arXiv:2601.08333v1 Announce Type: new Abstract: LLM-based agent architectures systematically conflate information transport mechanisms with epistemic justification mechanisms. We formalize this class of architectural failures as semantic laundering: a pattern where propositions with absent or weak warrant are accepted by the system as admissible by crossing architecturally trusted interfaces. We show that semantic laundering constitutes an architectural realization of the Gettier problem: propositions acquire high epistemic status without a connection between their justification and what makes them true. Unlike classical Gettier cases, this effect is not accidental; it is architecturally determined and systematically reproducible. The central result is the Theorem of Inevitable Self-Licensing: under standard architectural assumptions, circular epistemic justification cannot be eliminated. We introduce the Warrant Erosion Principle as the fundamental explanation for this effect and show that scaling, model improvement, and LLM-as-judge schemes are structurally incapable of eliminating a problem that exists at the type level.

arXiv:2601.08559v1 Announce Type: new Abstract: Sustainable water resource management in transboundary river basins is challenged by fragmented data, limited real-time access, and the complexity of integrating diverse information sources. This paper presents WaterCopilot-an AI-driven virtual assistant developed through collaboration between the International Water Management Institute (IWMI) and Microsoft Research for the Limpopo River Basin (LRB) to bridge these gaps through a unified, interactive platform. Built on Retrieval-Augmented Generation (RAG) and tool-calling architectures, WaterCopilot integrates static policy documents and real-time hydrological data via two custom plugins: the iwmi-doc-plugin, which enables semantic search over indexed documents using Azure AI Search, and the iwmi-api-plugin, which queries live databases to deliver dynamic insights such as environmental-flow alerts, rainfall trends, reservoir levels, water accounting, and irrigation data. The system features guided multilingual interactions (English, Portuguese, French), transparent source referencing, automated calculations, and visualization capabilities. Evaluated using the RAGAS framework, WaterCopilot achieves an overall score of 0.8043, with high answer relevancy (0.8571) and context precision (0.8009). Key innovations include automated threshold-based alerts, integration with the LRB Digital Twin, and a scalable deployment pipeline hosted on AWS. While limitations in processing non-English technical documents and API latency remain, WaterCopilot establishes a replicable AI-augmented framework for enhancing water governance in data-scarce, transboundary contexts. The study demonstrates the potential of this AI assistant to support informed, timely decision-making and strengthen water security in complex river basins.

arXiv:2601.08183v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) show promise in gastroenterology, yet their performance against comprehensive clinical workflows and human benchmarks remains unverified. To systematically evaluate state-of-the-art MLLMs across a panoramic gastrointestinal endoscopy workflow and determine their clinical utility compared with human endoscopists. We constructed GI-Bench, a benchmark encompassing 20 fine-grained lesion categories. Twelve MLLMs were evaluated across a five-stage clinical workflow: anatomical localization, lesion identification, diagnosis, findings description, and management. Model performance was benchmarked against three junior endoscopists and three residency trainees using Macro-F1, mean Intersection-over-Union (mIoU), and multi-dimensional Likert scale. Gemini-3-Pro achieved state-of-the-art performance. In diagnostic reasoning, top-tier models (Macro-F1 0.641) outperformed trainees (0.492) and rivaled junior endoscopists (0.727; p>0.05). However, a critical "spatial grounding bottleneck" persisted; human lesion localization (mIoU >0.506) significantly outperformed the best model (0.345; p

arXiv:2601.08634v1 Announce Type: cross Abstract: While recent research has systematically documented political orientation in large language models (LLMs), existing evaluations rely primarily on direct probing or demographic persona engineering to surface ideological biases. In social psychology, however, political ideology is also understood as a downstream consequence of fundamental moral intuitions. In this work, we investigate the causal relationship between moral values and political positioning by treating moral orientation as a controllable condition. Rather than simply assigning a demographic persona, we condition models to endorse or reject specific moral values and evaluate the resulting shifts on their political orientations, using the Political Compass Test. By treating moral values as lenses, we observe how moral conditioning actively steers model trajectories across economic and social dimensions. Our findings show that such conditioning induces pronounced, value-specific shifts in models' political coordinates. We further notice that these effects are systematically modulated by role framing and model scale, and are robust across alternative assessment instruments instantiating the same moral value. This highlights that effective alignment requires anchoring political assessments within the context of broader social values including morality, paving the way for more socially grounded alignment techniques.

