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Effect of the Maxing Huoqiao granule on nonsevere community-acquired pneumonia: A multicenter, double-blind, placebo-controlled randomized trial

βœ‡(Multiomics OR Omics) AND (Lung OR gastric OR Hepatocellular)
By: Qingming Ke Β· Caiping Zhao Β· Shengda Luo Β· Yuntao Liu Β· Ye Ye Β· Xingdong Lin Β· Jing Zeng Β· Xinghua Liu Β· Yang Liao Β· Hongtao Li Β· Shu Chen Β· Hong Ren Β· Liang Liu Β· Hudan Pan

Pharmacol Res. 2026 Apr 9:108186. doi: 10.1016/j.phrs.2026.108186. Online ahead of print.

ABSTRACT

Community-acquired pneumonia (CAP) remains a major global public health challenge with substantial morbidity and mortality. Although preclinical studies suggest that Maxing Huoqiao (MXHQ) granule may have therapeutic potential for pneumonia, high-quality clinical evidence is still limited. We conducted a multicenter, double-blind, randomized, placebo-controlled trial at two tertiary hospitals in China to evaluate the clinical efficacy of MXHQ as adjunctive therapy and to explore its potential mechanisms in adults with nonsevere CAP receiving standard moxifloxacin treatment. A total of 96 patients were enrolled and randomized (1:1:1) to receive standard-dose MXHQ, low-dose MXHQ, or placebo in addition to moxifloxacin for 7 days, with a 14-day follow-up. The primary endpoint was clinical cure, defined as composite recovery of major respiratory symptoms, lung rales, and fever; secondary endpoints included symptom relief, radiographic improvement, and safety. Compared with placebo, standard-dose MXHQ was associated with a higher day-14 clinical cure rate (30.78% vs. 68.97%; RR = 0.45, 95% CI = 0.24-0.83; P < 0.01). Furthermore, the standard-dose intervention was correlated with a shorter time to relief and recovery of cough and sputum (P < 0.05), as well as improvements in symptom scores (P < 0.05) and promoting lesion absorption on chest CT (P < 0.05). Low-dose MXHQ showed no significant clinical benefit, whereas safety profiles were comparable across all groups. Transcriptomic analyses of peripheral blood mononuclear cells, complemented by a Streptococcus pneumonia animal model, indicated that the clinical benefits of MXHQ are linked to the modulation of inflammation and innate immunity. These omics and in vivo observations suggest a potential mechanism underlying the protective effects of MXHQ against inflammatory injury and promotion of tissue repair, involving the regulation of anti-inflammatory mediators and tissue repair-related factors. (Chictr.org.cn, ID Number: ChiCTR2400082095).

PMID:41966499 | DOI:10.1016/j.phrs.2026.108186

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Talk to Right Specialists: Iterative Routing in Multi-agent Systems for Question Answering

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Feijie Wu Β· Zitao Li Β· Fei Wei Β· Yaliang Li Β· Bolin Ding Β· Jing Gao
arXiv:2501.07813v2 Announce Type: replace-cross Abstract: Retrieval-augmented generation (RAG) agents are increasingly deployed to answer questions over local knowledge bases that cannot be centralized due to knowledge-sovereignty constraints. This results in two recurring failures in production: users do not know which agent to consult, and complex questions require evidence distributed across multiple agents. To overcome these challenges, we propose RIRS, a training-free orchestration framework to enable a multi-agent system for question answering. In detail, RIRS summarizes each agent's local corpus in an embedding space, enabling a user-facing server to route queries only to the most relevant agents, reducing latency and avoiding noisy "broadcast-to-all" contexts. For complicated questions, the server can iteratively aggregate responses to derive intermediate results and refine the question to bridge the gap toward a comprehensive answer. Extensive experiments demonstrate the effectiveness of RIRS, including its ability to precisely select agents and provide accurate responses to single-hop queries, and its use of an iterative strategy to achieve accurate, multi-step resolutions for complex queries.
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From Multi-Agent to Single-Agent: When Is Skill Distillation Beneficial?

