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01.
medRxiv (Medicine) 2026-06-17

Cardio Heart Connect: Protocol for a Randomized Trial of a Commercially Available mHealth Fitness Intervention for Cardiac Rehabilitation After Transcatheter Aortic Valve Replacement

Background: Despite ample evidence of the benefits of cardiac rehabilitation (CR), few transcatheter aortic valve replacement (TAVR) patients participate. Commercially available mobile health offers an opportunity to deliver activity-promotion content to populations that are challenged to participate in CR. This study aims to test the efficacy of clinically controlled, commercially available fitness programming for improving physical activity and cardiovascular health outcomes designed to be initiated while patients are on waitlists for traditional CR. Methods: The Cardio Heart Connect study is a hybrid type I effectiveness-implementation trial aiming to enroll N=200 patients who have been placed on a cardiac rehab waitlist following a TAVR procedure from the University of Colorado Hospital Heart and Vascular Center. Participants will be randomized 1:1 to the Cardio Heart Connect intervention with commercially available fitness or attention control, designed to control for technology access. At baseline, post-intervention (8 weeks), and follow-up (12 months), we will assess the primary outcome of participants? daily steps as measured by smartwatch accelerometer and secondary outcomes of interest including functional capacity (Duke Activity Status Index; VO2max), quality of life (Kansas City Cardiomyopathy Questionnaire), and cardiovascular health status (Life Essential 8). In addition, we will use mixed methodologies to evaluate the implementation of intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Conclusions: Commercially available fitness programs have the potential to provide more accessible opportunities for patients recovering from TAVR to engage in physical activity and may be preferred due to their customizability, convenience, and ease of scheduling. Overall, this study will provide insight into the use of commercial mHealth to promote activity following TAVR.

02.
Nature (Science) 2026-06-10

‘Hidden hero’ peptides guard crops against sudden cold

作者: 未知作者

A protein signal remains silent under normal conditions but is activated under cold stress to protect developing pollen. This ‘on-demand’ resilience mechanism could enable the development of ‘climate smart’ crops that maintain high yields in good years and food security under climate stress. A peptide signal ensures that, in cold conditions, developing pollen receives nutrients at the right time.

03.
arXiv (CS.LG) 2026-06-11

Multi-agent rendezvous in fluid flows via reinforcement learning

arXiv:2606.11274v1 Announce Type: cross Abstract: Rendezvous is a critical task for multi-agent systems, requiring agents to coordinate to meet at an unspecified location. However, achieving this in fluid environments presents a challenge, as it remains unclear how agents can exploit underlying fluid kinematics to facilitate convergence. In this study, we adopt a multi-agent reinforcement learning (MARL) approach to develop physics-informed rendezvous strategies in vortical flows. Compared to a naive strategy, where agents navigate toward their counterparts, MARL strategies significantly improve the rendezvous rate. MARL strategies also show transferability across varying vortex intensities, vortex scales, and swarm sizes. By breaking the symmetry of the state-action map, MARL strategy leverages a non-intuitive mechanism that prevents agents from becoming trapped in separate vortices, thereby enhancing rendezvous success. Additionally, a heuristic strategy is extracted from the learned strategy and also outperforms the naive strategy. Furthermore, a theoretical analysis demonstrates that fluid deformation impedes the rendezvous process. Large finite-time Lyapunov exponents identify where fluid effects separate adjacent agents, suggesting that targets should be planned in weak-deformation regions. Our findings reveal the important role that agent-fluid interactions play in multi-agent tasks and highlight the MARL capability to explore swarm intelligence in complex flow environments.

