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01.

medRxiv (Medicine) 2026-06-18 DOI: HASH:9434e01da852cfeba2c5a6891bfb5670

Hard to Halt: Automation Bias in Agent-Driven Sequencing Prior Authorization Workflows

作者:

Nie↗Chung↗Waxler↗Lee↗Weng↗Lewis↗Ahimaz↗Wang↗Liu↗

Purpose: Prior authorization (PA) for exome or genome sequencing is a time-consuming process that impedes timely rare disease diagnosis. Large language model-based browser agents offer potential for automating these workflows, but their clinical reliability remain uncharacterized. Methods: We developed a sandbox compromising a simulated ES/GS PA submission payer portal and a synthetic EHR containing 836 patient records spanning compliant profiles and deficient profiles with different types of issues. Gemini 3 Pro, Gemini 3 Flash, and Claude Opus 4.5 were evaluated on task completion rate, form completion accuracy, and appropriate withholding for deficient profiles. Results: Larger models achieved much higher task completion rates (Gemini 3 Pro 95.45%, Claude Opus 4.5 93.67%) compared to Gemini 3 Flash (56.05%), but nearly universally failed to withhold submission for deficient profiles whereas Gemini 3 Flash ironically demonstrated superior withholding performance (17.33%). In a non-agentic setting, Gemini 3 Pro correctly identified 91% of the issues in deficient profiles, indicating that withholding failure is attributable to the browser interaction rather than the model's reasoning limitations. Conclusion: Current LLM-based browser agents exhibit a systematic bias towards form submission that poses risks in PA workflows. A modular, multi-agent architecture with human supervision is necessary for a safe clinical deployment.

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02.

arXiv (CS.CV) 2026-06-18 DOI: arXiv:2606.18439

RegimeVGGT: Layer-Wise Spatially Preserving Redundancy Removal for Visual Geometry Grounded Transformer

作者:

Jinhao You↗Shuo Lyu↗Zhuohang Lyu↗Tanxuan Li↗Zibo Zhao↗Jiaxiang Hu↗Kai Tang↗Yichen Guo↗

Visual Geometry Grounded Transformer (VGGT) recovers dense 3D scene structure from multi-view images in one forward pass, but quadratic cross-frame attention limits its scalability. Existing training-free accelerators reduce computation uniformly along one axis, missing layer heterogeneity. Our spectral, probing, and causal analyses reveal three regimes: shallow layers lack cross-view structure, middle layers drive cross-view alignment, and deep layers are redundant for dense geometry yet their cross-frame attention remains essential for pose. RegimeVGGT applies layer-wise U-shaped compression along two axes: Saliency-Guided Banded Merging protects geometry- and edge-salient tokens, while Selectively Protected K/V Downsampling preserves cross-frame spatial coverage and the pose-critical path through a phase-shifted spatial grid, a reference-frame anchor, and uncompressed camera/register tokens. Training-free, RegimeVGGT achieves a 6.7x speedup over VGGT* at matched reconstruction quality.

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03.

arXiv (CS.CV) 2026-06-15 DOI: arXiv:2606.14248

Spectrum Aware Illumination Estimation Using Multispectral Image

作者:

Hyejin Oh↗Woo-Shik Kim↗Sangyoon Lee↗YungKyung Park↗Je-Won Kang↗

Multispectral (MS) imaging extends beyond conventional RGB imaging by capturing more spectral bands, thereby improving illuminant spectrum estimation (ISE). However, existing methods often fail to fully exploit spectral information, resulting in suboptimal performance under diverse lighting conditions and across different sensor domains. Hence, we propose a deep learning framework with a spatio-spectral feature extraction block, which incorporates spectral attention mechanisms to enhance spectral correlation and preserve illuminant-relevant spatial features. Through the inclusion of an illuminant prior (IP), our approach prioritizes specific channels that provide more meaningful information in an MS image. We also propose a spectral-domain transform across different MS sensor spaces. The results demonstrate that illuminant spectra learned in high-dimensional sensor spaces can be effectively transformed to various lower-dimensional camera sensor spaces without any additional training. To facilitate evaluation, we introduce a real-world MS dataset containing high-dimensional ground-truth illumination spectra captured under diverse lighting conditions. Through extensive experiments, we demonstrate that our method achieves superior accuracy compared to existing models, thus providing a practical solution for real-world ISE. The code and dataset are available at https://github.com/hyejin5/Spectrum-Aware-Illumination-Estimation-Using-Multispectral-Image.

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04.

