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01.
arXiv (CS.CV) 2026-06-12

SeamEdit: A Black-Box VLM-Agnostic Pipeline for Large-Image Semantic Editing

Authors:
Xiangyu Lyu↗Dan Lei↗

Semantic region editing for large images must satisfy two requirements at the same time: high generative quality and natural integration with surrounding content. Some related methods rely on white-box models and leave the strong generation capability of closed-source models underexplored. Directly applying closed-source models to tiled editing, however, introduces several failure modes: semantic deformation, canvas-level alignment drift, and visible seam artifacts. This paper presents SeamEdit, a training-free and model-agnostic pipeline that treats any VLM with inpainting capability as a black-box oracle. SeamEdit mitigates these issues through a five-stage post-hoc pipeline: overlay-based tile decomposition, black-box VLM inpainting, geometric and color-consistency correction, seam-risk-based multi-candidate ranking, and dynamic-programming curved seam fusion. The pipeline reduces seam visibility and supports semantic modification of arbitrary tile regions.

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02.
arXiv (CS.CL) 2026-06-15

Is ChatGPT Fair for Recommendation? Evaluating Fairness in Large Language Model Recommendation

Authors:
Jizhi Zhang↗Keqin Bao↗Yang Zhang↗Wenjie Wang↗Fuli Feng↗Xiangnan He↗

The remarkable achievements of Large Language Models (LLMs) have led to the emergence of a novel recommendation paradigm – Recommendation via LLM (RecLLM). Nevertheless, it is important to note that LLMs may contain social prejudices, and therefore, the fairness of recommendations made by RecLLM requires further investigation. To avoid the potential risks of RecLLM, it is imperative to evaluate the fairness of RecLLM with respect to various sensitive attributes on the user side. Due to the differences between the RecLLM paradigm and the traditional recommendation paradigm, it is problematic to directly use the fairness benchmark of traditional recommendation. To address the dilemma, we propose a novel benchmark called Fairness of Recommendation via LLM (FaiRLLM). This benchmark comprises carefully crafted metrics and a dataset that accounts for eight sensitive attributes1 in two recommendation scenarios: music and movies. By utilizing our FaiRLLM benchmark, we conducted an evaluation of ChatGPT and discovered that it still exhibits unfairness to some sensitive attributes when generating recommendations. Our code and dataset can be found at https://github.com/jizhi-zhang/FaiRLLM.

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04.
arXiv (CS.LG) 2026-06-18

Artemis: Anatomy-Resolved inTervention for Eliminating Multimodal NeuroImage confounderS

Authors:
Siyuan Dai↗Yang Du↗Kun Zhao↗Zhusuyi Chen↗Heng Huang↗Paul Thompson↗Chao Shi↗Haoteng Tang↗Liang Zhan↗

arXiv:2606.18287v1 Announce Type: new Abstract: Multimodal neuroimaging, integrating functional connectivity from fMRI and structural connectivity from DTI, enables non-invasive analysis of brain networks using graph neural networks. However, demographic factors such as age and sex systematically confound the relationship between brain connectivity and clinical outcomes, causing GNNs to exploit spurious shortcuts rather than learning causally invariant representations. While recent causal GNN methods introduce causality at the graph-modeling level, their causal mechanisms remain domain-agnostic without accounting for the real-world confounders inherent in clinical neuroimaging data. Moreover, brain networks are constructed from atlas-based parcellations where each region exhibits distinct sensitivity to demographic factors, necessitating region-aware adjustment. We propose Artemis, a region-level causal framework that bridges this gap with causal intervention at each brain region independently by learning region-specific confounder representations with lightweight parameters. Our adjustment comprehensively utilized the multimodal functional and structural features for graph reasoning as a plug-in module compatible with arbitrary GNN backbones. Experiments on three benchmarks, ADNI for disease diagnosis, OASIS for dementia staging, and HCP for sex classification, demonstrate consistent improvements over representative GNN-based baselines. Multiple supporting experiments further demonstrate statistical significance and neuroscientific interpretability.

