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

Structuring The Future: Diffusion LLM Speculative Decoding via Calibrated Draft Graphs

Diffusion LLMs (dLLMs) have recently emerged as a powerful alternative to autoregressive LLMs (AR-LLMs) with the potential to operate at significantly higher token-generation rates. To unlock this potential, we present Spiffy, a speculative decoding algorithm to accelerate dLLM inference while provably preserving the model's output distribution. This work addresses the unique challenges involved in applying ideas from speculative decoding of AR-LLMs to dLLMs. Spiffy performs auto-speculation to eliminate the overheads of an independent draft model, structuring draft states in the form of a novel directed draft graph to take advantage of the bidirectional, blockwise nature of dLLM generation. These draft graphs are calibrated offline to maximize acceptance rates and are dynamically pruned during inference for improved computational efficiency. We present a detailed formulation of Spiffy and demonstrate its ability to accelerate LLaDA, Dream, and SDAR models in combination with KV caching and threshold-based dynamic unmasking leading to up to $8.6\times$ reduction in model inferences and $6.3\times$ acceleration in token rate.

02.
arXiv (CS.CL) 2026-06-17

Improving low-resource ASR using bilingual fine-tuning with language identification: a cross-linguistic evaluation

This study explores how bilingual fine-tuning affects automatic speech recognition (ASR) in low-resource languages. We evaluate this method across nine linguistically and geographically diverse language pairs, covering a range of language families and writing systems. To distinguish the two languages, during training, we pre-pend each input text with a language identification token. At inference, the model jointly predicts both the language and transcription from the speech input alone. As texts for which the language is incorrectly determined show low ASR performance, we also conduct a follow-up experiment in which the language identification token is provided both during training and inference. Our results show that bilingual fine-tuning can be beneficial when language identification accuracy is high, and that in cases where language identification performance is low, including the language identification token at inference helps to improve ASR performance.

03.
arXiv (quant-ph) 2026-06-12

A Robust Strontium Tweezer Apparatus for Quantum Computing

arXiv:2601.16564v2 Announce Type: replace-cross Abstract: Neutral atoms for quantum computing applications show promise in terms of scalability and connectivity. We demonstrate the realization of a versatile apparatus capable of stochastically loading a 5x5 array of optical tweezers with single $^{88}$Sr atoms featuring flexible magnetic field control and excellent optical access. A custom-designed oven, spin-flip Zeeman slower, and deflection stage produce a controlled flux of Sr directed to the science chamber. In the science chamber, featuring a vacuum pressure of $3 \times 10^{-11}$ mbar, the Sr is cooled using two laser cooling stages, resulting in $\sim 3 \times 10^5$ atoms at a temperature of 5(1) $\mu$K. The optical tweezers feature a $1/e^2$ waist of 0.81(2) $\mu$m, and loaded atoms can be imaged with a fidelity of $\sim 0.997$ and a survival probability of $0.99^{+0.01}_{-0.02}$. The atomic array presented here forms the core of a full-stack quantum computing processor targeted for quantum chemistry computational problems.

04.
arXiv (CS.LG) 2026-06-15

Trust but Verify: Mitigating Medical Hallucinations via Post-Hoc Adversarial Auditing and Multi-Agent Feedback Loops

arXiv:2606.14149v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved. This study examine whether LLMs recommend recently banned or withdrawn pharmaceuticals when answering clinical questions and tests an agent-based method for reducing such errors. We developed a five-agent "Trust but Verify" system using a single LLM backbone. To measure regulatory knowledge obsolescence, we created an adversarial dataset of 103 clinical MCQs where historically correct answers now refer to banned substances. This scale ensures statistical significance across various therapeutic classes. We evaluated three open-access model families (GPT-OSS, Llama-3, Falcon-3) under vanilla and agentic conditions. Performance was measured via pointwise score, label accuracy, Hallucination Error Rate (HER), and Component Fidelity (CF) score. We also observed clinical safety regression in proprietary models. In default configurations, all models showed high hallucination rates, consistently selecting banned drugs that matched training data patterns. Our proposed agentic architecture reduced HER by approximately 53% across models. Pointwise scores shifted from -0.25 (unsafe recommendation) toward 0.0 (appropriate refusal). The safety audit intercepted dangerous outputs even when models' parametric knowledge favored the banned substance. The proposed multi-agent framework offers a model-agnostic method for enforcing regulatory compliance that prioritizes patient safety over fluent text generation. Our work demonstrates a practical approach for deploying autonomous AI systems in safety-critical healthcare settings. It shows how real-time regulatory data can be integrated into LLM pipelines to support clinical decision-making.