04.
arXiv (quant-ph) 2026-06-16

Scheme for Transport-based Global Entanglement Distribution using Quantum Processors

arXiv:2606.15421v1 Announce Type: new Abstract: We propose a scheme for distributing entanglement over global distances in a heralded manner by using satellites to physically transport entangled processor nodes with rare-earth-ion qubits. A full analysis of channel losses, errors and background light is performed to determine the fidelity and number of entangled pairs that can be distributed between two ground stations. We show that the scheme works already with a single satellite and can distribute close to the theoretical maximum number of entangled pairs that can be generated in a satellite overpass. In addition, we argue that in theory transportation-based schemes outperform other satellite-based schemes and can be scaled up to a constellation without additional channel losses. Daytime operation seems feasible as long as the sky is clear, with an EPR pair fidelity ranging from 99.3% at shorter network lengths to 93.9% with global coverage and can be further improved by active error correction or entanglement purification.

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

Tight Bounds for Logistic Regression with Large Stepsize Gradient Descent in Low Dimension

arXiv:2602.12471v2 Announce Type: replace Abstract: We consider the optimization problem of minimizing the logistic loss with gradient descent to train a linear model for binary classification with separable data. With a budget of $T$ iterations, it was recently shown that an accelerated $1/T^2$ rate is possible by choosing a large stepsize $\eta = \Theta(\gamma^2 T)$ (where $\gamma$ is the dataset's margin) despite the resulting non-monotonicity of the loss. In this paper, we provide a tighter analysis of gradient descent for this problem when the data is two-dimensional: we show that GD with a sufficiently large learning rate $\eta$ finds a point with loss smaller than $\mathcal{O}(1/(\eta \gamma^2 T))$, as long as $T \geq \Omega(n/\gamma + 1/\gamma^2)$, where $n$ is the dataset size. Our improved rate comes from a tighter bound on the time $\tau$ that it takes for GD to transition from unstable (non-monotonic loss) to stable (monotonic loss), via a fine-grained analysis of the oscillatory dynamics of GD in the subspace orthogonal to the max-margin classifier. We also provide a lower bound of $\tau$ matching our upper bound up to logarithmic factors, showing that our analysis is tight.

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

The algebra of Krom logic programs

arXiv:2606.15719v1 Announce Type: cross Abstract: This paper investigates the algebraic structure of Krom logic programs, consisting only of facts and rules with at most one body atom. We show that sequential composition endows the class of Krom programs with a natural monoid structure and that this structure admits rich algebraic extensions to Krom seminearrings, Krom quemirings, Krom-Conway seminearrings, and Krom-Conway omegaseminearrings. Furthermore, we establish explicit generating sets and canonical decompositions, study the associated ${}^\omega$-operator, characterize the Kleene star in graph-theoretic terms, and relate finite Krom monoids to transformation monoids and finite-state automata. These results provide new connections between logic programming, algebraic automata theory, and algebraic graph theory.

07.
bioRxiv (Bioinfo) 2026-06-10

Promera: a unified model for biomolecular structure prediction, filtering, and design

Generative models have become staple tools for modeling and designing biomolecular structures. However, although these tools have improved in structural prediction accuracy, their ability to filter designed binders—an essential use case—remains insufficient; whereas design methods have focused more on unconstrained binder generation rather than capabilities enabled by controllable design. We introduce Promera, a unified generative model that combines all-atom structure prediction with improved filtering and controllable design. We find that Promera's confidence metrics are more accurate for filtering binders from non-binders for both miniproteins and nanobodies, while its co-folding performance surpasses popular open-source models (OpenFold3-p2, Boltz-2) on therapeutically relevant categories. As a design model, Promera generates binders by predicting masked protein sequences with optional epitope, paratope, and template constraints. Remarkably, our nanobody designs match the in silico success rates from backprop-based techniques (mBER) when evaluated under co-folding confidence filters. We further provide two in silico demonstrations of the the versatile capabilities of our design method: epitope targeting of the Andes hantavirus glycoprotein with VHHs and active state stabilization of the beta-2 andrenergic GPCR. We conclude by proposing a scaling law for co-folding models, suggesting a path for further performance improvement.