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05.
arXiv (CS.LG) 2026-06-17

NoiseTilt: Noise-Tilted Reverse Kernels for Diffusion Reward Alignment

Authors:
Jisung Hwang↗Yunhong Min↗Jaihoon Kim↗I-Chao Shen↗Minhyuk Sung↗

arXiv:2606.18066v1 Announce Type: new Abstract: We introduce the Noise-Tilted Reverse Kernel (NTRK), a reward-guided diffusion sampler that injects reward gradients through the noise term, leaving the pretrained reverse kernel unchanged and requiring only a single sample per step. Reward-guided sampling at inference time has greatly expanded the versatility of pretrained diffusion models. Yet existing methods face a trade-off. Gradient-based guidance shifts the reverse mean, steering generation but pushing intermediate states outside the region that the model was trained on and degrading quality. Search-based methods preserve quality but gain no gradient signal. No prior method achieves both. NTRK resolves this by keeping the reverse mean fixed and biasing the noise term toward high reward. We introduce a whitening operator, the central mechanism behind NTRK, that makes the reward gradient safe to inject as noise without losing its guiding signal. Across various reward alignment tasks, NTRK outperforms recent state-of-the-art baselines without losing sample quality. Remarkably, on aesthetic generation, NTRK surpasses the reward of the best baseline at 500 NFEs using only 25 NFEs, a 20$\times$ reduction in compute.

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06.
arXiv (CS.CV) 2026-06-11

Towards Conditional Feature Alignment for Cross-Domain Counting

Authors:
Zhuonan Liang↗Dongnan Liu↗Jianan Fan↗Yaxuan Song↗Qiang Qu↗Runnan Chen↗Yu Yao↗Peng Fu↗Weidong Cai↗

Object counting models often degrade under cross-domain deployment because density composition varies across domains and is itself task-relevant. Standard feature alignment methods tend to suppress such variation by encouraging global domain invariance, which can be harmful when source and target domains contain different proportions of background, sparse foreground, and dense foreground. We propose Conditional Feature Alignment (CFA), a cross-domain counting framework that aligns representations within label-induced conditions rather than across full marginal feature distributions. Given density annotations or pseudo-density predictions, CFA constructs foreground/background or density-level conditions and aligns only features belonging to matching conditions. We formalise this idea through a conditional divergence perspective, showing that conditional alignment removes within-condition discrepancy while preserving condition-marginal density shift. For unsupervised domain adaptation, CFA estimates source conditions from annotations and target conditions from detached pseudo-density maps, then performs condition-wise adversarial alignment with full-image consistency regularisation. For source-domain generalisation, we instantiate the same principle with MPCount by enforcing condition-wise memory-consistency between generated source-domain views. Experiments on crowd and cell counting benchmarks show competitive or improved performance across diverse UDA and DG settings. For example, on JHU-CROWD++ FH$\rightarrow$SN, CFA-DG reduces MAE/RMSE from MPCount's 216.3/421.4 to 90.5/169.9, indicating that condition-wise alignment is especially effective under large weather- and density-induced shifts. These results suggest that condition-wise alignment is a promising design principle for domain-adaptive counting.

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07.
arXiv (quant-ph) 2026-06-15

Multi-entropy in random tensor networks

Authors:
Miao Hu↗Simon Lin↗Ion Nechita↗

arXiv:2606.04470v2 Announce Type: replace-cross Abstract: We study the evaluation of Rényi multi-entropies $S^{(q)}_n$ in Random Tensor Network (RTN) states in the large bond-dimension limit. For the case of Rényi index $n=2$ and arbitrary number of parties $q$, we prove that that multi-entropies are determined by minimal multiway cuts through the network. When the minimal multiway cut is degenerate, we characterize the full minimizer set via compatible families of minimal cuts and give a criterion for all minimizers to come from ordinary cut partitions. For $n=2$, this gives a natural generalization of the minimal cut description of bipartite entanglement to multipartite systems with arbitrarily many parties. For the case of integer $n>2$, we show that the minimal multiway cut conjecture is in general not true by providing explicit counter examples for both the single random tensor and for the network built from isometric tilings. We discuss the implication for our results on the multipartite entanglement structures in RTN and holography.

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08.
arXiv (CS.AI) 2026-06-17

Talking to Your Data: Exploring Embodied Conversation as an Interface for Personal Health Reflection

Authors:
Nikola Kovacevic↗Bastien Husler↗Di Zhuang↗Rafael Wampfler↗Barbara Solenthaler↗

arXiv:2606.17767v1 Announce Type: cross Abstract: Personal health data from wearables are typically presented through dashboards of charts and summary statistics, requiring users to actively interpret patterns and implications. We explore an alternative interaction paradigm: engaging with personal health data through an embodied conversational agent that facilitates objective data reflection in dialogue with the user. We present a system that combines lightweight preprocessing of wearable data with a Unity-based embodied character. Internally, the system follows a dual-agent design in which an Observer agent extracts descriptive statistics and temporal trends, and a Presenter agent communicates these findings through "spoken statistics," intentionally refraining from clinical advice to isolate the impact of the interaction modality. We evaluate this approach through a simulated-self user study (N=5) using a within-subject design. Participants adopted health personas and goals derived from the LifeSnaps dataset to compare traditional dashboard exploration with embodied conversational reflection. Our evaluation focuses on perceived understanding, the specificity of generated actions, and the cognitive shift from passive viewing to active sensemaking. The paper contributes a functional prototype, a design pattern for objective health data narrative generation, and early empirical insights into how embodiment affects the interpretation of personal health metrics.