arXiv:2601.08732v1 Announce Type: cross Abstract: Accurate delineation of acute ischemic stroke lesions in MRI is a key component of stroke diagnosis and management. In recent years, deep learning models have been successfully applied to the automatic segmentation of such lesions. While most proposed architectures are based on the U-Net framework, they primarily differ in their choice of loss functions and in the use of deep supervision, residual connections, and attention mechanisms. Moreover, many implementations are not publicly available, and the optimal configuration for acute ischemic stroke (AIS) lesion segmentation remains unclear. In this work, we introduce ISLA (Ischemic Stroke Lesion Analyzer), a new deep learning model for AIS lesion segmentation from diffusion MRI, trained on three multicenter databases totaling more than 1500 AIS participants. Through systematic optimization of the loss function, convolutional architecture, deep supervision, and attention mechanisms, we developed a robust segmentation framework. We further investigated unsupervised domain adaptation to improve generalization to an external clinical dataset. ISLA outperformed two state-of-the-art approaches for AIS lesion segmentation on an external test set. Codes and trained models will be made publicly available to facilitate reuse and reproducibility.

arXiv:2504.08999v2 Announce Type: replace-cross Abstract: Large Language Models (LLMs) are increasingly augmented with external tools through standardized interfaces like the Model Context Protocol (MCP). However, current MCP implementations face critical limitations: they typically require local process execution through STDIO transports, making them impractical for resource-constrained environments like mobile devices, web browsers, and edge computing. We present MCP Bridge, a lightweight RESTful proxy that connects to multiple MCP servers and exposes their capabilities through a unified API. Unlike existing solutions, MCP Bridge is fully LLM-agnostic, supporting any backend regardless of vendor. The system implements a risk-based execution model with three security levels-standard execution, confirmation workflow, and Docker isolation - while maintaining backward compatibility with standard MCP clients. However, reliable execution within this framework requires models that can strictly adhere to protocol schemas. To this end, we also fine-tuned the Qwen3 4B and 8B model family on the Agent-Ark/Toucan-1.5M dataset using four Reinforcement Learning techniques: Group Relative Policy Optimization (GRPO), Dr. GRPO, Beta Normalization Policy Optimization (BNPO), and Decoupled Alignment Policy Optimization (DAPO). Evaluated on the MCPToolBench++ benchmark, our optimized model achieves an F1 score of 73.0% that outperforms GPT-OSS-120B (62.17%) and remains competitive with the 70B+ parameter baselines. Evaluation demonstrates that MCP Bridge successfully addresses the constraints of direct MCP connections while providing enhanced security controls and cross-platform compatibility, enabling sophisticated LLM-powered applications in previously inaccessible environments.

arXiv:2505.07917v2 Announce Type: replace-cross Abstract: Biomedical question-answering (QA) systems require effective retrieval and generation components to ensure accuracy, efficiency, and scalability. This study systematically examines a Retrieval-Augmented Generation (RAG) system for biomedical QA, evaluating retrieval strategies and response time trade-offs. We first assess state-of-the-art retrieval methods, including BM25, BioBERT, MedCPT, and a hybrid approach, alongside common data stores such as Elasticsearch, MongoDB, and FAISS, on a ~10% subset of PubMed (2.4M documents) to measure indexing efficiency, retrieval latency, and retriever performance in the end-to-end RAG system. Based on these insights, we deploy the final RAG system on the full 24M PubMed corpus, comparing different retrievers' impact on overall performance. Evaluations of the retrieval depth show that retrieving 50 documents with BM25 before reranking with MedCPT optimally balances accuracy (0.90), recall (0.90), and response time (1.91s). BM25 retrieval time remains stable (82ms), while MedCPT incurs the main computational cost. These results highlight previously not well-known trade-offs in retrieval depth, efficiency, and scalability for biomedical QA. With open-source code, the system is fully reproducible and extensible.