05.
arXiv (CS.CL) 2026-06-12

MoReBench: Evaluating Procedural and Pluralistic Moral Reasoning in Language Models, More than Outcomes

As AI systems progress, we rely more on them to make decisions with us and for us. To ensure that such decisions are aligned with human values, it is imperative for us to understand not only what decisions they make but also how they come to those decisions. Reasoning language models, which provide both final responses and (partially transparent) intermediate thinking traces, present a timely opportunity to study AI procedural reasoning. Unlike math and code problems which often have objectively correct answers, moral dilemmas are an excellent testbed for process-focused evaluation because they allow for multiple defensible conclusions. To do so, we present MoReBench: 1,000 moral scenarios, each paired with a set of rubric criteria that experts consider essential to include (or avoid) when reasoning about the scenarios. MoReBench contains over 23 thousand criteria including identifying moral considerations, weighing trade-offs, and giving actionable recommendations to cover cases on AI advising humans moral decisions as well as making moral decisions autonomously. Separately, we curate MoReBench-Theory: 150 examples to test whether AI can reason under five major frameworks in normative ethics. Our results show that scaling laws and existing benchmarks on math, code, and scientific reasoning tasks fail to predict models' abilities to perform moral reasoning. Models also show partiality towards specific moral frameworks (e.g., Benthamite Act Utilitarianism and Kantian Deontology), which might be side effects of popular training paradigms. Together, these benchmarks advance process-focused reasoning evaluation towards safer and more transparent AI.

06.
arXiv (CS.AI) 2026-06-24

G$^3$VLA: Geometric inductive bias for Vision-Language-Action Models

arXiv:2606.24472v1 Announce Type: cross Abstract: Vision-language-action (VLA) models have made rapid progress in generalist robot manipulation by harnessing semantic knowledge from pretrained vision-language backbones, but their visual tokens remain grounded in 2D image coordinates rather than the calibrated geometry of the robot's cameras – a mismatch especially pronounced in multi-camera setups, where views are coupled by known intrinsics and extrinsics yet processed as independent images. We propose G$^3$VLA, a camera-aware geometric module that injects calibrated structure into the visual-token stream of a pretrained VLA without altering its action space or imitation objective, combining intrinsic-conditioned ray embeddings, projective positional encoding (PRoPE), and bidirectional cross-view fusion. Geometric supervision is provided either from ground-truth point maps when available, or from confidence-gated $\pi^3$X teacher predictions, requiring no depth sensors or manual annotations. Instantiated on $\pi_0$, G$^3$VLA yields consistent gains across the LIBERO suites, RoboCasa24, RoboTwin2.0, and real-robot settings, with the largest improvements on spatially and object-sensitive tasks. We further validate on $\pi_{0.5}$ and GR00T 1.5, with results suggesting that geometric transfer is most effective when geometry-aware tokens have direct access to the action generation pathway. Our project page is at https://sites.google.com/view/g3vla

07.
arXiv (CS.CV) 2026-06-24

REDI-Match: Rotation-Equivariant Distillation for Efficient and Robust Dense Matching

