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02.
arXiv (CS.CL) 2026-06-16

Whose hotel does the AI recommend? An algorithm audit of reputation signals in LLM-assisted hotel selection

Travelers increasingly ask large language model (LLM) assistants which hotel to book, making these systems gatekeepers of property visibility – yet what moves their recommendations is undocumented. We conduct a pre-specified algorithm audit using a randomized choice-based conjoint: across personas, prompt templates, and twelve open-weight and proprietary models, assistants choose among five hotels whose guest rating, review volume and recency, management response, chain affiliation, price, eco-certification, and list position are independently randomized. We estimate the average marginal component effect of each signal on the probability of recommendation. Guest rating and price dominate (a top rating raises selection by 31.6 percentage points; a high price lowers it by 30.0), reproducing human valence-and-price primacy but over-weighting eco-certification and ignoring management response. List position – a content-free artifact – shifts recommendations causally, worth about \$12 per night. Stated reasons track revealed weights imperfectly. The findings ground generative engine optimization and the accountability of AI infomediaries in causal evidence.

03.
arXiv (CS.CV) 2026-06-18

Low-Cost Neuromorphic Fall Detection Using Synthetic Event Data and Hybrid SNNs

This work presents the development of hybrid models that integrate spiking neural networks (SNNs) with components of convolutional neural networks (CNNs) to learn from simulated event-based camera data (Dynamic Vision Sensor, DVS) generated from conventional smartphone videos. Aimed primarily at human fall detection, the approach leverages the energy efficiency and spatio-temporal processing capabilities of SNNs by converting video frames into event-based data. The proposed models are evaluated through simulations on multiple datasets, comparing their performance to that of traditional machine learning models. Results demonstrate significant gains in efficiency without sacrificing accuracy, underscoring the potential of combining SNNs and DVS technology for complex tasks in real-world environments.

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

Beyond Algorithms: Conceptual Innovation in Medical Imaging AI

arXiv:2606.19270v1 Announce Type: cross Abstract: Artificial intelligence has driven rapid progress in medical imaging research, producing increasingly sophisticated algorithms and steady improvements on benchmark tasks. However, this algorithm-centric trajectory has also revealed a growing imbalance: while computational methods advance rapidly, the conceptual foundations that define imaging tasks, evaluation metrics, and clinical meaning sometimes remain underexamined. In this Perspective, we distinguish algorithmic innovation, which focuses on improving computational implementations and performance within a fixed problem definition, from conceptual innovation, which reframes what problems are posed, how success is measured, and why an approach is clinically relevant. We argue that prevailing incentive structures, training pathways, and publication norms disproportionately reward algorithmic novelty, particularly for early-career researchers, while at times undervaluing conceptual contributions that are essential for scientific maturation and clinical translation. Through representative examples from medical imaging AI, we show how insufficient conceptual grounding can lead to misaligned objectives, fragile generalization, and limited real-world impact. We conclude with actionable recommendations for researchers, mentors, reviewers, and journals to better recognize, support, and integrate conceptual innovation alongside algorithmic advances.

05.
arXiv (CS.CV) 2026-06-16

Open-World Video Segmentation

While video segmentation has advanced rapidly on short clips and closed-set benchmarks, open-world video segmentation remains largely unexplored. The challenge is twofold: (1) existing methods are not designed to support object discovery and identity maintenance in long videos of dynamic ego-motion, and (2) existing evaluation protocols rely on a rigid 1:1 matching that unfairly penalizes semantically valid predictions with mismatched granularity. To address both gaps, we introduce Savvy, a practical and strong system for zero-shot open-world long-horizon video segmentation. Savvy combines hierarchical mask discovery, deferred admission, and track consolidation to support persistent object discovery, safe track promotion, and stable long-range identity maintenance. We further propose OGA, a granularity-aware evaluation suite for open-world video segmentation. Built on a Granularity-Agnostic (GA) matching protocol, OGA relaxes conventional 1:1 matching to an n:1 mapping, but still enforces temporal rigor by detecting support discontinuities through sever points and scoring each reference object through its dominant coherent fragment. This prevents fragmented or flickering support from being over-rewarded while enabling GA-adapted metrics and structural diagnostics: identity persistence (IP), and identity concentration (IC). On VIPSeg, we show that standard 1:1 evaluation substantially underestimates open-world methods, whereas GA evaluation recovers much of their suppressed performance. On the more realistic long-horizon benchmarks: ScanNet and HM3D, Savvy consistently outperforms strong baselines across both classical and proposed metrics, including STQ, VPQ$_\infty$, IP and IC. Together, these results establish a practical benchmark and a strong baseline for open-world long-horizon video segmentation.