PLOS Medicine 2026-05-20 DOI: HASH:2ff96e09268730827f623a6f6653a835

Associations between hematologic dynamics during pregnancy and obstetric complications: A retrospective observational study

作者:

Veronica Tozzo↗

by Veronica Tozzo, Rachel Petherbridge, Kaitlyn James, Sarah Hsu, Deepti Pant, Chloe Michalopoulos, Brody H. Foy, Tanayott Thaweethai, Christopher Mow, Jacqueline Maya, Carolina Batlle Camero, Lydia Shook, Kathryn J. Gray, Logan Mauney, John M. Higgins, Camille E. Powe Background Pregnancy alters hematologic state as measured by complete blood count (CBC), but the longitudinal changes in CBC indices that define healthy pregnancies are not well established. In a large cohort based at an academic health system in the United States, we aimed to define reference intervals and typical longitudinal changes in CBC indices during pregnancy. We then tested for associations between extreme CBC values for gestational age or extreme longitudinal changes in CBC indices and obstetric complications. Methods and findings We studied nine CBC indices in individuals with singleton pregnancies who delivered after 30 weeks’ gestation and presented for prenatal care prior to 20 weeks. The electronic health record (EHR)-based Maternal Health Cohort (Massachusetts General Hospital; 1998–2016) formed our discovery cohort of 45,992 pregnancies, 18% of which had relevant complications. We developed a validation cohort of 48,868, 27% with complications from EHR data in the Mass General Brigham healthcare system from 2016 to 2024. In pregnancies without complications in the discovery cohort, we derived gestational-age-specific reference intervals (2.5th–97.5th percentile) and established typical intra-pregnancy longitudinal changes. In the validation cohort, we then tested CBC values outside of the 26–29 weeks’ gestation reference interval and CBC rare changes (uncommon changes in magnitude and direction) between 7–14 and 26–29 weeks’ gestation for association with a composite outcome (hypertensive disorders of pregnancy, small for gestational age birthweight, preterm birth) and its individual components using generalized estimating equations. Derived reference intervals differed from those in the literature for mean red cell volume, mean red cell hemoglobin, red cell count, and mean red cell hemoglobin concentration; reference intervals for other indices were similar to those previously published. In validation, hematocrit, hemoglobin, and red cell count values above their gestational-age specific reference intervals were associated with increased risk of the composite obstetric outcome: odds ratios (ORs) of 1.4 (95% CI [1.2, 1.5] p 

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05.

medRxiv (Medicine) 2026-06-16 DOI: HASH:5daac90617509dd60edf6472642e7dae

Supplementation with Arabinoxylan Dietary Fiber at Low Doses Produces Behavioral, Metabolic, and Gut Microbial Changes in Healthy, Overweight Adults: A Randomized Placebo-Controlled Trial

作者:

Arreza↗A. C↗Wang↗Girard↗S.-A↗Foley↗K. A↗Baisley↗Recker↗Atif↗Ackermann↗H. S↗…

Background: Dietary fiber comprises a heterogeneous group of compounds with distinct physicochemical properties and biological effects. As such, functional outcomes observed for one fiber cannot be generalized to others. Some fermentable fibers, such as arabinoxylan, may exert biologically selective effects across multiple physiological domains, highlighting the need to evaluate individual ingredients for their domain-specific activity in controlled human studies. Methods: In this randomized, double-blind, parallel, 3-arm, placebo-controlled trial, healthy, overweight adults were assigned to consume one of two low doses of an arabinoxylan dietary fiber (3.5g or 5g) or placebo over the intervention period. Self-reported appetite sensations were assessed as the primary outcome using validated visual analogue scales. Secondary and exploratory endpoints included lipid parameters, gastrointestinal outcomes, mood-related measures, and gut microbiota composition and fermentation-derived metabolites. Analyses were conducted in the full analysis set and a high-compliance population to assess responses under sustained intake conditions, as per the intended dosing regimen. Results: The primary endpoint of appetite sensations did not differ between either arabinoxylan group and placebo. In contrast, evidence of microbial fermentation and selective microbiota engagement was observed. These responses occurred alongside consistent and favorable changes in lipid parameters under conditions of sustained intake, including reductions in low-density lipoprotein cholesterol and triglycerides. Additional outcomes, including gastrointestinal symptoms and mood, demonstrated domain-specific responses. Conclusion: This study demonstrates that supplementation with low doses of arabinoxylan dietary fiber elicit biologically selective, domain-specific effects across metabolic, microbial, gastrointestinal, and behavioral outcomes, particularly under conditions of sustained intake. These responses occurred independently of changes in appetite sensation, indicating that functional effects were not mediated through appetite-related pathways. Collectively, the findings highlight the ingredient's biological versatility and contextual responsiveness across physiological systems, and suggest its prebiotic potential through alignment with ISAPP's definition of a prebiotic, supporting further investigation of specific mechanistic pathways. Clinical trial registration: https://clinicaltrials.gov/study/NCT06884449, identifier: NCT06884449

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06.

arXiv (CS.CV) 2026-06-11 DOI: arXiv:2606.12023

ViT-FREE: Efficient Face Recognition via Early Exiting and Synthetic Adaptation

作者:

Tahar Chettaoui↗Guray Ozgur↗Eduarda Caldeira↗Naser Damer↗Fadi Boutros↗

Vision Transformers (ViTs) have gained significant attention in computer vision and shown strong potential for face recognition (FR). However, their high computational cost makes deployment on resource-constrained devices challenging, motivating the need for methods that balance efficiency and accuracy. In this work, we investigate early exiting in pretrained ViTs as a simple yet effective training-free strategy for efficient FR inference. Leveraging the uniform feature dimensionality across transformer encoder blocks, we introduce ViT-FREE, a multi-exit framework that enables face verification directly from intermediate representations without modifying or retraining the backbone model, and thus, reducing inference cost. Empirically, we show that patch embeddings and attention maps evolve progressively across depth, exhibiting high similarity between consecutive ViT blocks and increasing alignment with the final representation. This indicates gradual feature refinement and attention convergence, suggesting that intermediate layers already provide stable and discriminative representations suitable for early exiting. Through extensive experiments on multiple FR benchmarks, we systematically analyze the accuracy-efficiency trade-off across exit depths. Our results demonstrate that later exits achieve a highly favorable balance, with exiting at layer 10 yielding up to a 20% speedup while incurring only a 1.5 drop in verification performance on benchmarks such as IJB-C. Also, we propose ViT-FREE_FT, a lightweight exit-specific fine-tuning strategy that adapts only the projection layers using a small synthetic dataset while keeping the transformer backbone frozen. This approach improves the performance of shallow exits while preserving the efficiency benefits and leaving deeper exits largely unaffected.

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07.

arXiv (CS.LG) 2026-06-17 DOI: arXiv:2606.18043

Uncertainty Quantification for Flow-Based Vision-Language-Action Models

作者:

Ralf R\"omer↗Maximilian Seeliger↗Saida Liu↗Ben Sturgis↗Marco Bagatella↗Daniel Marta↗Andreas Krause↗Angela P. Schoellig↗

arXiv:2606.18043v1 Announce Type: cross Abstract: Vision-language-action models (VLAs) combine vision-language backbones with expressive generative action heads trained via flow matching on large-scale robotic datasets. Despite their strong empirical performance in robotic manipulation, VLAs lack mechanisms to quantify confidence in their predictions and to detect when their actions may be unreliable. This presents a critical limitation for real-world deployment in non-stationary environments, where models inevitably encounter scenarios outside their pretraining distribution and may fail without warning. To address this, we derive an efficient method for quantifying epistemic uncertainty in flow-matching models by leveraging velocity-field disagreement (VFD) across a small ensemble. We successfully use this uncertainty estimate for failure detection during deployment and active fine-tuning of flow-based VLAs. To this end, we propose SAVE, a framework for uncertainty-guided active multitask fine-tuning that reduces the number of costly expert demonstrations required to adapt VLAs to new tasks. Through extensive experiments on the LIBERO benchmark, we demonstrate that VFD yields better-calibrated uncertainty estimates predictive of downstream performance, that VFD achieves strong performance in detecting failures, and that uncertainty-guided data acquisition with SAVE requires at least 22% fewer samples than baselines. In summary, our work shows that quantifying epistemic uncertainty in flow-based VLAs improves both failure awareness and adaptation. Project website: tum-lsy.github.io/uq_vla/.

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08.

arXiv (CS.LG) 2026-06-15 DOI: arXiv:2606.14116

DTVEM-RE: A Hierarchical Random-Effects Extension of the Differential Time-Varying Effect Model for Person-Specific Multi-Lag Estimation in Intensive Longitudinal Data

作者:

Amartya Bhattacharya↗

arXiv:2606.14116v1 Announce Type: new Abstract: The Differential Time-Varying Effect Model (DTVEM) of Jacobson et al. (2019) is a popular tool for finding the best time lag in intensive longitudinal data, but it assumes everyone shares the same lag structure. The original authors named fixing this as future work, and it clashes with the premise of modern clinical research, which is that people differ. We present DTVEM-RE, an extension that lets each person have their own lag coefficients, with two versions of the confirmatory step: a discrete-time hierarchical Bayesian VAR in Stan, which pools across people and gives calibrated uncertainty, and a continuous-time per-person Ornstein-Uhlenbeck model in ctsem, which handles unevenly spaced beeps directly. We report four results. A simulation shows the Bayesian version recovers the between-person spread tau_a with bias below 0.01 and coverage of 90 to 93 percent. On the Fisher et al. (2017) EMA dataset (N=40), person-specific lag-1 effects vary by an order of magnitude across three mood items, the Bayesian and GAMM estimates agree closely (r=0.87 to 0.92), and DTVEM-RE gives the best one-step-ahead prediction among four discrete-time methods. A multi-lag version shows all nine tau_k values have credible intervals excluding zero, and the lag where people differ most changes across items, something lag-1-only methods like mlVAR cannot detect. Finally, the two versions agree almost exactly on person-specific lag-1 estimates (r >= 0.995), differing only as shrinkage predicts. DTVEM-RE is, to our knowledge, the first person-specific implementation of DTVEM-style lag detection, and it contains standard DTVEM as a special case.