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Binyan Xu Β· Dong Fang Β· Haitao Li Β· Kehuan Zhang
arXiv:2604.01608v1 Announce Type: new Abstract: Multi-agent systems (MAS) tackle complex tasks by distributing expertise, though this often comes at the cost of heavy coordination overhead, context fragmentation, and brittle phase ordering. Distilling a MAS into a single-agent skill can bypass these costs, but this conversion lacks a principled answer for when and what to distill. Instead, the empirical outcome is surprisingly inconsistent: skill lift ranges from a 28% improvement to a 2% degradation across metrics of the exact same task. In this work, we reveal that skill utility is governed not by the task, but by the evaluation metric. We introduce Metric Freedom ($F$), the first a priori predictor of skill utility. $F$ measures the topological rigidity of a metric's scoring landscape by quantifying how output diversity couples with score variance via a Mantel test. Guided by $F$, we propose a two-stage adaptive distillation framework. Stage 1 acts as a selective extraction mechanism, extracting tools and knowledge while discarding restrictive structures on "free" metrics to preserve exploration. Stage 2 targets computationally intensive iterative refinement exclusively toward "rigid" metrics ($F \lesssim 0.6$) to eliminate trajectory-local overfitting. Evaluating across 4 tasks, 11 datasets, and 6 metrics, $F$ strongly predicts skill utility ($\rho = -0.62$, $p
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SleepVLM: Explainable and Rule-Grounded Sleep Staging via a Vision-Language Model

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Guifeng Deng Β· Pan Wang Β· Jiquan Wang Β· Shuying Rao Β· Junyi Xie Β· Wanjun Guo Β· Tao Li Β· Haiteng Jiang
arXiv:2603.26738v2 Announce Type: replace-cross Abstract: While automated sleep staging has achieved expert-level accuracy, its clinical adoption is hindered by a lack of auditable reasoning. We introduce SleepVLM, a rule-grounded vision-language model (VLM) designed to stage sleep from multi-channel polysomnography (PSG) waveform images while generating clinician-readable rationales based on American Academy of Sleep Medicine (AASM) scoring criteria. Utilizing waveform-perceptual pre-training and rule-grounded supervised fine-tuning, SleepVLM achieved Cohen's kappa scores of 0.767 on an held out test set (MASS-SS1) and 0.743 on an external cohort (ZUAMHCS), matching state-of-the-art performance. Expert evaluations further validated the quality of the model's reasoning, with mean scores exceeding 4.0/5.0 for factual accuracy, evidence comprehensiveness, and logical coherence. By coupling competitive performance with transparent, rule-based explanations, SleepVLM may improve the trustworthiness and auditability of automated sleep staging in clinical workflows. To facilitate further research in interpretable sleep medicine, we release MASS-EX, a novel expert-annotated dataset.
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Ran Score: a LLM-based Evaluation Score for Radiology Report Generation

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Ran Zhang Β· Yucong Lin Β· Zhaoli Su Β· Bowen Liu Β· Danni Ai Β· Tianyu Fu Β· Deqiang Xiao Β· Jingfan Fan Β· Yuanyuan Wang Β· Mingwei Gao Β· Yuwan Hu Β· Shuya Gao Β· Jingtao Li Β· Jian Yang Β· Hong Song Β· Hongliang Sun
arXiv:2603.22935v1 Announce Type: new Abstract: Chest X-ray report generation and automated evaluation are limited by poor recognition of low-prevalence abnormalities and inadequate handling of clinically important language, including negation and ambiguity. We develop a clinician-guided framework combining human expertise and large language models for multi-label finding extraction from free-text chest X-ray reports and use it to define Ran Score, a finding-level metric for report evaluation. Using three non-overlapping MIMIC-CXR-EN cohorts from a public chest X-ray dataset and an independent ChestX-CN validation cohort, we optimize prompts, establish radiologist-derived reference labels and evaluate report generation models. The optimized framework improves the macro-averaged score from 0.753 to 0.956 on the MIMIC-CXR-EN development cohort, exceeds the CheXbert benchmark by 15.7 percentage points on directly comparable labels, and shows robust generalization on the ChestX-CN validation cohort. Here we show that clinician-guided prompt optimization improves agreement with a radiologist-derived reference standard and that Ran Score enables finding-level evaluation of report fidelity, particularly for low-prevalence abnormalities.
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PaLMR: Towards Faithful Visual Reasoning via Multimodal Process Alignment