08.
arXiv (CS.CV) 2026-06-15

Manga109-v2026: Revisiting Manga109 Annotations for Modern Manga Understanding

Manga is a culturally distinctive multimodal medium and one of the most influential forms of Japanese popular culture. As AI systems increasingly target manga understanding, OCR, and translation, Manga109 has become a foundational dataset for manga-related AI research. However, the current Manga109 dataset contains inaccurate transcriptions and coarse annotations, which do not align well with modern OCR and multimodal manga understanding tasks. In this work, we revisit the dialogue text annotations of Manga109 and identify five categories of annotation issues, including inaccurate transcriptions, missing text regions, overlapping dialogue and onomatopoeia, and under-segmented speech balloons. To address these issues, we combine OCR-based issue detection and manual revision to construct Manga109-v2026, revising approximately 29,000 dialogue annotations. Our revisions better align Manga109 with modern OCR and multimodal manga understanding systems while preserving expressive structures characteristic of manga.

09.
arXiv (CS.CV) 2026-06-18

Hallucination Detection and Correction in Medical VLMs via Counter-Evidence Verification

Vision-Language models (VLMs) reliability in medical diagnosis is challenged by trust-undermining hallucinations. Existing hallucination detection approaches mainly focus on identifying factual inconsistencies between generated text and reference data. While some studies analyze where models attend in images, they seldom verify whether such attention truly reflects the visual evidence supporting the generated text. To address this gap, we propose Co}unter-Evidence Verification (CoEV), a training-free plug-and-play framework that detects and corrects hallucinations through evidence-based factual consistency verification. CoEV performs bidirectional verification between textual assertions and visual evidence, testing whether each statement is supported by its corresponding evidence region, and assigns each statement into a four-quadrant diagnostic map capturing combinations of text factuality and visual grounding. CoEV detects hallucinated content and serves as a post hoc refinement tool, correcting hallucinations without retraining. Extensive experiments on four medical datasets show that CoEV combats hallucinations in VLMs.For hallucination detection, CoEV consistently outperforms existing methods, improving average PR-AUC and ROC-AUC by 3.0% and 3.9% absolute points respectively, with notable gains of up to 18.5% in specific VQA scenarios. For hallucination correction, it improves Micro-F1 by up to 12.5%, reduces hallucination rates by over 11.9% on medical report generation, and also boosts medical VQA accuracy. These results show that CoEV enables reliable detection and correction of hallucinations, providing clinicians with dependable, evidence-based cues for diagnosis. Code will be released upon acceptance.

10.
arXiv (CS.LG) 2026-06-16

A nonparametric two-sample test using a parametric integral probability metric

arXiv:2606.16941v1 Announce Type: cross Abstract: Detecting distributional differences between two independent samples is a fundamental problem in statistics and machine learning. Nonparametric two-sample testing provides a principled framework for determining whether two samples are drawn from the same underlying distribution, without assuming any specific parametric form for the distribution. In this study, we propose a new two-sample test statistic based on a newly introduced integral probability metric (IPM), using a specially designed parametric discriminator class with a single node of a neural network. We show that the resulting test statistic, called PReLU-IPM, is nonparametric and establish theoretical guarantees for the associated two-sample testing procedure, PReLU-TST, including its consistency and asymptotical equivalence to nonparametric IPM-based tests under regularity conditions. By analyzing multiple simulated and real benchmark datasets, we demonstrate that PReLU-TST achieves higher power across a range of alternatives or performs comparably to its competitors, for finite samples.

11.
bioRxiv (Bioinfo) 2026-06-12

A Graph-based QSAR Modeling Pipeline for Predicting In vitro PubChem Assays and In vivo Human Hepatotoxicity: Mechanistic Analysis of Caspase-3/7 Activation

