npj Digital Medicine, Published online: 04 April 2026; doi:10.1038/s41746-026-02594-6

A neural-symbolic AI agent system for biomedical concept mapping

npj Digital Medicine, Published online: 04 April 2026; doi:10.1038/s41746-026-02573-x

HoloTrauma 3X Triadic AI Co reasoning for robot assisted emergency maxillofacial reconstruction

arXiv:2604.01538v1 Announce Type: cross Abstract: Large language models have been adopted in the medical domain for clinical documentation to reduce clinician burden. However, studies have reported that LLMs often "forget" a significant amount of instruction-following ability when fine-tuned using a task-specific medical dataset, a critical challenge in adopting general-purpose LLMs for clinical applications. This study presents a model merging framework to efficiently adapt general-purpose LLMs to the medical domain by countering this forgetting issue. By merging a clinical foundation model (GatorTronLlama) with a general instruct model (Llama-3.1-8B-Instruct) via interpolation-based merge methods, we seek to derive a domain-adapted model with strong performance on clinical tasks while retaining instruction-following ability. Comprehensive evaluation across medical benchmarks and five clinical generation tasks (e.g., radiology and discharge summarization) shows that merged models can effectively mitigate catastrophic forgetting, preserve clinical domain expertise, and retain instruction-following ability. In addition, our model merging strategies demonstrate training efficiency, achieving performance on par with fully fine-tuned baselines under severely constrained supervision (e.g., 64-shot vs. 256-shot). Consequently, weight-space merging constitutes a highly scalable solution for adapting open-source LLMs to clinical applications, facilitating broader deployment in resource-constrained healthcare environments.

arXiv:2604.01681v1 Announce Type: cross Abstract: Large foundation models enable powerful reasoning for autonomous systems, but mapping semantic intent to reliable real-time control remains challenging. Existing approaches either (i) let Large Language Models (LLMs) generate trajectories directly - brittle, hard to verify, and latency-prone - or (ii) adjust Model Predictive Control (MPC) objectives online - mixing slow deliberation with fast control and blurring interfaces. We propose Agentic Fast-Slow Planning, a hierarchical framework that decouples perception, reasoning, planning, and control across natural timescales. The framework contains two bridges. Perception2Decision compresses scenes into ego-centric topologies using an on-vehicle Vision-Language Model (VLM) detector, then maps them to symbolic driving directives in the cloud with an LLM decision maker - reducing bandwidth and delay while preserving interpretability. Decision2Trajectory converts directives into executable paths: Semantic-Guided A* embeds language-derived soft costs into classical search to bias solutions toward feasible trajectories, while an Agentic Refinement Module adapts planner hyperparameters using feedback and memory. Finally, MPC tracks the trajectories in real time, with optional cloud-guided references for difficult cases. Experiments in CARLA show that Agentic Fast-Slow Planning improves robustness under perturbations, reducing lateral deviation by up to 45% and completion time by over 12% compared to pure MPC and an A*-guided MPC baseline. Code is available at https://github.com/cjychenjiayi/icra2026_AFSP.

arXiv:2603.29844v1 Announce Type: cross Abstract: The development of Vision-Language-Action (VLA) models has been significantly accelerated by pre-trained Vision-Language Models (VLMs). However, most existing end-to-end VLAs treat the VLM primarily as a multimodal encoder, directly mapping vision-language features to low-level actions. This paradigm underutilizes the VLM's potential in high-level decision making and introduces training instability, frequently degrading its rich semantic representations. To address these limitations, we introduce DIAL, a framework bridging high-level decision making and low-level motor execution through a differentiable latent intent bottleneck. Specifically, a VLM-based System-2 performs latent world modeling by synthesizing latent visual foresight within the VLM's native feature space; this foresight explicitly encodes intent and serves as the structural bottleneck. A lightweight System-1 policy then decodes this predicted intent together with the current observation into precise robot actions via latent inverse dynamics. To ensure optimization stability, we employ a two-stage training paradigm: a decoupled warmup phase where System-2 learns to predict latent futures while System-1 learns motor control under ground-truth future guidance within a unified feature space, followed by seamless end-to-end joint optimization. This enables action-aware gradients to refine the VLM backbone in a controlled manner, preserving pre-trained knowledge. Extensive experiments on the RoboCasa GR1 Tabletop benchmark show that DIAL establishes a new state-of-the-art, achieving superior performance with 10x fewer demonstrations than prior methods. Furthermore, by leveraging heterogeneous human demonstrations, DIAL learns physically grounded manipulation priors and exhibits robust zero-shot generalization to unseen objects and novel configurations during real-world deployment on a humanoid robot.