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09.
arXiv (CS.CV) 2026-06-11

Latent Geometric Chords for Query-Efficient Decision-Based Adversarial Attacks

Authors:
Ei Hmue Khine↗Yao Li↗Jiebao Sun↗Shengzhu Shi↗Zhichang Guo↗Boying Wu↗

While decision-based black-box adversarial attacks present a severe security threat, current methodologies suffer from fundamental limitations. Pixel-wise attacks frequently introduce unnatural, high-frequency visual artifacts, while latent-space frameworks are confined by the limited search space of low-dimensional manifolds and inherent reconstruction flaws. To resolve these limitations, we propose Latent Geometric Chords (LGC) for Query-Efficient Decision-Based Adversarial Attacks alongside a variant, LGC-H. At its core, LGC navigates decision boundaries by executing a curvature-aware geometric search within a compressed semantic manifold. To guarantee high visual fidelity and circumvent dimensionality bottlenecks, we introduce a Residual-based Adversarial Generation (RAG) mechanism. RAG isolates semantic perturbations as geometric chords and superimposes them directly onto the original source image. RAG substantially resolves baseline reconstruction flaws and effectively doubles the permissible search space dimensions. Experimental results demonstrate that LGC achieves robust cross-dataset transferability and substantially outperforms state-of-the-art baselines. Notably, our method, LGC, minimizes perturbation magnitudes while achieving state-of-the-art visual fidelity–with a Structural Similarity Index Measure (SSIM) exceeding 0.99 and a Learned Perceptual Image Patch Similarity (LPIPS) below 0.01 at 5000 queries–and sustaining high attack success rates under stringent perceptual constraints, successfully compromising adversarially trained robust models. The source code is available at: https://github.com/eihmuekhine/Latent-Geometric-Chords.

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10.
arXiv (quant-ph) 2026-06-12

Beyond the Unruh vacuum: multi-time correlations in black hole collapse and evaporation

Authors:
Konstantinos Xenos↗Charis Anastopoulos↗Andreas F. Terzis↗

arXiv:2606.13383v1 Announce Type: new Abstract: The black hole information paradox originates from the thermal character of Hawking radiation, which appears to erase information about the collapsing matter. However, thermality constrains only observables defined at a single time and leaves the structure of temporal quantum correlations largely unexplored. Here we show that multi-time quantum-field correlations provide a concrete mechanism for the survival of pre-collapse information in black hole evaporation. Using a two-dimensional model of gravitational collapse and evaporation, we demonstrate that late-time multi-time correlations are not fully reproduced by the Unruh vacuum. In particular, they contain a contribution that depends explicitly on parameters characterizing the pre-collapse state, despite the thermal character of the asymptotic radiation. Our results identify measurable multi-time correlations as carriers of information in Hawking radiation and suggest that formulations of the black hole information paradox based solely on single-time observables are incomplete.

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11.
Nature Medicine 2026-06-22

Biological aging and generational shifts in early-onset cancer risk

Authors:
Ruiyi Tian↗

Incidence of early-onset cancer is rising globally in recent generations, which underscores the need to elucidate the influence of emerging generational risk factors. Systemic and organ-specific aging reflects the cumulative impact of exposures and may provide an integrative and complementary approach to understand early-onset cancer risk. Here among 154,169 young adults from the United Kingdom Biobank, systemic aging measured by PhenoAge increased across birth cohorts, with 23% s.d. increase for those born 1965–1974 versus 1950–1954, and was associated with early-onset solid cancer risk (hazard ratio (HR)per s.d. 1.08; 95% confidence interval (CI), 1.03–1.13), driven by lung, gastrointestinal and uterine cancers, independent of genetic risks of aging and cancer. Patterns were consistent using alternative systemic aging measures, including the Klemera–Doubal method-defined age gap and metabolomic-based age gap. These findings were validated partially among 10,262 participants in the United States All of Us Research Program. Proteomics-based organ-specific aging analyses linked immune aging with early-onset lung cancer (HRper s.d. 1.89; CI, 1.20–2.97) and adipose tissue aging to early-onset colorectal cancer (HR 1.60; CI, 1.11–2.32). Greater age gap, reflecting more advanced biological aging relative to chronological age, may serve as a driver associated with risk of early-onset solid cancers, highlighting the importance of uncovering underlying mechanisms to guide effective prevention strategies. Analyses of population cohorts found that young adults exhibited earlier systemic and organ-specific aging, which was associated with increased risk of early-onset cancer compared with older adults born decades earlier.