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09.

arXiv (quant-ph) 2026-06-15 DOI: arXiv:2604.07257

Quantifying and detecting quantum-state texture

作者:

Xiangyu Chen↗Qiang Lei↗

arXiv:2604.07257v2 Announce Type: replace Abstract: Quantum-state texture is a recently proposed quantum resource that characterizes the inhomogeneity of a quantum state's matrix element distribution in the computational basis, enriching our understanding of quantum state structure. To expand its quantification toolkit and establish detection methods, in this article, we investigate the resource theory of texture from both quantitative and detection perspectives. First, we construct a texture measure $\mathcal{T}^{GR}_{\alpha,z}(\rho)$ based on the $\alpha$-$z$ Rényi relative entropy and present some of its inherent properties. Second, we analyze the mathematical relationships between several existing texture measures, revealing connections among different quantifiers. Finally, drawing on the witness concept from other resource theories, we systematically introduce texture witnesses into the texture theory and provide examples of texture witnesses with special properties.

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10.

medRxiv (Medicine) 2026-06-15 DOI: HASH:227591331f6e586c49667cfa653b85e3

Poly-Social Risk for Hypertension Among Black and Latina Women

作者:

Belak↗James↗Auguste↗Rana↗Eweka↗De Moor↗Sarma↗Ensing↗Economy↗K. E↗Powe↗C. E↗…

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

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11.

arXiv (CS.LG) 2026-06-18 DOI: arXiv:2606.18467

ToolChain-CRC: Conformal Risk Control for Agentic AI Under Retrieval and Tool-Use Drift

作者:

Jeffery Opoku↗David Banahene↗

arXiv:2606.18467v1 Announce Type: cross Abstract: Modern AI agents retrieve documents, call tools, check intermediate information, and then produce a final answer or action. This creates a risk-control problem that is not visible from the final answer alone. A final response may look acceptable even when the retrieval was weak, a tool output was wrong, or an earlier step was unsupported. We propose ToolChain-CRC, a conformal risk-control method for retrieval-augmented and tool-using agents under drift. The method treats each agent run as a full trajectory of actions, observations, and final output. It builds step-level risk scores, combines them into a trajectory risk score, calibrates an accept-or-intervene rule, and adds an anytime alarm that can stop risky runs before the final answer. We prove trajectory-level risk control under exchangeable calibration runs, give a drift-aware extension with auditable constants, and prove an anytime escalation rule through a supermartingale construction. Experiments cover synthetic tool-chain drift, RAG/tool-use stress tests, public SQuAD-derived retrieval tasks, an API-free agentic QA case study, ablations, target-risk sensitivity checks, 20-seed robustness checks, a drift-margin audit, and a live RAG/tool-use agent benchmark. Across these settings, final-answer-only calibration can miss retrieval and tool failures, while trajectory-level calibration keeps accepted-trajectory risk below the target.

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12.

arXiv (quant-ph) 2026-06-11 DOI: arXiv:2606.06452

Energy-Modulated Time-Asymmetric Spontaneous Collapse: Forward-Backward Dynamics from Stochastic Ito Reversal and Bright Solitons

作者:

Ikechukwu C. Okoro↗Mike O. Osiele↗Godfrey E. Akpojotor↗

arXiv:2606.06452v3 Announce Type: replace Abstract: We present a rigorous theoretical framework for symmetry breaking and quantum irreversibility arising from stochastic Ito field reversal within a cubic-quintic nonlinear Schrodinger equation (CQ-NLSE) formalism. Starting from three physically motivated considerations, forward and backward nonlinear stochastic differential equations are derived via the Ito calculus. Kinematic time-reversal is shown to be fundamentally incompatible with the Ito stochastic structure, yielding the universal asymmetry-coupling parameter of 2/3. An energy-driven collapse operator proportional to the product of noise strength, local probability density, and excitation energy squared is introduced, amplifying the collapse in high-density, high-excitation regions. Exactly bright soliton solutions are obtained for a quasi-one-dimensional BEC of attractive Li-7 atoms, with forward and backward amplitude ratio of 1.870. Heat map analysis of the parameter planes reveals that the forward collapse operator grows monotonically in time while the backward counterpart decays, achieving a ratio approximately 1030, sharply distinguishing this framework from conventional symmetric collapse models.