Background: Caspase-3 and -7 are key effector caspases in the apoptotic pathway, a form of programmed cell death, and their activities serve as a well-established biomarker for evaluating environmental chemical toxicity and informing chemical risk assessment. Loss of mitochondrial membrane potential is a key event in the activation of Caspase-3/7 signaling and the subsequent induction of apoptosis. Therefore, simultaneous assessment of mitochondrial membrane potential and Caspase-3/7 activity enables elucidation of the mechanisms and pathways through which apoptosis is initiated. Rapid and accurate assessment of the potential toxicity of environmental chemicals and drugs remains a major challenge. Quantitative Structure Activity Relationship (QSAR) modeling have been widely used for toxicity prediction. Graph-based approaches encode compounds directly as molecular graphs, allowing structure-activity relationships to be learnt from molecular topology without the information loss in binary fingerprints. While advanced graph models such as graph transformers (GTs) have shown outstanding performance in many domains, they have not been fully leveraged in QSAR modeling on Caspase and mitochondrial toxicity. Methods: We propose a QSAR modeling pipeline that encompasses assay data preprocessing, feature representations (fingerprints and molecular graphs), and benchmarking machine learning (ML) models, including classic ML models, graph neural networks (GNNs), GTs, and their consensus ensembles. Based on in vitro Caspase and mitochondrial assays in PubChem, we applied the pipeline to predict Caspase-3/7 activation and mitochondrial membrane potential (MMP). Beyond in vitro assays, we also built in vivo QSAR modeling for FDA Drug-Induced Liver Injury (DILI) gold standard on human hepatotoxicity. Moreover, mechanistic analysis on Caspase-3/7 activation was conducted by comparing with MMP disruption to identify chemical substructures that may be responsible for dual activations. We also investigated cell-line-specific responses by identifying structural motifs that selectively induce Caspase-3/7 activation in individual cell lines.Results:Experimental evaluations show that GTs and GNNs outperformed classic ML models when the number of active compounds is large, such as MMP disruption, while classic ML models and GTs performed good for highly imbalance data with limited active compounds, such as Caspase-3/7 activation. For DILI prediction, the full consensus model achieved the highest AUC 0.69 and Graphormer had the highest F1 score 0.79, both surpassing the previous best model with AUC 0.63 and F1 0.65 with a large margin.Our mechanistic analysis shows that phenolic compounds bearing a para-hydroxyphenyl motif, as well as members of the lipophilic chain family with long alkyl chains can trigger the collapse of MMP, leading to the activation of caspases-3 and -7. Human embryonic kidney (HEK293) was the only cell line with a distinct structural motif: 1,1-dichloroethane and chlorobenzene. Human neuroblastoma (SK-N-SH) is uniquely impacted by an epoxide fragment and rat hepatoma (H-4-II-E) is uniquely impacted by a tetramethylcyclohexene motif and an acetaldehyde fragment.Conclusions:The proposed pipeline for QSAR modeling, including data preprocessing, feature representations, and incorporation of advanced graph ML approaches, is highly effective in predicting not only on Caspase-3/7 activation and membrane potential collapse, but also on FDA DILI human hetatotoxicity. As future research directions, we will leverage extra information, e.g., biological activity and findings in existing toxicity literature, and recent advances in large language models and agentic AI to further improve the predictive performance and enable a sensitive and specific framework for assessing human hepatotoxicity of environmental compounds.

12.
arXiv (CS.CL) 2026-06-11

Substrate Asymmetry in User-Side Memory: A Diagnostic Framework

作者:

User-side memory in LLMs is typically scored as a single "personalization" capability: given a user's history, is the output more user-aware? We show this aggregate metric hides opposite-direction failures. Memory factorises into at least three orthogonal axes – behavioral consistency (style, voice), factual presence (recall facts in history), and factual absence (abstain when a fact is absent) – and no single substrate wins all three. Comparing per-user gamma-LoRA (a small LoRA adapter trained on each user's history; gamma denotes per-user, not per-task) against BGE-large dense top-K retrieval on a controlled 50-user synthetic corpus and a real-data probe (LaMP-3), we find gamma-LoRA decisively wins behavioral style while RAG decisively wins factual absence – and the same query-projection cells in attention layers 21-35 causally load-bear both effects in opposite directions (zeroing those LoRA weights raises absence-probe TPR by +33 pp and drops presence-probe TPR by 20 pp). On the more heavily RLHF-tuned Llama-3.1-8B-Instruct the asymmetry strengthens, not heals: parametric memory's behavioral advantage collapses while its absence-calibration deficit against retrieval widens – an alignment tax on parametric user-memory. On real-data LaMP-3, gamma-LoRA underperforms a majority baseline; a 9-condition mitigation sweep diagnoses this as instruction-following collapse, not substrate failure (a 9x2 cross-product shows the eval-time {1..5} logit mask drives main_acc to >=0.995 on every recipe), and the best training-time fix replicates bit-identically on Llama. Finally, substrate-selection routing is question-classification, not calibration: a 110M DistilBERT on the question text alone beats every logit-based router. We contribute the diagnostic framework, the diagnosed real-data negative, the alignment-tax replication, and the routing-as-classification finding.