arXiv:2505.13565v2 Announce Type: replace-cross Abstract: Artificial Intelligence (AI) poses both significant risks and valuable opportunities for democratic governance. This paper introduces a dual taxonomy to evaluate AI's complex relationship with democracy: the AI Risks to Democracy (AIRD) taxonomy, which identifies how AI can undermine core democratic principles such as autonomy, fairness, and trust; and the AI's Positive Contributions to Democracy (AIPD) taxonomy, which highlights AI's potential to enhance transparency, participation, efficiency, and evidence-based policymaking. Grounded in the European Union's approach to ethical AI governance, and particularly the seven Trustworthy AI requirements proposed by the European Commission's High-Level Expert Group on AI, each identified risk is aligned with mitigation strategies based on EU regulatory and normative frameworks. Our analysis underscores the transversal importance of transparency and societal well-being across all risk categories and offers a structured lens for aligning AI systems with democratic values. By integrating democratic theory with practical governance tools, this paper offers a normative and actionable framework to guide research, regulation, and institutional design to support trustworthy, democratic AI. It provides scholars with a conceptual foundation to evaluate the democratic implications of AI, equips policymakers with structured criteria for ethical oversight, and helps technologists align system design with democratic principles. In doing so, it bridges the gap between ethical aspirations and operational realities, laying the groundwork for more inclusive, accountable, and resilient democratic systems in the algorithmic age.

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The next test for Kite Pharma — and Gilead

It’s anito-cel, the CAR-T therapy for multiple myeloma that Gilead is developing in partnership with Arcellx. Gilead submitted the therapy to the FDA sometime before the end of December, Cindy Perettie, executive vice president of Kite Pharma, the cell therapy division of Gilead, told STAT at a Gilead media breakfast.

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OpenEvidence promises ‘medical super-intelligence’

It will be hard for OpenEvidence to top its 2025. The company announced nearly $500 million in funding last year and seemingly overnight became a go-to tool in the medical profession. A slide during the company’s Monday JPM presentation claims that queries to the company’s clinical evidence chatbot grew from 2.6 million in 2024 to 17.9 million in December 2025, with well over 100 million queries for the year.

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arXiv:2601.06197v1 Announce Type: new Abstract: Generative AI has unleashed the power of content generation and it has also unwittingly opened the pandora box of realistic deepfake causing a number of social hazards and harm to businesses and personal reputation. The investigation & ramification of Generative AI technology across industries, the resolution & hybridization detection techniques using neural networks allows flagging of the content. Good detection techniques & flagging allow AI safety - this is the main focus of this paper. The research provides a significant method for efficiently detecting dark side problems by imposing a Temporal Consistency Learning (TCL) technique. Through pretrained Temporal Convolutional Networks (TCNs) model training and performance comparison, this paper showcases that TCN models outperforms the other approaches and achieves significant accuracy for five dark side problems. Findings highlight how important it is to take proactive measures in identification to reduce any potential risks associated with generative artificial intelligence.

arXiv:2601.06453v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly grounded in sensor data to perceive and reason about human physiology and the physical world. However, accurately interpreting heterogeneous multimodal sensor data remains a fundamental challenge. We show that a single monolithic LLM often fails to reason coherently across modalities, leading to incomplete interpretations and prior-knowledge bias. We introduce ConSensus, a training-free multi-agent collaboration framework that decomposes multimodal sensing tasks into specialized, modality-aware agents. To aggregate agent-level interpretations, we propose a hybrid fusion mechanism that balances semantic aggregation, which enables cross-modal reasoning and contextual understanding, with statistical consensus, which provides robustness through agreement across modalities. While each approach has complementary failure modes, their combination enables reliable inference under sensor noise and missing data. We evaluate ConSensus on five diverse multimodal sensing benchmarks, demonstrating an average accuracy improvement of 7.1% over the single-agent baseline. Furthermore, ConSensus matches or exceeds the performance of iterative multi-agent debate methods while achieving a 12.7 times reduction in average fusion token cost through a single-round hybrid fusion protocol, yielding a robust and efficient solution for real-world multimodal sensing tasks.