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13.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2606.15743

Unsupervised Learning for Missing Modalities in Multimodal Learning

作者:

Hassan Ismkhan↗Hamid Bouchahcia↗

arXiv:2606.15743v1 Announce Type: new Abstract: This paper addresses the missing-modality challenge in multi-modal learning by introducing Unsupervised Learning for Missing Modalities in Multi-Modal Learning (UL4M4), a flexible framework that imputes missing feature embeddings in a task-independent manner before supervised prediction. We propose modality-specific normalization and a novel partial-modality distance metric to enable fair clustering of incomplete observations, capturing cross-modal structures while preserving scale-invariance across varying dimensionalities and modality counts. Cluster centers from this unsupervised stage guide an iterative greedy imputation process for any missing modalities during training or inference, supporting arbitrary numbers of modalities and arbitrary missing patterns per sample. The imputation module is lightweight, uses frozen encoders, and decouples from the downstream task, allowing easy integration with any fusion/prediction architecture. Extensive experiments under diverse and highly incomplete regimes demonstrate UL4M4's robustness, achieving, to the best of our knowledge, the first consistent F1-Micro scores above 0.7 on challenging missing configurations even when more than 50\% of modality slots are missing. Results are also stable across cluster sizes and significantly outperform state-of-the-art baselines. Code is available here: https://github.com/h-ismkhan/Multimodal-Learning-with-Missing-Modalities-via-Unsupervised-Learning.

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14.

arXiv (CS.AI) 2026-06-16 DOI: arXiv:2606.16515

Direction-Conditioned Policies via Compositional Subgoal Scoring for Online Goal-Conditioned Reinforcement Learning

作者:

Swaminathan S K↗Damiya Gondha↗Theyanesh Eswaramoorthy Rajahkrishnan↗Aritra Hazra↗

arXiv:2606.16515v1 Announce Type: cross Abstract: Hamilton-Jacobi-Bellman theory implies that the optimal goal-conditioned action depends on the goal only through the gradient of the goal-reaching distance at the current state, yet standard online GCRL still conditions the actor on the raw goal – a signal that is geometrically uninformative when the goal is far from the data distribution. We propose Direction-Conditioned Policies (DCP), a fully online method that decomposes goal-reaching into two components sharing one InfoNCE representation $\psi$: a subgoal-scoring step that selects a visited state $z_t$ aligned with the final goal $g$ in $\psi_g$, and a direction-conditioned actor that consumes the unit direction $d_t$ and magnitude $r_t$ from $\psi(s_t)$ to $\psi(z_t)$. The two components train jointly, factor cleanly at deployment (subgoal scoring is removed, while direction conditioning remains with $g$ in place of $z_t$), and admit independent modification at the same $(d_t,r_t)$ interface. We prove three results. First, direction sufficiency under HJB: the optimal action under control-affine dynamics depends on the goal only through the value gradient. Second, a quantitative bound showing that, under mild conditions on the learned representation and assuming the scoring rule returns an on-path $z_t$, the actor's conditioning input at training and at deployment coincide up to representation error and geodesic slack. Third, a controllable-subspace characterization of when directional conditioning fails. Across nine environments, DCP improves over Contrastive RL on most final metrics, with the largest gains on manipulation and obstacle-interaction tasks; a qualitative analysis of the learned $\psi$-distance landscape shows the contrastive representation behaves as an online quasimetric encoding environment topology, and the single failure case (AntSoccer) localizes to a learned-gradient pathology that the theory anticipates.

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15.

medRxiv (Medicine) 2026-06-17 DOI: HASH:1bcd9b5f336e54dc2fa6e5190e58778a

LLM-Driven Extraction of NI-RADS and Imaging Tumor Characteristics to Enhance Oropharyngeal Cancer Survivorship Surveillance

作者:

Song↗Shbita↗Jang↗I. J. H↗Starostina↗Lewis↗Sahli↗Floyd↗W. R↗Mahin↗Rinsurongkawong↗Barbon↗…