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

Leave-One-Out-, Bootstrap- and Cross-Conformal Anomaly Detectors

arXiv:2402.16388v4 Announce Type: replace-cross Abstract: The need for uncertainty quantification in anomaly detection systems has become increasingly important. In this context, effectively controlling Type I error rates without inflating Type II error rates in these systems can build trust and reduce costs associated with false discoveries. The field of conformal anomaly detection emerges as a promising approach for providing respective statistical and finite-sample validity guarantees through model calibration. However, reliance on calibration data imposes practical limitations, especially in low-data regimes. In this work, we formally define and evaluate leave-one-out-, bootstrap-, and cross-conformal methods for conformal anomaly detection, building on methods from the field of conformal prediction. Looking beyond the classical split-conformal approach, we show that derived methods for calculating resampling-conformal $p$-values offer a practical compromise between the data efficiency of full-conformal (transductive) approaches and the computational efficiency of split-conformal (inductive) methods. We validate derived methods and quantify their improvements for a range of one-class classifiers and datasets.

07.
arXiv (CS.LG) 2026-06-19

Does Text Actually Help? Uncovering and Resolving Text Collapse in Multimodal Time Series Forecasting

arXiv:2606.19413v1 Announce Type: new Abstract: Multimodal time series forecasting, which pairs numerical sequences with domain-relevant textual reports, promises to inject world knowledge into forecasting pipelines. However, we uncover a critical failure mode in existing frameworks that we term text collapse: the text branch converges to a content-independent transformation, contributing negligible discriminative signal regardless of the input description. We argue that text collapse is a consequence of a fundamental asymmetry in time series forecasting: the numerical input is strongly autocorrelated with the output, making the numerical backbone inherently dominant, while the text branch, despite carrying complementary and often critical information, is insufficiently utilized, leading to its systematic underexploitation. To address this, we propose REST-TS (Residual-Exclusive Supervision for Text in Time Series), which turns the asymmetry into a design principle: the numerical backbone produces its own independent numerical forecast, and the text branch is exclusively supervised to predict the structured components of the residual, the prediction gap that numbers cannot explain. Because no numerical pathway can reduce these losses, the text branch must extract genuine content from the input description. Evaluated across diverse real-world domains and backbone architectures, REST-TS achieves state-of-the-art performance and consistently demonstrates greater text-branch utilization than existing frameworks, providing strong empirical evidence that supervising the text branch on the residual compels it to extract genuine content from the input.

08.
arXiv (CS.CV) 2026-06-16

An Empirical Analysis of Optimization Dynamics and Sparsity Boundaries in Large-Scale Pedestrian Attribute Recognition

Pedestrian Attribute Recognition (PAR) is critical for video surveillance, enabling forensic search and re-identification systems. Extreme class imbalance remains a fundamental obstacle when merging PETA and PA-100K into a 109,000-image composite corpus, where minority attributes have positive sample fractions below 1%. This causes standard BCE optimization to suppress rare traits, a phenomenon we term the majority negative class cheating trap. We present a systematic ablation of Multi-Label Focal Loss hyperparameters (alpha and gamma) on a ResNet-18 backbone. A calibrated configuration (alpha=0.50, gamma=2.0) achieves a Macro F1-score of 62.32%, matching BCE baseline while preserving superior hard-example mining and convergence dynamics. Our approach uses pure loss-function engineering with zero computational overhead for edge deployment. We identify the Sparsity Wall, a hard boundary where positive sample fractions below 0.1% make global loss reweighting ineffective, requiring instance-level intervention.

