such as normals and surface energies, while remaining compatible with modern differentiable optimization. Existing neural representations typically sacrifice one or more of these properties: implicit fields typically require iso-surfacing for downstream use, while explicit neural maps are constrained by canonical-domain parametrizations or exhibit seam artifacts between local charts. We introduce Blended Chart Surfaces, a compact, network-free, explicit representation that is smooth by construction and anchored to user-provided topology. Given a coarse proxy mesh encoding the intended surface topology and approximate geometry, Blended Chart Surfaces jointly optimize for a polynomial map at each proxy vertex using an off-the-shelf optimizer to fit to an implicit target shape, avoiding the need for an input parametrization. Neighboring maps are fused using a smooth 'one-ring coordinate' blending scheme, decoupling topology and coarse geometry (carried by the proxy) from geometric details (carried by the local patches). The surface is globally smooth, fully differentiable, and enables stable evaluation of derivatives, making differential quantities and surface energies directly accessible. Additionally, our construction is equivariant to rigid motions and scaling of the proxy mesh. We evaluate Blended Chart Surfaces on various topologies and geometric complexity, and compare against explicit alternatives including interpolating-function baselines and mesh-displacement MLPs. Across these, Blended Chart Surfaces achieve a favorable trade-off among compactness, simplicity, access to differential quantities, and expressivity while remaining smooth across patch boundaries.

24.
arXiv (CS.AI) 2026-06-16

When Agent Automation Becomes Profitable: Quantifying and Insuring Autonomous AI Risk through Trace-Economic Underwriting

arXiv:2606.16465v1 Announce Type: new Abstract: AI agents can now take irreversible actions in operational systems, but agent-caused losses are still not clearly assigned, priced, or transferred. Providers often disclaim consequential damages, users are left with uncompensated losses, and default human review limits the efficiency gains of automation. We ask when autonomous AI deployment can become economically acceptable despite failure risk. Our answer is to quantify risk at the customer-task-trace episode level and transfer it through insurance. Automation is acceptable when its expected benefit exceeds the premium, control cost, and remaining risk. This requires a defined role with bounded permissions and comparable traces. We introduce trace-economic underwriting, which maps tool-use traces to customer exposure and claimable loss, then uses this representation for pricing, control, and risk transfer. It uses deterministic economic labels rather than an LLM judge. In our trace-to-loss testbed, trace-economic pricing reduces pricing MAE from $17.7K to $569 and removes regressive cross-subsidy. A 300-trace expert audit accepts 295 labels unchanged. On 1,000 real SWE-smith traces, trace-conditioned controls reduce CVaR95 by 72%. Theorem~1 gives a finite-sample scope condition. We release code, labels, and audit sheets.

25.
arXiv (CS.AI) 2026-06-19

Configurable Clinical Information Extraction with Agentic RAG: What Works, What Breaks, and Why

arXiv:2606.19602v1 Announce Type: new Abstract: Patient contexts span hundreds of heterogeneous documents and thousands of structured data points, yet the document-level metadata that AI systems need for retrieval and triage is absent or incomplete. Standard retrieval-augmented generation fails on this data, mishandling temporal reasoning, cross-document dependencies, and missing metadata. We deploy ACIE (Agentic Clinical Information Extraction) at University Medicine Essen: an on-premise agentic RAG pipeline that reasons over complete patient contexts and grounds every answer in source passages for clinician verification. We quantify the metadata gap, trace the architectural decisions it shaped, and evaluate extraction alongside an independent retrospective lymphoma registry study, in which nuclear-medicine physicians verify every extracted value against its cited sources. Across 7,326 judgments, clinicians accepted 96.5\% of extractions, with per-type acceptance ranging from 80\% to 99\%.