13.
medRxiv (Medicine) 2026-06-15

Pulmonary extracellular vesicles drive alveolar macrophage dysfunction via microRNA transfer in Acute Respiratory Distress Syndrome

Background: Alveolar macrophage (AM) dysfunction contributes to Acute Respiratory Distress Syndrome (ARDS) pathogenesis. We investigated the role of extracellular vesicles (EVs) in mediating this dysfunction. Methods: Pulmonary EVs were isolated from broncho-alveolar lavage and non-directed bronchial lavage samples of ventilated sepsis patients with and without ARDS, and post-operative control patients via ultracentrifugation. AMs were isolated from lung tissue resections of lobectomy patients. AMs were treated with pooled EVs for 24 hours prior to functional, metabolic and autophagy profiling. EV cargo was profiled via small RNA transcriptomics and proteomics. Mechanistic role of EV microRNAs was assessed via mimic / antagomir transfection. Results: Pulmonary EVs from sepsis patients with ARDS impaired AM efferocytosis, and control EVs had no effect. ARDS EV treatment enhanced AM mitochondrial-linked respiration, but not glycolysis. ARDS EV treatment impaired LC3B-II and LAMP1 expression, indicating dysregulated AM autophagy-lysosomal machinery. Proteomics revealed downregulation of innate immune pathways in ARDS EVs. Transcriptomics revealed enrichment of 24 microRNAs in ARDS EVs; miR-652-3p was the most enriched, validated by RT-qPCR. EV miR-652-3p was associated with 90-day mortality (9.20 vs 0.59 RQ, p=0.0295) and inversely correlated with oxygenation (PaO2/FiO2). AM transfection with miR-652-3p mimic induced similar dysregulation of function and autophagy as ARDS EVs. Transfection of ARDS EVs with antagomirs to miR-652-3p prior to AM treatment partially rescued efferocytosis and autophagy. Conclusions: Targeting EV miR-652-3p may restore alveolar macrophage function and reduce excessive inflammation, thus offering a novel therapeutic strategy for patients with ARDS.

14.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

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

Entropy-Aware On-Policy Distillation of Language Models

On-policy distillation is a promising approach for transferring knowledge between language models, where a student learns from dense token-level signals along its own trajectories. This framework typically uses reverse KL divergence, encouraging the student to match the teacher's high-confidence predictions. However, we show that the mode-seeking property of reverse KL reduces generation diversity and yields unstable learning signals when the teacher distribution has high entropy. To address this, we introduce Entropy-Aware On-Policy Distillation. Our key idea is augmenting the standard reverse KL objective with forward KL when teacher entropy is high, capturing the full range of plausible outputs while retaining precise imitation elsewhere. It balances mode-seeking precision with mode-covering robustness without sacrificing on-policy training efficiency. Experiments show that our method maintains generation diversity (sustained token-level entropy) and improves student-teacher alignment (lower forward KL on high-entropy tokens). Across six math reasoning benchmarks, this yields Pass@8 accuracy gains of +1.37 for Qwen3-0.6B-Base, +2.39 for Qwen3-1.7B-Base, and +5.05 for Qwen3-4B-Base compared to baseline on-policy distillation methods. These results demonstrate that accounting for teacher uncertainty is essential for maintaining diversity and achieving effective knowledge transfer.