Nature, Published online: 24 March 2026; doi:10.1038/s41586-026-10403-z

Author Correction: 7-Dehydrocholesterol is an endogenous suppressor of ferroptosis

arXiv:2603.03378v1 Announce Type: cross Abstract: Large language model (LLM) agents offer a promising data-driven approach to automating Site Reliability Engineering (SRE), yet their enterprise deployment is constrained by three challenges: restricted access to proprietary data, unsafe action execution under permission-governed environments, and the inability of closed systems to improve from failures. We present AOI (Autonomous Operations Intelligence), a trainable multi-agent framework formulating automated operations as a structured trajectory learning problem under security constraints. Our approach integrates three key components. First, a trainable diagnostic system applies Group Relative Policy Optimization (GRPO) to distill expert-level knowledge into locally deployed open-source models, enabling preference-based learning without exposing sensitive data. Second, a read-write separated execution architecture decomposes operational trajectories into observation, reasoning, and action phases, allowing safe learning while preventing unauthorized state mutation. Third, a Failure Trajectory Closed-Loop Evolver mines unsuccessful trajectories and converts them into corrective supervision signals, enabling continual data augmentation. Evaluated on the AIOpsLab benchmark, our contributions yield cumulative gains. (1) The AOI runtime alone achieves 66.3% best@5 success on all 86 tasks, outperforming the prior state-of-the-art (41.9%) by 24.4 points. (2) Adding Observer GRPO training, a locally deployed 14B model reaches 42.9% avg@1 on 63 held-out tasks with unseen fault types, surpassing Claude Sonnet 4.5. (3) The Evolver converts 37 failed trajectories into diagnostic guidance, improving end-to-end avg@5 by 4.8 points while reducing variance by 35%.

arXiv:2602.18807v1 Announce Type: cross Abstract: We evaluate GPTutor, an LLM-powered tutoring system for an undergraduate discrete mathematics course. It integrates two LLM-supported tools: a structured proof-review tool that provides embedded feedback on students' written proof attempts, and a chatbot for math questions. In a staggered-access study with 148 students, earlier access was associated with higher homework performance during the interval when only the experimental group could use the system, while we did not observe this performance increase transfer to exam scores. Usage logs show that students with lower self-efficacy and prior exam performance used both components more frequently. Session-level behavioral labels, produced by human coding and scaled using an automated classifier, characterize how students engaged with the chatbot (e.g., answer-seeking or help-seeking). In models controlling for prior performance and self-efficacy, higher chatbot usage and answer-seeking behavior were negatively associated with subsequent midterm performance, whereas proof-review usage showed no detectable independent association. Together, the findings suggest that chatbot-based support alone may not reliably support transfer to independent assessment of math proof-learning outcomes, whereas work-anchored, structured feedback appears less associated with reduced learning.