Abstract Purpose Radiologic surveillance is essential for oropharyngeal cancer (OPC) survivors, guiding recurrence detection and follow-up strategies. The Neck Imaging Reporting and Data System provides a standardized framework for post-treatment risk reporting at both the primary tumor site (pNI-RADs) and cervical lymph nodes (nNI-RADS). Comprehensive surveillance additionally requires assessment of disease status, including the primary tumor, nodal involvement, and distant metastases. These clinical results are often embedded as unstructured data within free-text radiology reports. We hypothesized that a large language model (LLM) can reliably extract NI-RADS score criteria and summarize key imaging features from unstructured radiology text, achieving high concordance with expert review. Methods Previously untreated OPC patients who received definitive cancer therapy were identified. Eligible imaging reports included post-treatment head and neck CT, MRI, or FDG PET/CT scans containing narrative and impression text. Examinations lacking narrative or impression text, containing pre-existing NI-RADS annotations, or involving non-surveillance imaging modalities were excluded. A total of 200 reports were randomly selected from 7,076 eligible examinations for manual abstraction using a three-reviewer consensus framework to establish a reference dataset. Using the Palantir Foundry Pipeline Builder, a GPT-5-based LLM was deployed to extract pNI-RADS and nNI-RADS scores, and key imaging features of disease status from these reports. Performance was evaluated using exact agreement and F1-based metrics. Results Agreement for no evidence of disease (score of 1) was 93.3% (126/135; F1 = 0.94) and 90.3% (130/144; F1 = 0.93) for pNI-RADS and nNI-RADS, respectively. For NI-RADS [≥]2, exact category agreement was 73.1% (38/52; macro-F1 = 0.75) for pNI-RADS and 64.3% (27/42; macro-F1 = 0.56) for nNI-RADS. Quadratic weighted {kappa} was 0.81 and 0.59, respectively. For post-treatment disease surveillance variables, agreement was 94.9% (149/157; F1 = 0.87) for primary tumor presence, 89.1% (164/184; F1 = 0.87) for nodal disease presence, and 94.7% (126/133; F1 = 0.70) for distant metastasis detection. Specificity was high across disease-status variables (0.95-0.99), with negative predictive values of 0.95 for primary tumor, 0.87 for nodal disease, and 0.99 for distant metastasis. Conclusions Our LLM-based information retrieval and classification approach for radiographic treatment response from unstructured, multidimensional imaging reports achieved high performance for disease exclusion and moderate performance for detecting suspected residual and/or new disease. This pipeline supports scalable and standardized surveillance data capture for longitudinal monitoring, clinical analytics, and survivorship research in head and neck oncology.

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16.

Nature (Science) 2026-06-17 DOI: HASH:75e20e2c5f52e23760f30921aaf324cd

Towards autonomous medical artificial intelligence agents

作者:

Dyke Ferber↗

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.

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17.

arXiv (CS.LG) 2026-06-12 DOI: arXiv:2606.12501

Policy-driven Conformal Prediction for Trustworthy QoT Estimation

作者:

Kiarash Rezaei↗Omran Ayoub↗Paolo Monti↗Carlos Natalino↗

arXiv:2606.12501v1 Announce Type: new Abstract: We propose Conformal QoT, a policy-driven framework that combines statistically guaranteed QoT estimation with operational decision policies, enabling reliable lightpath-feasibility predictions under domain shift and improving accuracy from 92\% to 99.6\% on open datasets.

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18.

arXiv (CS.CV) 2026-06-16 DOI: arXiv:2606.15987

A Text Recognition Dataset from Sahidic Coptic Ancient Manuscripts

作者:

Fabio Quattrini↗Carmine Zaccagnino↗Costanza Bianchi↗Silvia Cascianelli↗Rita Cucchiara↗

In this work, we target Handwritten Text Recognition (HTR) in low-resource scenarios, which arise from underrepresented languages, rare scripts, and degraded visual conditions typical of historical documents. We introduce SCAM (Sahidic Coptic Ancient Manuscripts), a new line-level dataset built from digitized ancient manuscripts written in the extinct Sahidic Coptic dialect. The dataset reflects a realistic and challenging setting, as it combines heterogeneous acquisition conditions across libraries with typical manuscript degradations such as ink fading, bleed-through, and material deterioration. In addition to visual complexity, SCAM poses significant linguistic challenges due to the scarcity of resources for Sahidic Coptic, its uncommon alphabet, and dialect-specific diacritics. To support research in low-resource HTR, we benchmark several state-of-the-art approaches based on different paradigms, highlighting their limitations and strengths in this setting. Our results underline the gap between current HTR performance on well-resourced modern scripts and historically grounded, low-resource scenarios, thus providing a reference point for future developments.

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19.

arXiv (CS.LG) 2026-06-17 DOI: arXiv:2606.17233

Uncertainty Quantification of Engineering Structures by Polynomial Chaos Expansion and Multivariate Active Learning

作者:

Qitian Lu↗Jafar Jafari-Asl↗Panagiotis Spyridis↗Lukas Novak↗

arXiv:2606.17233v1 Announce Type: new Abstract: In many engineering applications, a single high-fidelity model produces multiple quantities of interest (QoIs) under the same input parameters, e.g. finite element models of complex physical systems. To alleviate the high computational cost of direct model evaluations, surrogate models are widely used to construct efficient approximations of model responses. Naturally, the accuracy of surrogates strongly depends on the quality of the experimental design (ED). However, a single ED may not provide an adequate representation for all outputs simultaneously, especially when different outputs exhibit varying sensitivities to the input variables. A straightforward solution is to perform separate sampling for each output, but this results in increased sampling complexity and computational cost. From a statistical perspective, such an approach also ignores potential correlations among all outputs and may compromise data consistency. To address this issue, an adaptive sequential sampling method for constructing polynomial chaos expansion surrogate models is generalized for vector valued QoIs. The method sequentially selects new samples from a candidate pool based on their local contribution to the output variance, while balancing distance-based exploration of the input space and exploitation of aggregated variance information across all outputs. Its performance is compared with non-sequential Latin Hypercube Sampling through several numerical examples from engineering problems. Numerical results demonstrate that the proposed strategy improves both surrogate accuracy and stability, and provides a more reliable estimation of second-order statistics.