09.
arXiv (CS.CV) 2026-06-16

G2IA: Geometry-Guided Instance-Aware Retrieval and Refinement for Cross-Modal Place Recognition

Cross-modal place recognition (CMPR) enables camera-only robots to localize against pre-built LiDAR maps in autonomous navigation scenarios. This image-to-point-cloud setting is challenged by two coupled ambiguities: the modality gap between perspective RGB appearance and sparse metric geometry, and perceptual aliasing among urban places with similar roads, facades, intersections, and object arrangements. Instead of treating CMPR as a single global descriptor matching problem, we argue that reliable retrieval requires both geometry-aware representation alignment and fine-grained candidate verification. In this paper, we propose G2IA, a geometry-guided instance-aware framework for image-to-point-cloud place recognition. In the retrieval stage, visual geometry priors from VGGT and instance features are integrated to construct place descriptors that are more compatible with LiDAR-derived map representations. In the refinement stage, the retrieved candidates are re-ranked by explicitly verifying whether local instance shapes and their relative spatial layouts are consistent across modalities. Experiments on public benchmarks demonstrate that G2IA consistently improves image-to-point-cloud place recognition under different localization thresholds, and exhibits strong cross-dataset generalization.

10.
arXiv (CS.AI) 2026-06-18

InfoPO: Information-Driven Policy Optimization for User-Centric Agents

arXiv:2603.00656v2 Announce Type: replace Abstract: Real-world user requests to LLM agents are often underspecified. Agents must interact to acquire missing information and make correct downstream decisions. However, current multi-turn GRPO-based methods often rely on trajectory-level reward computation, which leads to credit assignment problems and insufficient advantage signals within rollout groups. A feasible approach is to identify valuable interaction turns at a fine granularity to drive more targeted learning. To address this, we introduce InfoPO (Information-Driven Policy Optimization), which frames multi-turn interaction as a process of active uncertainty reduction and computes an information-gain reward that credits turns whose feedback measurably changes the agent's subsequent action distribution compared to a masked-feedback counterfactual. It then combines this signal with task outcomes via an adaptive variance-gated fusion to identify information importance while maintaining task-oriented goal direction. Across diverse tasks, including intent clarification, collaborative coding, and tool-augmented decision making, InfoPO consistently outperforms prompting and multi-turn RL baselines. It also demonstrates robustness under user simulator shifts and generalizes effectively to environment-interactive tasks. Overall, InfoPO provides a principled and scalable mechanism for optimizing complex agent-user collaboration. Code is available at https://github.com/kfq20/InfoPO.

11.
arXiv (CS.AI) 2026-06-16

FreeSonic: Training-Free Temporal-Aware Decoupled Attention for Precise Audio Editing

arXiv:2606.15186v1 Announce Type: cross Abstract: Text-to-audio (TTA) generation has made significant strides, yet achieving precise and consistent audio editing remains a major challenge. However, existing methods struggle to balance temporal consistency with background preservation. In this paper, we propose FreeSonic, a training-free framework leveraging the state-of-the-art Rectified Flow-based TangoFlux model. FreeSonic utilizes an optimized inversion-reverse process and joint text-audio attention maps for precise target segment extraction. For content editing, a novel scheduled attention decoupling confines modifications to target regions while preserving original acoustic context. Furthermore, task-oriented noise injection enhances versatility for tasks such as audio removal and non-rigid replacement. Extensive experimental results demonstrate that FreeSonic achieves a superior balance by providing a high-fidelity and efficient solution for precise and consistent audio editing. Project and demos: https://free-sonic.github.io/