arXiv:2602.20130v1 Announce Type: cross Abstract: Objective: To improve the efficiency of medical question answering (MedQA) with large language models (LLMs) by avoiding unnecessary reasoning while maintaining accuracy. Methods: We propose Selective Chain-of-Thought (Selective CoT), an inference-time strategy that first predicts whether a question requires reasoning and generates a rationale only when needed. Two open-source LLMs (Llama-3.1-8B and Qwen-2.5-7B) were evaluated on four biomedical QA benchmarks-HeadQA, MedQA-USMLE, MedMCQA, and PubMedQA. Metrics included accuracy, total generated tokens, and inference time. Results: Selective CoT reduced inference time by 13-45% and token usage by 8-47% with minimal accuracy loss ($\leq$4\%). In some model-task pairs, it achieved both higher accuracy and greater efficiency than standard CoT. Compared with fixed-length CoT, Selective CoT reached similar or superior accuracy at substantially lower computational cost. Discussion: Selective CoT dynamically balances reasoning depth and efficiency by invoking explicit reasoning only when beneficial, reducing redundancy on recall-type questions while preserving interpretability. Conclusion: Selective CoT provides a simple, model-agnostic, and cost-effective approach for medical QA, aligning reasoning effort with question complexity to enhance real-world deployability of LLM-based clinical systems.

arXiv:2601.16449v2 Announce Type: replace-cross Abstract: Understanding human emotions from multimodal signals poses a significant challenge in affective computing and human-robot interaction. While multimodal large language models (MLLMs) have excelled in general vision-language tasks, their capabilities in emotional reasoning remain limited. The field currently suffers from a scarcity of large-scale datasets with high-quality, descriptive emotion annotations and lacks standardized benchmarks for evaluation. Our preliminary framework, Emotion-LLaMA, pioneered instruction-tuned multimodal learning for emotion reasoning but was restricted by explicit face detectors, implicit fusion strategies, and low-quality training data with limited scale. To address these limitations, we present Emotion-LLaMAv2 and the MMEVerse benchmark, establishing an end-to-end pipeline together with a standardized evaluation setting for emotion recognition and reasoning. Emotion-LLaMAv2 introduces three key advances. First, an end-to-end multiview encoder eliminates external face detection and captures nuanced emotional cues via richer spatial and temporal multiview tokens. Second, a Conv Attention pre-fusion module is designed to enable simultaneous local and global multimodal feature interactions external to the LLM backbone. Third, a perception-to-cognition curriculum instruction tuning scheme within the LLaMA2 backbone unifies emotion recognition and free-form emotion reasoning. To support large-scale training and reproducible evaluation, MMEVerse aggregates twelve publicly available emotion datasets, including IEMOCAP, MELD, DFEW, and MAFW, into a unified multimodal instruction format. The data are re-annotated via a multi-agent pipeline involving Qwen2 Audio, Qwen2.5 VL, and GPT 4o, producing 130k training clips and 36k testing clips across 18 evaluation benchmarks.

arXiv:2602.12691v2 Announce Type: replace-cross Abstract: We study how to improve large foundation vision-language-action (VLA) systems through online reinforcement learning (RL) in real-world settings. Central to this process is the value function, which provides learning signals to guide VLA learning from experience. In practice, the value function is estimated from trajectory fragments collected from different data sources, including historical policies and intermittent human interventions. Estimating the value function of current behavior quality from the mixture data is inherently an off-policy evaluation problem. However, prior work often adopts conservative on-policy estimation for stability, which avoids direct evaluation of the current high-capacity policy and limits learning effectiveness. In this paper, we propose ALOE, an action-level off-policy evaluation framework for VLA post-training. ALOE applies chunking-based temporal-difference bootstrapping to evaluate individual action sequences instead of predicting final task outcomes. This design improves effective credit assignment to critical action chunks under sparse rewards and supports stable policy improvement. We evaluate our method on three real-world manipulation tasks, including smartphone packing as a high-precision task, laundry folding as a long-horizon deformable-object task, and bimanual pick-and-place involving multi-object perception. Across all tasks, ALOE improves learning efficiency without compromising execution speed, showing that off-policy RL can be reintroduced in a reliable manner for real-world VLA post-training. Videos and additional materials are available at our project website.