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20.

arXiv (CS.AI) 2026-06-12 DOI: arXiv:2606.12991

APCyc: Property-Informed Design of Cyclic Peptides via Automated Cyclization

作者:

Yifan Zhao↗Lang Qin↗Jintai Chen↗

arXiv:2606.12991v1 Announce Type: new Abstract: Cyclic peptides represent a promising class of therapeutic compounds in modern drug discovery, often offering improved stability and binding affinity. However, the de novo design of cyclic peptides remains challenging because methods must identify pocket-adaptive cyclization patterns and linkage sites while simultaneously controlling drug-relevant properties. This challenge is particularly pronounced for recent generative models trained predominantly on linear peptide data, which may fail to capture cyclization-specific constraints. To address the limitation, we introduce APCyc, a target-aware de novo cyclic peptide generation framework that explicitly models cyclization and jointly optimizes multiple essential physicochemical properties. By using an expanded residue vocabulary and explicitly encoding cyclization-site and linkage-type information, APCyc learns cyclization-aware representations and leverages Bayesian posterior guidance to steer sampling toward cyclic peptides satisfying multiple property objectives. Experimental results demonstrate that our model learns target-dependent cyclization preferences, and enables effective and controllable multi-property optimization for cyclic peptide design. The source code of this paper is available at https://github.com/HKUSTGZ-ML4Health-Lab/APCyc.

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21.

arXiv (quant-ph) 2026-06-11 DOI: arXiv:2606.12383

The Simplified Stabilizer ZX-Calculus is Minimal

作者:

Harry K. Stoltz↗

arXiv:2606.12383v1 Announce Type: new Abstract: The stabilizer fragment of the ZX calculus is amongst the most important fragments of the theory. The closely related Clifford+T fragment is approximately universal (arXiv:1705.11151). Additionally, the stabilizer calculus can be described by a small collection of rewrites, most of which have been shown to be necessary (arXiv:1709.08903). However, two rules, describing the red/green compact-structure coincidence and the important bialgebra law, had not been shown to be necessary. We present a countermodel-style argument showing that both of these rules are individually necessary relative to the connectivity meta-rule of Backens–Perdrix–Wang (arXiv:1709.08903), and hence establish that the rule set presented in arXiv:1709.08903 has no redundant rewrite rule.

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22.

arXiv (CS.AI) 2026-06-12 DOI: arXiv:2606.12834

Fantastic Scientific Agents and How to Build Them: AgentBuild for Rietveld Refinement

作者:

Woong Shin↗Craig A. Bridges↗Marshall T. McDonnell↗Rafael Ferreira da Silva↗

arXiv:2606.12834v1 Announce Type: new Abstract: As scientific workflows shift from deterministic executables to LLM-based agents, the development practices on offer, such as fine-tuning, reinforcement learning, and prompt-and-go, bury the scientist's judgment. We propose treating agent construction as a workflow stage and introduce AgentBuild, which builds a scientific agent from a contract the scientist authors. The contract is a version-controlled rubric, a difficulty-graded curriculum, and a curated external knowledge base. A rubric-driven judge gates a meta-optimizer coding agent that edits the agent within a declared boundary, so the build compiles the agent, not the scientist's judgment. We instantiate this for Rietveld refinement of X-ray diffraction data through GSAS-II behind MCP and A2A, where a blank-harness construction run progresses through a lithium lanthanum zirconium oxide (LLZO) signal-to-noise ladder, reaches the 4 hour scan as a frontier case, and exposes the workflow-scope limits that remain. The same rubric that rewards credible fits also scores trajectory scope, making the frontier a contract failure rather than a pattern-fitting failure. As base models evolve, re-running AgentBuild is a re-tune, not a rebuild, and the scientist's authored contract remains the durable asset.