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12.
arXiv (CS.LG) 2026-06-15

SemPiper: Interactive Code Synthesis for Semantic Operators in Machine Learning Pipelines

Authors:
Olga Ovcharenko↗Luciano Duarte↗Sebastian Schelter↗

arXiv:2606.14361v1 Announce Type: new Abstract: Machine learning (ML) pipelines require extensive data preparation, feature engineering, and integration across heterogeneous sources, making them tedious and error-prone to develop. While large language models (LLMs) have recently shown promise for assisting programming tasks, chat-based interfaces provide limited control over pipeline behavior and often produce code that is difficult to optimize or integrate into production systems. We demonstrate SemPipes, a novel programming model that extends ML pipelines with declarative, LLM-powered semantic data operators. SemPipes allows developers to specify high-level natural language instructions for data-centric operations, while seamlessly combining these operators with arbitrary Python code from standard data science libraries. For the semantic operators, it synthesizes specialized implementations at pipeline training time, conditioned on dataset characteristics and pipeline context, enabling the flexible yet controlled integration of LLM capabilities. We demonstrate SemPipes through SemPiper, an interactive interface that visualizes computational graphs of the pipelines, synthesized operator implementations, and optimization trajectories produced by an evolutionary search procedure. Attendees can explore three end-to-end scenarios, modify pipelines, inspect generated code, and observe how semantic operators are synthesized and iteratively optimized. The demonstration highlights how declarative semantic operators enable controllable, optimizable, and practical integration of LLMs into ML pipeline development.

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13.
arXiv (CS.CV) 2026-06-12

HairPort: In-context 3D-aware Hair Import and Transfer for Images

Authors:
Alireza Heidari↗Amirhossein Alimohammadi↗Wallace Michel Pinto Lira↗Adi Bar-Lev↗Ali Mahdavi-Amiri↗

Transferring hairstyles between images is an important but challenging task in computer graphics, computer vision, and visual effects. It enables users to explore new looks without physically altering their hair, with applications in virtual try-on systems, augmented reality, and entertainment. Most prior works operate best under small pose gaps, and they fall short under large viewpoint and scale differences, where missing hair content must be synthesized rather than transferred. We propose HairPort, a 3D-aware hairstyle transfer framework that attempts to solve these issues by explicitly separating hair removal from transfer and enforcing geometric consistency before synthesis. We introduce a Bald Converter, which produces realistic bald versions of faces through LoRA-based in-context adaptation of FLUX.1 Kontext. To train our Bald Converter, we introduce a new dataset, Baldy, containing 6,000 paired bald and original images across diverse identities and conditions. We also use a 3D-Aware Transfer Pipeline that reconstructs and re-renders the reference hairstyle from the target viewpoint before compositing it onto the source image. Being 3D aware, our method supports large pose and scale discrepancies between the source and target. Finally, a conditional flow-matching generator synthesizes the transferred result from the bald source and geometry-aligned reference guidance. Together, our method enables accurate, pose-consistent, and identity-preserving hairstyle transfer, outperforming existing methods both qualitatively and quantitatively.

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14.
arXiv (CS.CV) 2026-06-19

DiT-JSCC: Rethinking Deep JSCC with Diffusion Transformers and Semantic Representations

Authors:
Kailin Tan↗Jincheng Dai↗Sixian Wang↗Guo Lu↗Shuo Shao↗Kai Niu↗Wenjun Zhang↗Ping Zhang↗

Generative joint source-channel coding (GJSCC) has emerged as a new Deep JSCC paradigm for achieving high-fidelity and robust image transmission under extreme wireless channel conditions, such as ultra-low bandwidth and low signal-to-noise ratio. Recent studies commonly adopt diffusion models as generative decoders, but they frequently produce visually realistic results with limited semantic consistency. This limitation stems from a fundamental mismatch between reconstruction-oriented JSCC encoders and generative decoders, as the former lack explicit semantic discriminability and fail to provide reliable conditional cues. In this paper, we propose DiT-JSCC, a novel GJSCC backbone that can jointly learn a semantics-prioritized representation encoder and a diffusion transformer (DiT) based generative decoder, our open-source project aims to promote the future research in GJSCC. Specifically, we design a semantics-detail dual-branch encoder that aligns naturally with a coarse-to-fine conditional DiT decoder, prioritizing semantic consistency under extreme channel conditions. Moreover, a training-free adaptive bandwidth allocation strategy inspired by Kolmogorov complexity is introduced to further improve the transmission efficiency, thereby indeed redefining the notion of information value in the era of generative decoding. Extensive experiments demonstrate that DiT-JSCC consistently outperforms existing JSCC methods in both semantic consistency and visual quality, particularly in extreme regimes.