12.
arXiv (CS.AI) 2026-06-18

Graph Grounded Cross Attention Transformer Neural Network for Structurally Constrained Full Event Sequence Generation in Predictive Process Monitoring

arXiv:2606.18726v1 Announce Type: cross Abstract: Structurally constrained event sequence generation remains challenging because generated paths must preserve transition feasibility, temporal order, termination, and attribute consistency. In predictive process monitoring (PPM), this challenge appears as full event sequence generation, whereas existing work mainly addresses component tasks such as next activity, remaining time, outcome, and attribute prediction. This paper proposes the Graph Grounded Cross Attention Transformer Neural Network (GGATN) for this unified PPM task. GGATN uses a global process graph as structured activity memory, contextualizes sequence positions through Transformer self attention, and injects process topology through graph grounded cross attention. Unlike autoregressive decoding, GGATN generates activities, timestamps, length, and event level and sequence level attributes in a single pass, followed by Viterbi style graph constrained decoding for feasible paths and explicit termination. Experiments on six benchmark event logs show more reliable generation quality than local instruction prompted LLM baselines. GGATN achieves strong performance on sequence similarity, Damerau Levenshtein similarity, bigram based control flow similarity, and duration distribution, while maintaining zero hallucinated activities and zero sequence level attribute inconsistency. Ablation analyses confirm the global graph encoder as a stable structural prior. Interpretability analyses show how graph structure, sequence context, feedback refinement, and constrained decoding shape generation.

13.
arXiv (quant-ph) 2026-06-12

Relativistic Locality from Electromagnetism to Quantum Field Theory

arXiv:2412.11532v2 Announce Type: replace Abstract: Electromagnetism is the paradigm case of a theory that satisfies relativistic locality. This can be proven by demonstrating that, once the theory's laws are imposed, what is happening within a region fixes what will happen in the contracting light-cone with that region as its base. The Klein-Gordon and Dirac equations meet the same standard. We show that this standard can also be applied to quantum field theory (without collapse), examining two different ways of assigning reduced density matrix states to regions of space. Our preferred method begins from field wave functionals and judges quantum field theory to be local. Another method begins from particle wave functions (states in Fock space) and leads to either non-locality or an inability to assign states to regions, depending on the choice of creation operators. We take this analysis of quantum field theory (without collapse) to show that the many-worlds interpretation of quantum physics is local at the fundamental level. We argue that this fundamental locality is compatible with either local or global accounts of the non-fundamental branching of worlds, countering an objection that has been raised to the Sebens-Carroll derivation of the Born Rule from self-locating uncertainty.

14.
arXiv (CS.LG) 2026-06-16

An Exploratory Study of Blood Glucose Estimation from Photoplethysmography Signals using Machine Learning

arXiv:2606.15927v1 Announce Type: new Abstract: Diabetes and extreme blood sugar levels are some of the major health problems faced by humans today across the world. While Continuous Glucose Monitoring (CGM) has emerged as an effective technology for management of diabetes as well as for monitoring blood sugar levels, this technology has traditionally been invasive (that is, requiring the piercing of the skin) and carries the risk of irritation, induration, etc. This highlights the need for accurate and non-invasive CGM methods that can be deployed at scale. With the emergence of various sensing technologies and their integration in wearables like the smart-watch, we now have the capability to continuously monitor body signals like the Photoplethysmogram (PPG) in a non-invasive manner. Having the ability to continuously monitor blood glucose through CGMs and continuously monitor PPG signals through a smart-watch offers an opportunity to get dense data on these two, opening the possibility of building machine learning and deep learning based models to estimate blood glucose level from PPG signals. In this work, we first present a paired dataset comprising continuous PPG signals from a smartwatch along with glucose values recorded using a CGM device. We also present the results of some preliminary experimental explorations performed on our dataset. These preliminary results suggest that some predictive signals may exist, though more exploration is needed with more data from a larger number of individuals. The dataset can be accessed at https://zenodo.org/records/20577959

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

Private Learning with Public Feature Conditioning

arXiv:2606.18773v1 Announce Type: cross Abstract: We study differentially private (DP) regression in settings where each data sample includes public, non-sensitive features – common in applications such as recommendation and advertising systems. While such label-DP or semi-sensitive-feature settings have been primarily explored in the context of classification, effective approaches for regression remain underexplored. We introduce Cond-DP, a conditioned variant of DPSGD that leverages the structure of public feature matrices to improve optimization under privacy constraints. Motivated by the observation that these public features often exhibit rapidly decaying spectra, Cond-DP incorporates a data-driven conditioning matrix to reshape the optimization landscape and accelerate convergence. We provide convergence guarantees for convex, strongly convex, and non-convex settings, and recover standard DPSGD as a special case when the conditioning matrix is the identity. We show how to construct an effective conditioning matrix for Cond-DP directly from public features, enabling provably faster convergence than DPSGD in private linear regression without incurring additional privacy cost. Empirically, Cond-DP with this conditioning matrix consistently outperforms state-of-the-art baselines across a wide range of datasets and model architectures under label DP, demonstrating strong and robust performance in practice.