arXiv:2601.06060v1 Announce Type: cross Abstract: AI-generated "slop" is often seen as digital pollution. We argue that this dismissal of the topic risks missing important aspects of AI Slop that deserve rigorous study. AI Slop serves a social function: it offers a supply-side solution to a variety of problems in cultural and economic demand - that, collectively, people want more content than humans can supply. We also argue that AI Slop is not mere digital detritus but has its own aesthetic value. Like other "low" cultural forms initially dismissed by critics, it nonetheless offers a legitimate means of collective sense-making, with the potential to express meaning and identity. We identify three key features of family resemblance for prototypical AI Slop: superficial competence (its veneer of quality is belied by a deeper lack of substance), asymmetry effort (it takes vastly less effort to generate than would be the case without AI), and mass producibility (it is part of a digital ecosystem of widespread generation and consumption). While AI Slop is heterogeneous and depends crucially on its medium, it tends to vary across three dimensions: instrumental utility, personalization, and surrealism. AI Slop will be an increasingly prolific and impactful part of our creative, information, and cultural economies; we should take it seriously as an object of study in its own right.

arXiv:2601.06144v1 Announce Type: cross Abstract: Artificial intelligence (AI) in healthcare has led to many promising developments; however, increasingly, AI research is funded by the private sector leading to potential trade-offs between benefits to patients and benefits to industry. Health AI practitioners should prioritize successful adaptation into clinical practice in order to provide meaningful benefits to patients, but translation usually requires collaboration with industry. We discuss three features of AI studies that hamper the integration of AI into clinical practice from the perspective of researchers and clinicians. These include lack of clinically relevant metrics, lack of clinical trials and longitudinal studies to validate results, and lack of patient and physician involvement in the development process. For partnerships between industry and health research to be sustainable, a balance must be established between patient and industry benefit. We propose three approaches for addressing this gap: improved transparency and explainability of AI models, fostering relationships with industry partners that have a reputation for centering patient benefit in their practices, and prioritization of overall healthcare benefits. With these priorities, we can sooner realize meaningful AI technologies used by clinicians where mutua

arXiv:2601.06300v1 Announce Type: cross Abstract: Clinical trial amendments frequently introduce delays, increased costs, and administrative burden, with eligibility criteria being the most commonly amended component. We introduce \textit{eligibility criteria amendment prediction}, a novel NLP task that aims to forecast whether the eligibility criteria of an initial trial protocol will undergo future amendments. To support this task, we release $\texttt{AMEND++}$, a benchmark suite comprising two datasets: $\texttt{AMEND}$, which captures eligibility-criteria version histories and amendment labels from public clinical trials, and $\verb|AMEND_LLM|$, a refined subset curated using an LLM-based denoising pipeline to isolate substantive changes. We further propose $\textit{Change-Aware Masked Language Modeling}$ (CAMLM), a revision-aware pretraining strategy that leverages historical edits to learn amendment-sensitive representations. Experiments across diverse baselines show that CAMLM consistently improves amendment prediction, enabling more robust and cost-effective clinical trial design.

arXiv:2601.07136v1 Announce Type: cross Abstract: The rapid emergence of multi-agent AI systems (MAS), including LangChain, CrewAI, and AutoGen, has shaped how large language model (LLM) applications are developed and orchestrated. However, little is known about how these systems evolve and are maintained in practice. This paper presents the first large-scale empirical study of open-source MAS, analyzing over 42K unique commits and over 4.7K resolved issues across eight leading systems. Our analysis identifies three distinct development profiles: sustained, steady, and burst-driven. These profiles reflect substantial variation in ecosystem maturity. Perfective commits constitute 40.8% of all changes, suggesting that feature enhancement is prioritized over corrective maintenance (27.4%) and adaptive updates (24.3%). Data about issues shows that the most frequent concerns involve bugs (22%), infrastructure (14%), and agent coordination challenges (10%). Issue reporting also increased sharply across all frameworks starting in 2023. Median resolution times range from under one day to about two weeks, with distributions skewed toward fast responses but a minority of issues requiring extended attention. These results highlight both the momentum and the fragility of the current ecosystem, emphasizing the need for improved testing infrastructure, documentation quality, and maintenance practices to ensure long-term reliability and sustainability.