Vision Foundation Models (VFMs) have significantly advanced dense feature matching, yet severe in-plane rotation remains a critical challenge. Existing solutions face a fundamental dilemma: data-driven methods require inefficient parameter scaling to implicitly learn rotations, whereas strictly equivariant networks lack the semantic capacity of modern VFMs. Consequently, current frameworks typically freeze VFMs and shift the entire burden of rotation generalization to the downstream decoder. To break this architectural bottleneck, we propose REDI-Match, an efficient framework driven by a novel Rotation-Equivariant Distillation (REDI) paradigm. Instead of relying on rotation data augmentation to establish rotational correspondences, REDI distills the non-equivariant semantic representations of a VFM into a lightweight, strictly rotation-equivariant encoder, leveraging an equivariant geometric architecture to constrain robust high-dimensional semantics. To fully exploit these features, we equip the decoder with an entropy-driven spatial alignment module. By evaluating discrete rotation hypotheses, this mechanism explicitly locks onto the canonical coordinate system, eliminating global ambiguity before continuous refinement. Extensive experiments demonstrate that REDI-Match establishes a new state-of-the-art (SOTA) across multiple benchmarks. Notably, it achieves a 13.89% absolute pose accuracy improvement on the highly challenging SatAst dataset while operating 1.9x faster than the current SOTA (RoMa v2), enabling real-time inference (~41 FPS) on a single RTX 4090 GPU. Code: https://github.com/YinjiGe/REDI-Match.

08.
bioRxiv (Bioinfo) 2026-06-12

PHI-Reason: evidence-grounded species-level phage-host prediction from structured biological text profiles

Phage–host interaction (PHI) prediction is a fundamental problem in microbiology with applications in microbial ecology and microbiome engineering. Existing computational approaches typically convert phage and host information into numerical representations derived from sequence similarity, protein content, genome composition or reference databases, then score candidate hosts or train host-prediction models. Although effective, such representations often make it difficult to inspect which biological evidence supports a prediction. Here, we present PHI-Reason, a species-level PHI prediction framework that reformulates host prediction as constrained biological text reasoning. Instead of embedding phages and hosts directly as numerical vectors, PHI-Reason converts heterogeneous PHI-related evidence from phage genomes, host genomes, functional annotations, homology searches and biological metadata into modular natural-language profiles. A frozen large language model then performs species-level candidate-host ranking or pairwise PHI assessment by integrating the supplied evidence at inference time. Across species-level benchmarks, PHI-Reason achieved competitive host-prediction performance and recovered complementary correct assignments relative to established sequence- and reference-based methods. Its explicit profile design enabled systematic evidence perturbation and rationale-grounding analyses, showing that predictions depend on coherent multi-source biological evidence and that hallucination risk from unsupported or incomplete profiles can be made operationally measurable. These results position PHI-Reason as a constrained evidence-integration framework for species-level PHI prediction. Rather than replacing sequence-based predictors, it provides an interpretable layer that shows how far explicit biological evidence can support host inference, and where that evidence falls short.

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

Rapid Poison: Practical Poisoning Attacks Against the Rapid Response Framework

The Rapid Response (RR) framework, deployed in production systems, including Anthropic's ASL-3 safeguards, continuously improves jailbreak-detection classifiers. When new jailbreaks emerge that bypass these classifiers, Rapid Response generates synthetic variants for training, helping the model generalize from the new attacks and quickly adapt. We reveal that prompt injection can infiltrate this pipeline to deliver poisoned samples into the classifier's training set, enabling two attack objectives: (I) targeted poisoning attacks that create false positives on harmless samples by categorizing them as a jailbreak, with a specific desired feature (e.g., certain formatting, subject, or keyword), (II) concept-based backdoor attacks that induce false negatives on jailbreak inputs, generalizing even to jailbreaks from attack strategies the defender explicitly trained against, when the backdoor trigger is present. Importantly, our threat model restricts adversaries to modifying only jailbreak samples (not benign data or labels), a constraint unexplored by prior work that makes the second objective particularly challenging. We address this with Omission Attack, which exploits a new phenomenon: when training on concept-absent unsafe samples, the classifier misassociates that concept's presence with the safe label. Both attacks cause substantial and in some cases near-complete label flipping at only a 1% poisoning rate, achieving up to 100% false positive rates and up to 96% false negative rates.