16.
arXiv (CS.AI) 2026-06-19

Residual-Space Evolutionary Optimization via Flow-based Generative Models

arXiv:2606.20084v1 Announce Type: new Abstract: Data editing with generative methods typically requires differentiable objectives and gradient-based search. However, these assumptions break down in flow-based settings, where edits are performed through forward and backward integration and often involve non-differentiable or black-box objectives. We introduce residual-space evolutionary optimization, a model-agnostic framework that addresses this gap by combining flow-based generative editing with evolutionary algorithms. Building on the observation that conditional flow matching (CFM) can disentangle condition-controlled factors from instance-specific residuals, our framework directly operates in residual space and separates two complementary search regimes: self-pollination performs local exploitation through feature-preserving residual refinement, and cross-pollination promotes broader exploration by recombining residuals across heterogeneous samples. As a proof of concept, we validate on MorphoMNIST, a benchmark dataset for counterfactual generation, and on crystal data, demonstrating that this exploration–exploitation decomposition provides a useful mechanism for balancing target alignment, instance preservation, and diversity, and extends beyond images to real-world scientific domains.

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

Public transit gains and spatially uneven travel demand changes after NYC congestion pricing

arXiv:2606.17530v1 Announce Type: cross Abstract: New York City implemented the nation's first cordon-based congestion pricing program in January 2025, providing an opportunity to evaluate how system-wide urban mobility responds to large-scale pricing interventions. Because such policies generate spillovers across modes and locations, credible control groups are difficult to construct. We address this challenge using time series foundation models to generate probabilistic counterfactual demand forecasts with calibrated uncertainty. Applying this framework to bus, subway, and aggregate trip volume data, we find that post-policy bus and subway ridership increased significantly relative to expected no-policy demand, while overall travel demand decreased modestly. The effects are spatially heterogeneous: while reductions in overall travel demand are concentrated within the Congestion Relief Zone, transit gains extend beyond Manhattan's core. Socio-demographic analyses further reveal uneven adaptation across neighborhoods, highlighting spatial equity implications. Our framework provides a scalable approach for the uncertainty-aware evaluation of system-wide urban interventions when clean control groups are unavailable.

18.
arXiv (CS.AI) 2026-06-11

The Power of Test-Time Training for Approximate Sampling

arXiv:2606.11437v1 Announce Type: cross Abstract: Efficiently sampling from a complex probability distribution is a fundamental problem which has become increasingly pertinent in recent years with the rise of generative AI, as sophisticated sampling procedures from LLMs have been proposed to solve challenging reasoning problems. The efficacy of such sampling algorithms is limited, however, by the relationship between the LLM and the particular sampling task at hand, which has motivated the framework of test-time training (TTT). TTT works by updating a model's weights in response to partial generations and reward feedback received at inference time, thus adapting to the particular problem. In this work, we propose a formalization for TTT as the problem of producing a sample from a given probability measure $\mu^\star$ belonging to a known class ${F}$ of distributions, given an oracle $\hat \mu$ which yields approximate density estimates for $\mu^\star$. This is closely related to the problem of reducing sampling to approximate counting studied in seminal works of Jerrum, Valiant & Vazirani (1986) and Jerrum & Sinclair (1989): namely, when ${F}$ is the class of all distributions, it coincides exactly with the aforementioned counting-to-sampling reduction. In this paper, we first show a quadratic lower bound on the query complexity of sampling from $\mu^\star$ given query access to $\hat \mu$ (for sufficiently large classes ${F}$), thus showing that the random walk approach proposed by Jerrum & Sinclair (1989) and refined by Hayes & Sinclair (2010), is optimal. This answers an open question posed by Hayes & Sinclair. We then show that this lower bound can be circumvented if the size of ${F}$ is bounded appropriately. As we discuss, this latter result can be viewed as an abstraction of TTT, and thus represents a starting point for the development of a principled theoretical framework for TTT.