arXiv:2504.14523v2 Announce Type: replace Abstract: Training models on synthetic data has emerged as an increasingly important strategy for improving the performance of generative AI. This approach is particularly helpful for large multimodal models (LMMs) due to the relative scarcity of high-quality paired image-text data compared to language-only data. While a variety of methods have been proposed for generating large multimodal datasets, they do not tailor the synthetic data to address specific deficiencies in the reasoning abilities of LMMs which will be trained with the generated dataset. In contrast, humans often learn in a more efficient manner by seeking out examples related to the types of reasoning where they have failed previously. Inspired by this observation, we propose a new approach for synthetic data generation which is grounded in the analysis of an existing LMM's reasoning failures. Our methodology leverages frontier models to automatically analyze errors produced by a weaker LMM and propose new examples which can be used to correct the reasoning failure via additional training, which are then further filtered to ensure high quality. We generate a large multimodal instruction tuning dataset containing over 553k examples using our approach and conduct extensive experiments demonstrating its utility for improving the performance of LMMs on multiple downstream tasks. Our results show that models trained on our synthetic data can even exceed the performance of LMMs trained on an equivalent amount of additional real data, demonstrating the high value of generating synthetic data targeted to specific reasoning failure modes in LMMs. We will make our dataset and code publicly available.

arXiv:2505.19562v2 Announce Type: replace Abstract: Large language models (LLMs) are approaching expert-level performance in medical question answering (QA), demonstrating strong potential to improve public healthcare. However, underlying biases related to sensitive attributes such as sex and race pose life-critical risks. The extent to which such sensitive attributes affect diagnosis remains an open question and requires comprehensive empirical investigation. Additionally, even the latest Counterfactual Patient Variations (CPV) benchmark can hardly distinguish the bias levels of different LLMs. To further explore these dynamics, we propose a new benchmark, FairMedQA, and benchmark 12 representative LLMs. FairMedQA contains 4,806 counterfactual question pairs constructed from 801 clinical vignettes. Our results reveal substantial accuracy disparity ranging from 3 to 19 percentage points across sensitive demographic groups. Notably, FairMedQA exposes biases that are at least 12 percentage points larger than those identified by the latest CPV benchmark, presenting superior benchmarking sensitivity. Our results underscore an urgent need for targeted debiasing techniques and more rigorous, identity-aware validation protocols before LLMs can be safely integrated into practical clinical decision-support systems.

arXiv:2511.19577v2 Announce Type: replace Abstract: Chronic pain (CP) and opioid use disorder (OUD) are common and interrelated chronic medical conditions. Currently, there is a paucity of evidence-based integrated treatments for CP and OUD among individuals receiving medication for opioid use disorder (MOUD). Wearable devices have the potential to monitor complex patient information and inform treatment development for persons with OUD and CP, including pain variability (e.g., exacerbations of pain or pain spikes) and clinical correlates (e.g., perceived stress). However, the application of large language models (LLMs) with wearable data for understanding pain spikes, remains unexplored. Consequently, the aim of this pilot study was to examine the clinical correlates of pain spikes using a range of AI approaches. We found that machine learning models achieved relatively high accuracy (>0.7) in predicting pain spikes, while LLMs were limited in providing insights on pain spikes. Real-time monitoring through wearable devices, combined with advanced AI models, could facilitate early detection of pain spikes and support personalized interventions that may help mitigate the risk of opioid relapse, improve adherence to MOUD, and enhance the integration of CP and OUD care. Given overall limited LLM performance, these findings highlight the need to develop LLMs which can provide actionable insights in the OUD/CP context.