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

Learning and Generating Mixed States Prepared by Shallow Channel Circuits

arXiv:2604.01197v4 Announce Type: replace-cross Abstract: Learning quantum states from measurement data is a central problem in quantum information and computational complexity. In this work, we study the problem of learning to generate mixed states on a finite-dimensional lattice. Motivated by recent developments in mixed state phases of matter, we focus on arbitrary states in the trivial phase. A state belongs to the trivial phase if there exists a shallow preparation channel circuit under which local reversibility is preserved throughout the preparation. We prove that any mixed state in this class can be efficiently learned from measurement access alone. Specifically, given copies of an unknown trivial phase mixed state, our algorithm outputs a shallow local channel circuit that approximately generates this state in trace distance. The sample complexity and runtime are polynomial (or quasi-polynomial) in the number of qubits, assuming constant (or polylogarithmic) circuit depth and gate locality. Importantly, the learner is not given the original preparation circuit and relies only on its existence. Our results provide a structural foundation for quantum generative models based on shallow channel circuits. In the classical limit, our framework also inspires an efficient algorithm for classical diffusion models using only a polynomial overhead of training and generation.

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

Near-Optimal Regret for Distributed Adversarial Bandits: A Black-Box Approach

arXiv:2602.06404v2 Announce Type: replace Abstract: We study distributed adversarial bandits, where $N$ agents cooperate to minimize the global average loss while observing only their own local losses. We show that the minimax regret for this problem is $\tilde{\Theta}(\sqrt{(\rho^{-1/2}+K/N)T})$, where $T$ is the horizon, $K$ is the number of actions, and $\rho$ is the spectral gap of the communication matrix. Our algorithm, based on a novel black-box reduction to bandits with delayed feedback, requires agents to communicate only through gossip. It achieves an upper bound that significantly improves over the previous best bound $\tilde{O}(\rho^{-1/3}(KT)^{2/3})$ of Yi and Vojnovic (2023). We complement this result with a matching lower bound, showing that the problem's difficulty decomposes into a communication cost $\rho^{-1/4}\sqrt{T}$ and a bandit cost $\sqrt{KT/N}$. We further demonstrate the versatility of our approach by deriving first-order and best-of-both-worlds bounds in the distributed adversarial setting. Finally, we extend our framework to distributed linear bandits in $R^d$, obtaining a regret bound of $\tilde{O}(\sqrt{(\rho^{-1/2}+1/N)dT})$, achieved with only $O(d)$ communication cost per agent and per round via a volumetric spanner.

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

Can LLMs Accurately Score Medical Diagnoses and Clinical Reasoning?

arXiv:2604.14892v3 Announce Type: replace-cross Abstract: Evaluating medical AI systems using expert clinician panels is costly and slow, motivating the use of large language models (LLMs) as alternative adjudicators. Here, we evaluate an LLM Jury, composed of three frontier AI models, for scoring 3334 diagnoses on 300 real-world low- and middle-income country (LMIC) hospital cases. Both LLM- and clinician-generated diagnoses are scored against expert panel diagnoses across four dimensions: diagnosis, differential diagnosis, clinical reasoning, and negative treatment risk. The LLM Jury scores are compared with expert and independent re-scoring panel scores to assess error metrics, inter-rater agreement, severe-risk errors, and the effect of post hoc calibration using isotonic regression. In our data, we find that: (i) the uncalibrated LLM Jury scores preserve ordinal agreement with the expert clinician panel scores, but are systematically lower; (ii) the probability of severe-risk errors is lower for the LLM Jury than the human expert re-score panels; (iii) the LLM Jury combined with LLM diagnoses can be used to identify diagnoses at high risk of error, enabling targeted expert review and improved panel efficiency; (iv) the calibrated LLM Jury scores and rankings of diagnosing agents show excellent agreement with those of the primary expert panels; (v) LLM Jury models show no self-preference bias, they did not score diagnoses generated by their own underlying model or models from the same vendor more (or less) favourably than those generated by other models. Together, these results provide evidence that a calibrated LLM Jury is a trustworthy and reliable proxy for expert clinician evaluation in medical AI benchmarking. Confirming these findings in other clinical settings is an important direction for future work.