19.
arXiv (CS.CL) 2026-06-15

Natively Unlearnable Large Language Models

Unlearning aims to remove the influence of specific training data sources, but this has proved challenging because the contributions of different sources are entangled within the model. Isolating source contributions to disjoint parameters makes removal easier, though it obstructs joint learning across sources. We propose NULLs (Natively Unlearnable LLMs), a model class that satisfies the two opposing goals of isolating source-specific contributions and learning jointly across sources, by training a set of shared backbone neurons alongside a pool of sparsely activated sinks. During training, information specific to a source naturally concentrates in its sinks while information shared across sources accumulates in the backbone. A source is then unlearned at deployment by disabling its corresponding sinks, with no gradient updates and no access to the retained data. We show that NULLs scales to Wikipedia's ~6M articles, isolating each as an independent source. Unlearning a single article removes knowledge specific to it while preserving facts shared with semantically related articles, closely matching retraining from scratch. We note that unlearning with NULLs is also robust: in a case study of unlearning the Harry Potter books, NULLs resists both adversarial extraction and relearning that reverses post-hoc unlearning. Finally, NULLs preserves general language capabilities, matching a standard transformer on downstream benchmarks. Together, these results suggest that source-level unlearning need not be an afterthought. It can be built natively into LLM training while retaining the benefits of shared representation learning.

20.
arXiv (CS.AI) 2026-06-18

A CEFR-Inspired Classification Framework with Fuzzy C-Means To Automate Assessment of Programming Skills in Scratch

arXiv:2604.00730v2 Announce Type: replace-cross Abstract: Context: Schools, training platforms, and technology firms increasingly need to assess programming proficiency at scale with transparent, reproducible methods that support personalized learning pathways. Objective: This study introduces a pedagogical framework for Scratch project assessment, aligned with the Common European Framework of Reference (CEFR), providing universal competency levels for students and teachers alongside actionable insights for curriculum design. Method: We apply Fuzzy C-Means clustering to 2008246 Scratch projects evaluated via Dr.Scratch, implementing an ordinal criterion to map clusters to CEFR levels (A1-C2), and introducing enhanced classification metrics that identify transitional learners, enable continuous progress tracking, and quantify classification certainty to balance automated feedback with instructor review. Impact: The framework enables diagnosis of systemic curriculum gaps-notably a "B2 bottleneck" where only 13.3% of learners reside due to the cognitive load of integrating Logic Synchronization, and Data Representation–while providing certainty–based triggers for human intervention.

21.
arXiv (CS.CL) 2026-06-18

Learning User Simulators with Turing Rewards

Learning to simulate human users in interactive settings could advance the training of agent assistants, evaluation of personalization systems, research in the social sciences, and more. Existing approaches generally do so by training a large language model (LLM) to match a single ground truth response, either by maximizing the log probability or by using a similarity reward. We instead propose {Turing-RL}: a Turing-Test-based reinforcement learning approach for training user simulator models. {Turing-RL} uses a discriminative Turing reward with an LLM judge to score how indistinguishable a generated response is from the real user's given the user's history, and the user simulator LLM learns to produce responses indistinguishable from what the user could have said with such rewards. Across two different domains–conversational chat and Reddit forum discussion–we find that {Turing-RL} consistently outperforms baseline methods on both LLM and human evaluation metrics. Our study suggests that optimizing for indistinguishability, rather than response matching, is effective for learning user simulators.

22.
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

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.