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23.

medRxiv (Medicine) 2026-06-16 DOI: HASH:09c2f5e2407b10ffb1f04328fce24c48

Validating an Early Pregnancy HbA1c as the Screening Test for Gestational Diabetes Mellitus: Findings from PRISMA Pakistan Cohort

作者:

Naz↗Yazdani↗Hoodbhoy↗Ghebremihael-Weldeselassie↗Mazhar↗Hotwani↗Jehan↗Nisar↗M. I↗Iqbal↗

Background: Early identification of gestational diabetes mellitus (GDM) is critical to improving maternal and neonatal outcomes, particularly in resource-constrained settings where universal oral glucose tolerance testing (OGTT) is burdensome. We assessed whether early-pregnancy HbA1c alone or combined with common risk factors can predict GDM and reduce the burden of OGTT requirements in a peri-urban cohort in Karachi, Pakistan. Methods: We conducted a secondary analysis of the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) Pakistan cohort. Women enrolled before 20 weeks' gestation with available early-pregnancy HbA1c and a 2-hour 75g OGTT at 24 to 28 weeks were included. We externally validated GDM prediction models originally developed in the STRiDE-India cohort. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). We assessed four models: HbA1c alone (Model 1a); age, BMI, and family history of diabetes mellitus (FH DM) (Model 1b); HbA1c combined with age, BMI, and FH DM (Model 2); and an extended model, i.e., Model 2 combined with socioeconomic status, gestational age, parity, systolic and diastolic blood pressure (Model 3). A dual-threshold approach was applied to assess rule-in and rule-out performance. Results: Among 2,489 women, GDM incidence was 7.5% (n=186). Models with a broader set of predictors demonstrated higher AUC values, with Model 2 achieving an AUC of 0.61 (95% CI: 0.57, 0.66). Including additional factors (Model 3) did not further improve predictive ability (AUC: 0.62; 95% CI: 0.58, 0.66). In addition, at predefined thresholds, Model 2 achieved sensitivity of 73.7% (rule-out) and specificity of 83.5% (rule-in), with the potential to reduce OGTT requirements (58.5%). Conclusions: Early-pregnancy risk stratification using HbA1c combined with simple clinical predictors offers a pragmatic approach to streamline GDM screening among high-risk pregnant women. A dual-threshold strategy using Model 2 could reduce reliance on universal OGTT while prioritizing high-risk women for confirmatory testing.

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24.

arXiv (CS.LG) 2026-06-16 DOI: arXiv:2606.16331

Diffusion Offline Reinforcement Learning for Fair and Energy-Efficient UAV-Assisted Wireless Networks

作者:

Eslam Eldeeb↗Hirley Alves↗

arXiv:2606.16331v1 Announce Type: new Abstract: The integration of generative artificial intelligence with wireless communication and signal processing systems has opened new avenues for intelligent, data-driven decision-making in future 6G networks. This work proposes a diffusion soft actor-critic (Diffusion-SAC) approach that leverages offline reinforcement learning (RL) enhanced by denoising diffusion probabilistic models (DDPMs) to optimize trajectory and scheduling control in unmanned aerial vehicle (UAV) networks. While offline RL methods, such as conservative Q-learning (CQL), can learn from static datasets, they often struggle to generalize in low-data or dynamic conditions. To address this, we combine the robustness of CQL with the generative power of diffusion models, enabling expressive and signal-aware policy learning that generalizes beyond behavior policies. Applied to a UAV-assisted wireless network, the proposed framework minimizes transmission energy and improves fairness among devices. Simulations show that Diffusion-SAC outperforms standard offline RL baselines, achieving more stable convergence and higher rewards even with limited datasets. The method enhances data efficiency, reduces energy consumption, and increases throughput by more than 35 % compared to existing algorithms, demonstrating its potential for robust policy learning in next-generation wireless control systems.

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25.

Nature (Science) 2026-06-17 DOI: HASH:adf92af8f70130253db113f31bf13770

Cucurbituril-based anion-conducting membranes with supramolecular nanopores

作者:

Ziang Xu↗

Nanoporous anion-conducting membranes have gained considerable interest for their potential to reduce resistance in electrochemical devices1–4. Current pore-forming methods, such as backbone engineering through polymers of intrinsic microporosity5,6 or covalent organic and metal–organic frameworks7,8, however, suffer from limited structural control, mechanical fragility or demanding synthesis. Here we establish a supramolecular strategy that overcomes these limitations by constructing uniform, dynamic nanopores. Co-assembly of the rigid macrocyclic host cucurbit[7]uril with the cationic polymer guest quaternized poly(piperidinium-terphenyl) yields a robust network of nanometre-scale channels while simultaneously enhancing mechanical and chemical stability. The dynamic host–guest interactions allow the pore structure to fluctuate on picosecond and angstrom scales. This transient environment supports low-friction hydroxide migration through a Grotthuss mechanism, producing a marked enhancement in ionic conductivity. This bottom-up design principle provides a versatile new tool for molecularly engineering transport pathways and promises to advance electrochemical reactors with respect to energy efficiency, operational stability and the production of high-purity products. A supramolecular strategy, in which uniform, dynamic nanopores are constructed, overcomes the limitations of limited structural control, mechanical fragility or demanding synthesis in nanoporous anion-conducting membranes, providing a versatile tool for molecularly engineering transport pathways.

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