19.
medRxiv (Medicine) 2026-06-18

From Paper Letters to an Integrated Digital Workflow: Improving Efficiency, Reliability, and Engagement in Health Guidance

Background: Post-checkup health guidance in Japan has traditionally relied on paper-based communication and manual administrative processes. These workflows are time-consuming, prone to transcription errors, and can delay timely engagement with health guidance recipients. Objective: To assess whether replacing a paper-based workflow with an integrated digital system using Microsoft Access, robotic process automation (RPA), and web-based responses could improve administrative efficiency, operational reliability, and engagement among health guidance recipients. Methods: This single-site quality improvement initiative redesigned the existing letter-based workflow. Access served as a central interface for managing recipients and generating guidance letters. RPA (EzRobot) automated repetitive clerical and billing-related tasks. A web form accessed via a QR code enabled recipients to respond digitally. Outcomes included manual administrative handling time per case, occurrence of transcription-related errors, health guidance completion rate, and guidance duration distribution. Results: Following implementation, staff active handling time per case decreased from approximately 10 minutes to less than 1 minute (approximately 30 seconds), while automated RPA execution typically required about 4-5 minutes per case without staff input. No transcription-related errors were detected during the post-implementation observation period. Health guidance completion rates improved from 28.3% to 39.2% (chi-square test, P=200 days decreased from 30.5% to 20.9% and cases with >=240 days decreased from 13.6% to 8.9% (R4 n=59, R5 n=158). Conclusion: An integrated Access-RPA-Web workflow was associated with improvements in administrative efficiency and operational reliability in post-checkup health guidance while retaining human verification and exception handling. This pragmatic, non-AI-dependent approach may offer a useful model for process-level improvement in preventive care settings.

20.
arXiv (CS.CV) 2026-06-19

FrequencyFormer: A Co-Designed Sensor-to-Processor Pipeline for Frequency-Domain Vision Transformer Inference

Deploying vision transformers (ViTs) on sensor-edge systems is limited not only by on-device compute, but also by the energy and bandwidth required to transmit high-dimensional image data from the sensor to the processor. While in-sensor and near-sensor computing reduce this cost through early feature extraction, existing methods often provide only modest compression. We observe that the frequency domain provides a naturally compact representation of visual information and can be exploited at the sensor level to reduce sensor-to-processor data movement. Building on this insight, we present FrequencyFormer, a co-designed sensor-to-processor pipeline for efficient ViT inference. FrequencyFormer includes: (1) a multi-scale DCT tokenizer that compresses a 224x224 image into compact frequency-domain tokens, achieving up to 128x reduction in off-chip data volume with modest accuracy loss; (2) a LUT-based near-sensor hardware implementation that leverages fixed DCT coefficients for multiplier-free, energy- and area-efficient tokenization; and (3) a modified MIPI-based low-power communication architecture that further reduces transfer energy. FrequencyFormer serves as a drop-in replacement for standard ViT patch embedding and remains compatible with pretrained backbones across classification, detection, and segmentation tasks. The pipeline achieves 28.8 TOPS/W, reduces communication energy by 230x, and lowers total sensor-side energy by 2.22x, demonstrating frequency-domain tokenization as a scalable foundation for in-sensor ViT deployment.

21.
Nature (Science) 2026-06-17

Towards autonomous medical artificial intelligence agents

作者:

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

22.
arXiv (CS.CV) 2026-06-16

Human Cognition in Machines: A Unified Perspective of World Models

This report of world models distinguishes prior works by the cognitive functions they innovate. Many works claim an almost human-like cognitive capability in their world models. To evaluate these claims requires a proper grounding in first principles from human and machine cognition theory. In moving towards human-like world models we present a conceptual unified framework for world models that fully incorporates all the cognitive functions (i.e., memory, perception, language, reasoning, imagining, motivation, and metacognition) and identify gaps in existing research as a guide for future states of the art. In particular, we find that motivation (especially intrinsic motivation) and metacognition remain drastically under-researched, and we propose concrete directions to address these gaps informed by active inference and global workspace theory. We also introduce epistemic world models, a new category encompassing agent frameworks for scientific discovery that operate over structured knowledge. Our taxonomy, applied to video, embodied, and epistemic world models, suggests research directions where prior taxonomies have not.