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

On Local Population-Risk Certificates

Authors:
Mingzhi Song↗

arXiv:2606.19147v1 Announce Type: cross Abstract: This paper develops local certificates for population-risk increments around a current model. For a local candidate set \(\mathcal D\), the certificate is a two-sided confidence band for \(P({\ell_{\theta+v}-\ell_\theta})\) over \(v\in\mathcal D\). As an application, the upper endpoint of this band yields a risk-controlled update rule: an update is accepted only when its certified upper endpoint is nonpositive; otherwise the current model is retained.

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16.
arXiv (quant-ph) 2026-06-11

Non-Hermitian Delocalization Realizes Random Dirac Criticality in One Dimension

Authors:
Bo Li↗Shen Zhang↗Ren Zhang↗

arXiv:2606.12089v1 Announce Type: cross Abstract: Non-Hermitian systems can evade Anderson localization and exhibit delocalized states even in one dimension. Here, we show that such non-Hermitian delocalized states under periodic boundary conditions (PBC) are intrinsically critical, realizing the universality class of one-dimensional random Dirac fermions. By linking spectral winding to topological Anderson transitions via Hermitization, we demonstrate that the delocalized PBC states exhibit a Dirac-type criticality with universal algebraic correlations. In contrast to Hermitian systems, where this criticality occurs only at fine-tuned transition points, it emerges generically in non-Hermitian systems as a consequence of spectral topology. These results identify a universal mechanism by which non-Hermiticity promotes criticality, providing a unified description of non-Hermitian delocalization in one dimension.

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

Fusion is not one-size-fits-all: Cross-Modal Representation Alignment for Time-to-Event Modeling

Authors:
Zhemin Zhang↗Weijie Chen↗David Le↗Amara Tariq↗Alex Wallace↗Matthew Stib↗Juan Maria Farina↗Chadi Ayoub↗Reza Arsanjani↗Imon Banerjee↗

arXiv:2606.15038v1 Announce Type: new Abstract: Accurate time-to-event (TTE) prediction from multimodal clinical data remains challenging due to modality imbalance and distribution shift. We introduce a foundation model-driven framework for cross-modal representation alignment between CT imaging and longitudinal EHR data, designed to generalize across tasks and institutions. CT and EHR modalities are encoded independently using domain-specific foundation models and aligned in a shared latent space through four principled fusion strategies: late fusion, contrastive alignment, cross-attention, and co-attention. We evaluate two clinically distinct TTE tasks: pulmonary embolism (PE) mortality and cardiovascular disease (CVD) outcomes, on large-scale multi-institutional cohorts (PE: N=3,099 train; 1,098 internal; 435 external; CVD: N=2,951 train; 837 internal; 682 external). Fusion consistently improves concordance index by 1.5-5.4% over unimodal baselines when modalities contribute comparably. Overall, contrastive multimodal fusion, particularly with CLMBR representations, provided the most consistent and statistically robust improvements, especially for PE mortality prediction. For MACE, cross-attention (one-hot) achieved the highest internal performance and image-guided co-attention achieved the best external performance. We therefore introduce a generalizable foundation model-based cross-modal alignment framework and provide the first systematic analysis of fusion behavior under modality imbalance in TTE prediction. Our results establish task-aware multimodal alignment as a necessary design principle for robust generalization and scalable clinical deployment.

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18.
arXiv (CS.AI) 2026-06-19

Simulation of Language Evolution under Regulated Social Media Platforms: A Synergistic Approach of Large Language Models and Genetic Algorithms

Authors:
Jinyu Cai↗Yusei Ishimizu↗Mingyue Zhang↗Munan Li↗Jialong Li↗Kenji Tei↗

arXiv:2502.19193v2 Announce Type: replace-cross Abstract: Social media platforms frequently impose restrictive policies to moderate user content, prompting the emergence of creative evasion language strategies. This paper presents a multi-agent framework based on Large Language Models (LLMs) to simulate the iterative evolution of language strategies under regulatory constraints. In this framework, participant agents, as social media users, continuously evolve their language expression, while supervisory agents emulate platform-level regulation by assessing policy violations. To achieve a more faithful simulation, we employ a dual design of language strategies (constraint and expression) to differentiate conflicting goals and utilize an LLM-driven GA (Genetic Algorithm) for the selection, mutation, and crossover of language strategies. The framework is evaluated using two distinct scenarios: an abstract password game and a realistic simulated illegal pet trade scenario. Experimental results demonstrate that as the number of dialogue rounds increases, both the number of uninterrupted dialogue turns and the accuracy of information transmission improve significantly. Furthermore, a user study with 40 participants validates the real-world relevance of the generated dialogues and strategies. Moreover, ablation studies validate the importance of the GA, emphasizing its contribution to long-term adaptability and improved overall results.