23.
arXiv (CS.CL) 2026-06-12

Rigel: Reverse-Engineering the Metal 4.1 Tensor Compute Path on the Apple M4 Max GPU

Apple's Metal 4.1 exposes a tensor compute path: the Metal Performance Primitives (MPP) matmul2d operation over cooperative_tensor fragments, whose interface is documented but whose hardware behavior is deliberately hidden. The specification states which data-type rows are supported, never whether they are hardware-accelerated, where the operation physically executes, what its accumulator width is, or how it partitions matrix fragments across threads. We present Rigel, an empirical characterization of this path on a single Apple M4 Max (a pre-neural-accelerator generation). Using a checksum-gated, provenance-tracked microbenchmark harness, Rigel recovers eleven facts the v4.1 specification hides or contradicts. The headline finding: the Metal 4.1 fp8 (E4M3) matmul2d is emulated, not accelerated: it sustains 0.94x the throughput of fp16 despite reading half the operand bytes, so on M4 it is a memory-footprint feature, not a performance feature. We further show, via a three-signal triangulation (throughput ceiling, comparison against simdgroup_matrix, and per-rail power attribution), that matmul2d executes entirely on the GPU shader cores with no dedicated matrix datapath and no evidence of Apple Neural Engine routing; that it accumulates in >=fp32; and we reconstruct the opaque 8x8 cooperative_tensor fragment layout Apple documents nowhere. Acting on the characterization, a hand-fused GEMM + bias + GELU kernel beats the decomposed path by +6.5-12.9% in the cache-resident regime. All findings are reproducible from committed MIT-licensed code and per-cell CSVs.

24.
arXiv (CS.CV) 2026-06-18

Hallucination Detection and Correction in Medical VLMs via Counter-Evidence Verification

Vision-Language models (VLMs) reliability in medical diagnosis is challenged by trust-undermining hallucinations. Existing hallucination detection approaches mainly focus on identifying factual inconsistencies between generated text and reference data. While some studies analyze where models attend in images, they seldom verify whether such attention truly reflects the visual evidence supporting the generated text. To address this gap, we propose Co}unter-Evidence Verification (CoEV), a training-free plug-and-play framework that detects and corrects hallucinations through evidence-based factual consistency verification. CoEV performs bidirectional verification between textual assertions and visual evidence, testing whether each statement is supported by its corresponding evidence region, and assigns each statement into a four-quadrant diagnostic map capturing combinations of text factuality and visual grounding. CoEV detects hallucinated content and serves as a post hoc refinement tool, correcting hallucinations without retraining. Extensive experiments on four medical datasets show that CoEV combats hallucinations in VLMs.For hallucination detection, CoEV consistently outperforms existing methods, improving average PR-AUC and ROC-AUC by 3.0% and 3.9% absolute points respectively, with notable gains of up to 18.5% in specific VQA scenarios. For hallucination correction, it improves Micro-F1 by up to 12.5%, reduces hallucination rates by over 11.9% on medical report generation, and also boosts medical VQA accuracy. These results show that CoEV enables reliable detection and correction of hallucinations, providing clinicians with dependable, evidence-based cues for diagnosis. Code will be released upon acceptance.

25.
medRxiv (Medicine) 2026-06-22

Exploring the association of Obesity on Cold and Warm Autoimmune Hemolytic Anemia in San Joaquin Valley: A Retrospective Cross-Sectional Study

The relationship between obesity and specific autoimmune diseases haas been well-established, specifically due to obesity's role in promoting pro-inflammatory states. Although not much literature has been documented regarding obesity association with AIHA. As such, this study aims to assess any correlations in patients with elevated body mass index (BMI) and autoimmune hemolytic anemia (AIHA). Here we present a retrospective cross-sectional study conducted over a four-year period, across four medical centers during which a new electronic medical record was implemented. The study included 25 patients who had a previously documented history of AIHA from another facility, DAT positive with indicators of hemolysis, or DAT positive with monomer specific antisera. The patients BMI was recorded at the time of presentation to the hospital. However, for patients with a prior history of AIHA or those transferred from another facility, the BMI that was closest to the time period of when the patient was diagnosed with AIHA was used as an adjunct. Our results show that there is an association of patients with elevated BMI (>25) and AIHA; however, various other confounding variables should be taken into consideration, and further research should be done to establish a causal relationship.