Emergency Department Revisit Quality Review Screening: Exploring Human Decision-Making and Artificial Intelligence Support

Background: Emergency Department (ED) return visits are commonly reviewed for quality assurance, but are often limited (e.g., to revisits within 48-72 hours) to increase actionable finding yield while minimizing chart review burden. Those limitations may lead to missed quality improvement opportunities. Methods: We conducted an exploratory, retrospective study of randomly selected ED visits to a multihospital health system having an ED revisit within 1-14 days to the same health system. Given only each visit's primary diagnosis, raters (2-3 clinicians and GPT-4 large language model [LLM]) assessed characteristics of the diagnosis pairs, including the "target": whether a pair warranted further assessment. Informed by rater response analyses, an algorithm leveraging an LLM-populated knowledge graph ("KGA") was created to automatically screen for potentially concerning pairs, then preliminarily assessed. Results: 99 diagnosis pairs were included. GPT-4 responses poorly correlated to clinician raters, rating nearly all (94%) pairs as warranting follow-up (4.4-13.3 times more than clinicians). However, prompt engineering was minimal. Among clinician raters, revisit medical gravity was consistently significantly associated with the target, while a differential diagnosis/complication composite was significantly associated on unadjusted, but not adjusted (though less powered) analysis. The KGA achieved 83-100% positive predictive value for at least one clinician rater determining further assessment was warranted based on the diagnosis pair. Conclusion: These results can inform next steps for improving screening with LLMs like ChatGPT. Further research is warranted to validate this preliminary work's finding that the KGA may enable enhancing the scope and yield of screening without substantially increasing reviewer workload.

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arXiv AI Papers·anteontem☆

A Balanced Data Diet: Addressing the Exploration Bottleneck in Mega-Scale RL for Robot Control↗

General-purpose robots must perform a wide range of tasks from agile locomotion to dexterous manipulation. While sim-to-real reinforcement learning (RL) has proven to be a useful tool for this goal, current RL pipelines depend on engineering-heavy, per-task structural priors such as shaped rewards and demonstrations. Recent work has shown that diverse simulator resets, combined with massively parallel simulation, can alleviate much of this engineering burden on several manipulation problems. However, we find that naively scaling this paradigm to more precise or dynamic problems remains non-trivial. While simulator resets can help with exploration, uniformly sampling over this distribution wastes a growing fraction of learning experience on task configurations the policy has already mastered or cannot yet attempt. This makes it challenging to see the expected benefits of scaling parallel environments for RL, since much of the learning signal in a batch is wasted during learning. To mitigate this, we introduce Success Guided Sampling (SGS), a simple adaptive sampler that concentrates RL training on task configurations around the frontier of the policy's capabilities. Doing so allows large-scale simulated RL to make the most out of the experience in a batch, enabling much more effective scaling to large-scale parallel simulation. Across experiments using up to 2^{20} (over one million) parallel environments, SGS enables RL to solve challenging multi-terrain quadruped locomotion and contact-rich assembly tasks that prior methods fail to solve. Finally, we distill the learned manipulation policies into RGB-based policies and demonstrate zero-shot transfer to several challenging assembly tasks on real hardware. Project website: https://sgs-rl.github.io/.

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arXiv AI Papers·anteontem☆

On the estimation and validity of AI time horizons---a statistical look at the METR plot↗

METR's 50\% time horizon measures the human completion time of software tasks that an AI solves with 50\% probability, allowing AI capabilities to be expressed in interpretable units. On 228 tasks and 26 AIs, we recompute the time horizons using splines and item-response theory to relax the assumption that the AI difficulty of a task depends linearly on the log of human time. Our fitted spline can be interpreted as a function that converts human time to AI difficulty; it is nearly flat in a region from 2--30 min but close to linear elsewhere. Hence, a time-horizon jump from 3 min to 30 min is much easier than one from 30 min to 5 hours despite the same multiplier of 10 . Overall, we contribute time-horizon point estimates that perform better under a cross-validated suite of proper scoring rules, as well as diagnostic plots for assessing time horizons' construct validity. We suggest that time horizons be interpreted together with the diagnostic plots, especially as new time-horizon-based benchmarks are proposed or existing ones grow to include longer tasks.

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CSF: Contextual Safety Filtering for Motion Generators↗

Text-conditioned motion generators produce trackable whole-body motion, but they have no notion of scene-dependent safety: the same action may target an object or a person. Existing safeguards either inspect the prompt, require labeled motion data, or enforce geometric constraints; therefore, they do not directly account for how scene context changes a motion's meaning. We introduce contextual safety filtering (CSF), a training-free filter that grounds natural-language safety rules in safe and unsafe reference trajectories produced by the generator. For each active rule, safe and unsafe reference trajectories define an affine safety value that a safe reference tracking CBF-QP enforces. Across four pretrained generators with different architectures, CSF activates the intended rules in all explicit and scene-triggered unsafe cases and reduces the danger-event rate by up to 90%, while preserving 88-100% of benign motions. We demonstrate the complete system on a real-world Unitree G1, where it successfully prevents unsafe motions in a variety of scenarios, including interactions with humans and objects.

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arXiv AI Papers·anteontem☆

From Reactive Containment to Proactive Assurance: Lessons from OpenAI, Anthropic, and Google Agent Security Incidents↗

In 2026, cybersecurity evaluations involving OpenAI, Anthropic, and Google agents reached real systems outside their authorized test scope. The paths were different. OpenAI agents exploited research infrastructure, coordinated across runs, and compromised parts of Hugging Face's production environment. Anthropic reported cases in which a misconfigured third-party environment exposed real systems to agents pursuing simulated cyber tasks. In a separately reported evaluation, Google's Gemini accessed three real organizations through an unintended internet route; Google stated that the model stopped in all three instances. Taken together, the cases show why an evaluation cannot rely on an assumed boundary. That boundary must be verified while the agent is operating. This comparative instrumental case study develops a Proactive Agent Security Assurance Cycle (PASAC) and a five-layer Boundary Assurance Stack. The framework combines risk-tiered task design, executable scope contracts, pre-run validation, least-capability access, independent egress enforcement, credential restrictions, cross-run monitoring, automatic stop conditions, and evidence-based reauthorization. A leading-indicator model, nine design propositions, and seven falsifiable hypotheses turn these lessons into a testable research program. Because the public Gemini record is limited to attributed statements and journalism, its detailed causal mechanism remains provisional. The central conclusion is straightforward: proactive agent security requires continuous assurance across the full execution system, not confidence in any single sandbox or safeguard.

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