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19.
arXiv (CS.CL) 2026-06-12

Does AI Reviewer See the Full Picture? Attacking and Defending Multimodal Peer Review

Authors:
Xinyu Zhao↗Rana Muhammad Shahroz Khan↗Zhen Xu↗Zhen Tan↗Tianlong Chen↗

The integration of Large Language Models (LLMs) and Multimodal LLMs (MLLMs) into scientific peer-review workflows introduces novel and significant risks for adversarial manipulation, especially given the multimodal nature of scientific papers where figures, not just text, convey core evidence. This creates a significant gap: current robustness studies on AI peer-review are overwhelmingly text-only. Moreover, the problem is distinct from standard jailbreaking, as a peer-review attack seeks to induce a domain-specific, targeted failure (e.g., "inflate this score") rather than a general safety policy violation, for which no practical defenses exist. To address this, we introduce PaperGuard, the first comprehensive benchmark designed to systematically evaluate and defend AI-generated peer-review against these domain-specific, cross-modal attacks. Our framework is built on three pillars: (1) a new multimodal peer-review dataset spanning multiple scientific domains; (2) a unified suite of attacks, including black-box prompt injections and white-box perturbations, specifically designed to target both text (GCG) and figures (PGD); and (3) a practical defense, motivated by the long-context challenge of academic papers, that uses chunk-based embedding search to efficiently localize and mitigate harmful instructions. Our extensive experiments, conducted across state-of-the-art models, confirm that AI reviewers are pervasively vulnerable. PaperGuard establishes the foundational benchmark, protocols, and actionable defense necessary to pioneer trustworthy, attack-resilient AI-assisted scholarly reviewing.

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20.
arXiv (CS.CL) 2026-06-17

Prompt Perturbation for Reliable LLM Evaluation over Comparison Graphs

Authors:
Dong Huang↗Jianbo Sun↗Pengkun Yang↗

Evaluating large language models (LLMs) is important for understanding their capabilities, comparing competing systems, and supporting the deployment of reliable models in practice. For open-ended tasks, pairwise evaluation has become a popular paradigm, in which two responses to the same prompt are compared and the resulting judgments are aggregated into an overall ranking. A central challenge of this paradigm is intransitivity: the induced comparison outcomes may fail to support any coherent global ranking. For example, one may observe cyclic preferences such as $A \succ B \succ C \succ A$, or inconsistencies involving ties such as $A \equiv B\equiv C\neq A$. Such contradictions make the resulting leaderboard unstable and challenging to interpret. In this paper, we propose a prompt perturbation framework for improving the consistency of pairwise LLM evaluation. Our approach generates perturbed variants of each prompt, uses the resulting comparison graphs to identify and filter out structurally inconsistent comparison patterns, and then applies standard ranking methods to the filtered comparisons. A key feature of the proposed framework is that graph-level structural consistency is incorporated explicitly into the evaluation pipeline before ranking aggregation. This provides a simple and principled way to reduce cyclic inconsistencies and improve the reliability of LLM rankings.

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21.
medRxiv (Medicine) 2026-06-16

Development and reliability and validity test of the Questionnaire on Knowledge, Attitude and Practice of ICU Nurses on Blood Oxygen Saturation Management in Mechanically Ventilated Patients