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Yantao Li Β· Qiang Hui Β· Chenyang Yan Β· Kanzhi Cheng Β· Fang Zhao Β· Chao Tan Β· Huanling Gao Β· Jianbing Zhang Β· Kai Wang Β· Xinyu Dai Β· Shiguo Lian
arXiv:2603.06652v1 Announce Type: cross Abstract: Reinforcement learning has recently improved the reasoning ability of Large Language Models and Multimodal LLMs, yet prevailing reward designs emphasise final-answer correctness and consequently tolerate process hallucinations--cases where models reach the right answer while misperceiving visual evidence. We address this process-level misalignment with PaLMR, a framework that aligns not only outcomes but also the reasoning process itself. PaLMR comprises two complementary components: a perception-aligned data layer that constructs process-aware reasoning data with structured pseudo-ground-truths and verifiable visual facts, and a process-aligned optimisation layer that constructs a hierarchical reward fusion scheme with a process-aware scoring function to encourage visually faithful chains-of-thought and improve training stability. Experiments on Qwen2.5-VL-7B show that our approach substantially reduces reasoning hallucinations and improves visual reasoning fidelity, achieving state-of-the-art results on HallusionBench while maintaining strong performance on MMMU, MathVista, and MathVerse. These findings indicate that PaLMR offers a principled and practical route to process-aligned multimodal reasoning, advancing the reliability and interpretability of MLLMs.
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Not All Candidates are Created Equal: A Heterogeneity-Aware Approach to Pre-ranking in Recommender Systems

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Pengfei Tong Β· Siyuan Chen Β· Chenwei Zhang Β· Bo Wang Β· Qi Pi Β· Pixun Li Β· Zuotao Liu
arXiv:2603.03770v1 Announce Type: cross Abstract: Most large-scale recommender systems follow a multi-stage cascade of retrieval, pre-ranking, ranking, and re-ranking. A key challenge at the pre-ranking stage arises from the heterogeneity of training instances sampled from coarse-grained retrieval results, fine-grained ranking signals, and exposure feedback. Our analysis reveals that prevailing pre-ranking methods, which indiscriminately mix heterogeneous samples, suffer from gradient conflicts: hard samples dominate training while easy ones remain underutilized, leading to suboptimal performance. We further show that the common practice of uniformly scaling model complexity across all samples is inefficient, as it overspends computation on easy cases and slows training without proportional gains. To address these limitations, this paper presents Heterogeneity-Aware Adaptive Pre-ranking (HAP), a unified framework that mitigates gradient conflicts through conflict-sensitive sampling coupled with tailored loss design, while adaptively allocating computational budgets across candidates. Specifically, HAP disentangles easy and hard samples, directing each subset along dedicated optimization paths. Building on this separation, it first applies lightweight models to all candidates for efficient coverage, and further engages stronger models on the hard ones, maintaining accuracy while reducing cost. This approach not only improves pre-ranking effectiveness but also provides a practical perspective on scaling strategies in industrial recommender systems. HAP has been deployed in the Toutiao production system for 9 months, yielding up to 0.4% improvement in user app usage duration and 0.05% in active days, without additional computational cost. We also release a large-scale industrial hybrid-sample dataset to enable the systematic study of source-driven candidate heterogeneity in pre-ranking.
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DisenReason: Behavior Disentanglement and Latent Reasoning for Shared-Account Sequential Recommendation

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Jiawei Cheng Β· Min Gao Β· Zongwei Wang Β· Xiaofei Zhu Β· Zhiyi Liu Β· Wentao Li Β· Wei Li Β· Huan Wu
arXiv:2603.03782v1 Announce Type: cross Abstract: Shared-account usage is common on streaming and e-commerce platforms, where multiple users share one account. Existing shared-account sequential recommendation (SSR) methods often assume a fixed number of latent users per account, limiting their ability to adapt to diverse sharing patterns and reducing recommendation accuracy. Recent latent reasoning technique applied in sequential recommendation (SR) generate intermediate embeddings from the user embedding (e.g, last item embedding) to uncover users' potential interests, which inspires us to treat the problem of inferring the number of latent users as generating a series of intermediate embeddings, shifting from inferring preferences behind user to inferring the users behind account. However, the last item cannot be directly used for reasoning in SSR, as it can only represent the behavior of the most recent latent user, rather than the collective behavior of the entire account. To address this, we propose DisenReason, a two-stage reasoning method tailored to SSR. DisenReason combines behavior disentanglement stage from frequency-domain perspective to create a collective and unified account behavior representation, which serves as a pivot for latent user reasoning stage to infer the number of users behind the account. Experiments on four benchmark datasets show that DisenReason consistently outperforms all state-of-the-art baselines across four benchmark datasets, achieving relative improvements of up to 12.56\% in MRR@5 and 6.06\% in Recall@20.
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EDU-MATRIX: A Society-Centric Generative Cognitive Digital Twin Architecture for Secondary Education