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

SkillJuror: Measuring How Agent Skill Organization Changes Runtime Behavior

arXiv:2606.11543v1 Announce Type: new Abstract: Agent Skills augment large language model (LLM) agents with procedural knowledge at inference time, but current benchmarks rarely distinguish what a Skill says from how it is organized. We study this distinction through Progressive Disclosure, where a concise root file points agents to supporting resources on demand, and compare it with a normalized flat baseline. We present SkillJuror, a framework for evaluating Skill writing paradigms through semantically controlled variants, matched multi-trial evaluations, and trajectory evidence while holding task knowledge fixed. In an 82-task SkillsBench study, Progressive Disclosure changes runtime behavior before aggregate outcomes: distinct Skill resources touched per trajectory rise from 1.18 to 3.85, and effective uptake events rise from 1.33 to 3.92. It also yields 17 additional verifier-passing trials out of 410 matched trials (+4.1%) over the normalized flat baseline. The benefit is task-dependent. Progressive Disclosure helps when supporting resources guide implementation, checking, or repair, but is weaker when success hinges on exact output conventions, numerical thresholds, or long artifact-generation pipelines. These results show that Skill organization is not mere presentation: it can change how agents search and apply procedural knowledge, while outcome gains depend on whether the exposed resources are actionable for the task. Code is available at https://github.com/zhiyuchen-ai/skill-juror.

24.
arXiv (CS.LG) 2026-06-15

Riemannian Metric Matching for Scalable Geometric Modeling of Distributions

arXiv:2606.14334v1 Announce Type: new Abstract: High-dimensional datasets often concentrate near low-dimensional structures, but estimating their geometry from samples typically relies on graphs and kernels that scale poorly with dataset size and dimension. We propose Riemannian metric matching: a denoising probabilistic framework for learning the Riemannian geometry of data using neural networks. Specifically, we learn the carré du champ operator, which, using diffusion geometry, gives us access to the Riemannian geometry toolkit for downstream machine learning and statistical tasks. Our key observation is that the carré du champ operator can be formulated as a conditional expectation over random perturbations of the data, which can be exploited for sample-wise training and constant cost, amortized inference without explicit kernel construction. Empirically, metric matching rivals or improves the accuracy of $k$-NN-based diffusion geometry estimators, while enabling amortized inference that is up to $400\times$ faster, and supports graph-free geometric analysis on high-dimensional images where nearest neighbors break down.

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arXiv (CS.LG) 2026-06-19

Alternating Direction Method of Multipliers for Nonlinear Matrix Decompositions

arXiv:2512.17473v3 Announce Type: replace-cross Abstract: We present an algorithm based on the alternating direction method of multipliers (ADMM) for solving nonlinear matrix decompositions (NMD). Given an input matrix $X \in \mathbb{R}^{m \times n}$ and a factorization rank $r \ll \min(m, n)$, NMD seeks matrices $W \in \mathbb{R}^{m \times r}$ and $H \in \mathbb{R}^{r \times n}$ such that $X \approx f(WH)$, where $f$ is an element-wise nonlinear function. We evaluate our method on several representative nonlinear models: the rectified linear unit activation $f(x) = \max(0, x)$, suitable for nonnegative sparse data approximation, the component-wise square $f(x) = x^2$, applicable to probabilistic circuit representation, and the MinMax transform $f(x) = \min(b, \max(a, x))$, relevant for recommender systems. The proposed framework flexibly supports diverse loss functions, including least squares, $\ell_1$ norm, and the Kullback-Leibler divergence, and can be readily extended to other nonlinearities and metrics. We illustrate the applicability, efficiency, and adaptability of the approach on real-world datasets, highlighting its potential for a broad range of applications.