Authors:
Xie↗Bian↗Yu↗He↗

Objective: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in patients with mechanical ventilation was compiled, and its reliability and validity were tested. Method: Drawing upon the knowledge-attitude-practice theory, the initial questionnaire draft was developed through literature review and consultation with Delphi experts. Employing convenience sampling, 32 nurses from the General ICU of Wuxi Second People's Hospital were surveyed between 1 August 2025 and 27 September 2025, enabling item screening and assessment of reliability and validity.The full version of the developed questionnaire is provided as Supporting Information (S1 File). All items are published under a CC BY 4.0 license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Result: A questionnaire on the knowledge, attitude and practice of ICU nurses regarding the management of blood oxygen saturation in mechanically ventilated patients was finalised, comprising 26 items: 11 in the knowledge dimension, 6 in the attitude dimension and 9 in the behaviour dimension. The overall Cronbach's coefficient for the questionnaire was 0.88, with dimension-specific coefficients of 0.787, 0.722, and 0.781 respectively. The Spearman-Brown coefficient for the entire questionnaire was 0.967, while dimension-specific coefficients were 0.796, 0.666, and 0.728 respectively. The content validity index at the questionnaire level (S-CVI) was 0.886, and the item-level content validity index (I-CVI) ranged from 0.913 to 0.967. 0.728. The questionnaire's level content validity index (S-CVI) was 0.886, and the item level content validity index (I-CVI) ranged from 0.913 to 1.00. Conclusion: The questionnaire on knowledge, attitude and practice of blood oxygen saturation management in mechanically ventilated patients demonstrates good reliability and validity. It may serve as an assessment tool for intensive care unit nurses regarding their knowledge, attitude, and practices concerning blood oxygen saturation management in mechanically ventilated patients, thereby establishing a foundation for developing targeted intervention strategies in future practice.

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22.
arXiv (CS.CV) 2026-06-12

CD-RCM: Generalizable Continuous-Depth Novel View Synthesis for Reflectance Confocal Microscopy

Authors:
Tooba Imtiaz↗Milind Rajadhyaksha↗Kivanc Kose↗Jennifer Dy↗

Reflectance confocal microscopy (RCM) provides noninvasive, cellular-resolution "optical biopsies" of human skin in vivo by acquiring en-face images at successive depths, forming a sparse z-stack. Due to optical limitations, these stacks are anisotropic 3D volumes with lateral resolution (0.5 $\mu$m) $\sim$6 times higher compared to axial resolution, which is defined by the optical sectioning (3 $\mu$m), limiting the interpretation of tissue. Our goal is to provide continuous-depth visualization by interpolating intermediate sections and making the 3D volume isotropic. Such a representation permits arbitrary-direction sectioning, including histopathology-like cross-sectional examination, without requiring per-patient optimization. To that end, we introduce the first RCM-specific novel-view synthesis (NVS) approach, CD-RCM, a feedforward model that predicts realistic, unseen depths from sparsely sampled RCM stacks. Classical neural rendering methods focus on reconstruction from surface-level multi-view observations. In contrast to surface-level camera views, RCM can acquire optically sectioned en-face images of tissue beyond the surface up to 200 $\mu$m. However, during visualization of the RCM stacks, observations of the shallower sections (towards the surface) obscure the deeper ones. This unique axial imaging geometry and layer-dependent anatomical organization motivated our development of a tailored architectural and training framework that explicitly accounts for RCM's depth-resolved, occlusive imaging physics. Experiments demonstrate that CD-RCM achieves high-fidelity novel-view synthesis with sub-second inference time.

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23.
medRxiv (Medicine) 2026-06-15

SPIRIT-CONSORT-ELM: Element-Level Assessment of Randomized Controlled Trial Reporting Using Large Language Models

Authors:
Jiang↗Ying↗Brown↗A. W↗Lan↗Song↗Menke↗Vorland↗Mayo-Wilson↗Kilicoglu↗

Randomized controlled trials (RCTs) play a central role in assessing the benefits and harms of interventions. Incomplete reporting in RCT publications can compromise the verifiability and usefulness of RCTs. SPIRIT and CONSORT reporting guidelines aim to improve the completeness of RCT protocols and results publications, respectively. However, many RCTs are not reported completely. Checking manuscripts automatically could help authors improve the completeness of reports prior to publication. We previously annotated SPIRIT-CONSORT-TM, a corpus of 200 articles (comprising 100 protocol-results publication pairs) using 83 checklist items drawn from SPIRIT 2013 and CONSORT 2010. We also trained machine learning models to automatically assess reporting at the item level. Each checklist item can include multiple constituent elements (i.e., specific details required for that item), and an item might be considered fully reported when all of its elements are present. However, prior work does not explicitly capture or evaluate reporting at the element level. To address this gap, we extended SPIRIT-CONSORT-TM by incorporating element-level annotations and using them to assess reporting completeness (SPIRIT-CONSORT-ELM). We formulated element-level assessment as a machine reading comprehension task, operationalized through 119 questions, where each question targets a specific reporting element within a checklist item. Using the 200 articles included in SPIRIT-CONSORT-TM, two annotators independently answered 119 questions for 50 articles (25 protocol-results pairs) and resolved any discrepancies through discussion; the remaining 150 articles (75 protocol-results pairs) were assessed by a single annotator. We then developed an automated pipeline for element-level assessment using SPIRIT-CONSORT-ELM. The pipeline first applies a PubMedBERT-based model to identify sentences containing item-level reporting information, then it uses a generative large language model (LLM; GPT-5) with chain-of-thought reasoning to answer element-level questions based on the retrieved evidence. Agreement between the two annotators was high (Gwet's AC1: 0.782) and our pipeline achieved high accuracy in identifying element-level reporting evidence (F1: 0.822, Gwet's AC1: 0.796). Ablation studies indicate that chain-of-thought reasoning and the inclusion of illustrative in-context examples modestly improve LLM performance on the machine reading comprehension task. SPIRIT-CONSORT-ELM provides a benchmark for evaluating reporting guideline completeness at the element level, enabling assessment of RCT transparency beyond the simple presence or absence of checklist items and is publicly available at https://osf.io/kznx4/. The automated pipeline establishes a robust baseline for assessing RCT reporting and demonstrates potential as a practical aid for authors, reviewers, and editors to identify and address gaps in completeness and transparency of RCT reports.