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Wenjing Zhai Β· Jianbin Zhang Β· Tao Liu
arXiv:2602.18705v1 Announce Type: cross Abstract: Existing multi-agent simulations often suffer from the "Agent-Centric Paradox": rules are hard-coded into individual agents, making complex social dynamics rigid and difficult to align with educational values. This paper presents EDU-MATRIX, a society-centric generative cognitive digital twin architecture that shifts the paradigm from simulating "people" to simulating a "social space with a gravitational field." We introduce three architectural contributions: (1) An Environment Context Injection Engine (ECIE), which acts as a "social microkernel," dynamically injecting institutional rules (Gravity) into agents based on their spatial-temporal coordinates; (2) A Modular Logic Evolution Protocol (MLEP), where knowledge exists as "fluid" capsules that agents synthesize to generate new paradigms, ensuring high dialogue consistency (94.1%); and (3) Endogenous Alignment via Role-Topology, where safety constraints emerge from the agent's position in the social graph rather than external filters. Deployed as a digital twin of a secondary school with 2,400 agents, the system demonstrates how "social gravity" (rules) and "cognitive fluids" (knowledge) interact to produce emergent, value-aligned behaviors (Social Clustering Coefficient: 0.72).
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MolReasoner: Toward Effective and Interpretable Reasoning for Molecular LLMs

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Guojiang Zhao Β· Zixiang Lu Β· Yutang Ge Β· Sihang Li Β· Zheng Cheng Β· Haitao Lin Β· Lirong Wu Β· Hanchen Xia Β· Hengxing Cai Β· Wentao Guo Β· Hongshuai Wang Β· Mingjun Xu Β· Siyu Zhu Β· Guolin Ke Β· Linfeng Zhang Β· Zhifeng Gao
arXiv:2508.02066v2 Announce Type: replace-cross Abstract: Large Language Models (LLMs) have shown impressive performance across various domains, but their ability to perform molecular reasoning remains underexplored. Existing methods mostly rely on general-purpose prompting, which lacks domain-specific molecular semantics, or fine-tuning, which faces challenges in interpretability and reasoning depth, often leading to structural and textual hallucinations. To address these issues, we introduce MolReasoner, a two-stage framework that transitions LLMs from memorization to high-fidelity chemical reasoning. In the Mol-SFT stage, knowledge-enhanced Chain-of-Thought (CoT) data provides a strong foundation, while the Mol-RL stage refines reasoning using a novel, task-adaptive reward system to mitigate hallucinations. Extensive evaluations demonstrate that MolReasoner significantly outperforms a wide range of strong baselines in both molecule generation and captioning tasks. Further analyses highlight the framework's synergistic design and its ability to produce more interpretable outputs. Our work presents a principled and effective new approach for advancing high-fidelity molecular reasoning.
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Anonymization-Enhanced Privacy Protection for Mobile GUI Agents: Available but Invisible

βœ‡cs.AI, q-bio.NC updates on arXiv.org
By: Lepeng Zhao Β· Zhenhua Zou Β· Shuo Li Β· Zhuotao Liu
arXiv:2602.10139v2 Announce Type: replace-cross Abstract: Mobile Graphical User Interface (GUI) agents have demonstrated strong capabilities in automating complex smartphone tasks by leveraging multimodal large language models (MLLMs) and system-level control interfaces. However, this paradigm introduces significant privacy risks, as agents typically capture and process entire screen contents, thereby exposing sensitive personal data such as phone numbers, addresses, messages, and financial information. Existing defenses either reduce UI exposure, obfuscate only task-irrelevant content, or rely on user authorization, but none can protect task-critical sensitive information while preserving seamless agent usability. We propose an anonymization-based privacy protection framework that enforces the principle of available-but-invisible access to sensitive data: sensitive information remains usable for task execution but is never directly visible to the cloud-based agent. Our system detects sensitive UI content using a PII-aware recognition model and replaces it with deterministic, type-preserving placeholders (e.g., PHONE_NUMBER#a1b2c) that retain semantic categories while removing identifying details. A layered architecture comprising a PII Detector, UI Transformer, Secure Interaction Proxy, and Privacy Gatekeeper ensures consistent anonymization across user instructions, XML hierarchies, and screenshots, mediates all agent actions over anonymized interfaces, and supports narrowly scoped local computations when reasoning over raw values is necessary. Extensive experiments on the AndroidLab and PrivScreen benchmarks show that our framework substantially reduces privacy leakage across multiple models while incurring only modest utility degradation, achieving the best observed privacy-utility trade-off among existing methods. Code available at: https://github.com/one-step-beh1nd/gui_privacy_protection
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