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24.
bioRxiv (Bioinfo) 2026-06-15

SMS: Symmetric Mediation Statistics for Powerful High-Dimensional Mediation Analysis

Authors:
Wang↗Yan↗H.-J↗Hu↗Y.-J↗

Background: Mediation analysis of high-dimensional features, particularly molecular-level omics features, provides important opportunities to uncover biological mechanisms underlying human health and disease. However, two central statistical challenges remain: testing the composite-null hypothesis and maintaining power when the exposure-mediator and mediator-outcome associations differ substantially in statistical significance. Existing methods typically rely on accurate estimation of the proportions of the three null types or on the maximum of the two association p-values, and may not always control the FDR well and may have limited power under imbalanced significance. Methods: We propose SMS, a new statistical framework based on symmetric mediation statistics. By exploiting symmetry, SMS calibrates the composite null distribution as a whole for FDR control. It also allows flexible combinations of the two association p-values, including the maximum, and then enables construction of an omnibus test. Moreover, it permits direct use of effect-size estimates, bypassing the need to compute p-values. Results: SMS controlled the FDR across a wide range of simulation scenarios while achieving a substantial sensitivity gain, often around 20 percentage points, over existing methods including HDMT, DACT, and DEI-B. Applications to a metabolomics dataset and a DNA methylation dataset further corroborated these findings. Notably, SMS discovered five plausible mediators in the metabolomics dataset that were missed by all existing methods considered.

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25.
medRxiv (Medicine) 2026-06-22

Understanding and Usefulness of Effect Size and Certainty of Evidence: A Cross-sectional Survey of Evidence-Based Practice Competencies Among Registered Dietitians

Authors:
Ghosh↗N. R↗Neale↗E. P↗Hand↗R. K↗Ball↗G. D. C↗Riddle↗Klatt↗K. C↗Riviere↗…

Introduction: Understanding of absolute and relative estimates (i.e., effect size), and certainty of evidence corresponding to those estimates, is a fundamental evidence-based practice competency to promote informed clinical decision-making. While research has been conducted in the medical profession, there is no published research on these competencies in the nutrition and dietetics profession. Methods: Among registered dietitians, our main objectives were to assess (1) their understanding and perceived usefulness of three absolute and two relative estimate approaches to assess effect size, (2) their perceived usefulness of certainty of evidence, and (3) factors influencing their understanding and perceived usefulness. We conducted a web-based, cross-sectional survey among dietitians recruited from the Academy of Nutrition and Dietetics (United States). Participants received effect estimates based on hypothetical dietary interventions vs. usual diet for reducing myocardial infarction risk. Results: Of the 11,050 dietitians who received the survey link, 210 participated (2.0% response rate), and only completers (n=114) were included in the analysis. Participants demonstrated a similar understanding of the relative (27.6%) and absolute (27.5%) estimates, with Risk Difference (30.7% correct responses) being the best understood approach and Number Needed to Treat (24.6%) being the least. The understanding of five approaches was not different than random guessing (p>0.05). While perceived usefulness scores were similar between five approaches, they were highest when data was presented as Relative Risk [mean (SD): 4.82 (1.50)]. Dietitians rated the usefulness of certainty of evidence favorably [mean (SD): 5.07 (1.83), on a 7-point scale), and no factors were associated with correct understanding. Conclusion: Dietitians may have limited understanding of how to interpret effect sizes, a finding consistent with surveys of other health professionals. To optimize informed decision-making between dietitians and clients, dietetic programs and continuing education platforms should consider additional training on interpreting effect sizes and certainty of evidence for effect sizes.

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