10.
arXiv (CS.CL) 2026-06-24

SURGELLM: Rethinking Multi-Task Evaluation through Task-Aware Feature Gating with Class-Balanced Normalization

Fine-tuned encoders deployed across heterogeneous NLP tasks face three compounding problems: mismatched inductive biases, class-imbalance corruption of feature statistics, and no mechanism to condition attention on external lexical knowledge. We introduce \surgellm, a unified transformer framework that addresses each with a dedicated lightweight module: a surgical feature gate (learned per-dimension sigmoid over curated lexical indicators and \texttt{[CLS]}; provably degenerates to identity when features are uninformative), task-conditioned prefix tokens (quantized feature values and task identity prepended to every input), and Instance-Weighted Normalization (IWN; removes class-prior bias from gate statistics). We prove an excess-risk bound linking gate benefit to surgical feature alignment. Across four tasks, SST-2, multi-hop retrieval, LLM-prompt attribution, and authorship detection, covering 17,830 examples and eleven model variants over three seeds, the IWN variant achieves macro-F1 0.940 ($+0.036$ over the strongest non-IWN baseline; $+0.130$ on authorship detection). A random-vocabulary control ($-0.028$ avg.\ F1) confirms gains are lexical, not parametric. Code, vocabularies, and a $99.5\%$-recovery auto-extraction recipe are released.

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

TMR-GGNN: Credit Card Fraud Detection based on Time-Aware Multi-Relational Guided Graph Neural Network

arXiv:2606.18444v1 Announce Type: cross Abstract: In recent years, credit card fraud detection has faced significant challenges due to highly imbalanced data, evolving fraud patterns, and complex relational structures among transaction entities. To address these issues, this research proposes a novel framework called Timeaware Multi Relational Guided Graph Neural Network (TMR GGNN). Particularly, the proposed TMR GGNN extends the encoder decoder Graph Neural Network GNN architecture by modeling heterogeneous interactions across customers, merchants, devices, and IPs over temporal windows. Subsequently, the proposed TMR GGNN approach constructs a dynamic, multi relational graph and incorporates a time aware relational attention mechanism within the encoder to adaptively weigh the transaction relevance based on temporal proximity and semantic context. Consequently, the decoder employs a contrastive learning module to distinguish between real and synthesized transaction patterns, while improving the models generalization of rare fraud cases. Additionally, to effectively manage severe class imbalances and emphasize discriminative learning, a composite loss function combining Information Noise Contrastive Estimation (InfoNCE) based contrastive loss with Focal Loss is introduced. This integration assists in improving fraud identification while mitigating false negatives.

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

ORCA: A Platform for Open-Source Dexterity Research

arXiv:2606.14561v1 Announce Type: cross Abstract: Robotics manipulation research increasingly focuses on two-finger parallel grippers for their effectiveness, affordability, and ease of teleoperation. Grippers are nonetheless limited by their form factor, often requiring bimanual setups even for simple reorientation tasks. Anthropomorphic hands are a more natural platform for dexterous robot learning – closer to the human hand, and capable of learning from human video – yet they remain hard to use in learning research: even where open and accessible hand hardware exists, the software for control, simulation, teleoperation, and retargeting is scattered in one-off code bases, and largely disconnected from the robot-learning ecosystem. In this work, we introduce the \orca~learning stack, an open-source research stack for dexterity as a first-class robot learning domain. Our \orca~stack unifies low-level control, simulation, teleoperation from a range of consumer platforms, and hand retargeting, behind a single interface, and integrates natively with popular robot-learning frameworks such as \lerobot, so dexterous hand researchers can leverage the same data, training, and evaluation pipelines used for non-dexterous robot learning. We demonstrate a complete end-to-end workflow, collecting expert demonstrations of an in-hand reorientation task by teleoperation with a consumer-grade VR headset, training an autonomous policy with \lerobot, and evaluating the learned policy in a fully reproducible and observable setup. We open-source the entire stack as a shared, reproducible foundation for dexterous-manipulation research.

13.
arXiv (quant-ph) 2026-06-19

Strain- and Electric-Field-Tunable Valley Polarization in Mo0.75V0.25Te2(Mo3VTe8) for Valleytronic Application

arXiv:2606.19954v1 Announce Type: cross Abstract: Valley polarization in 2D TMDs is promising for low-power valleytronic and spin-valley information processing, but time-reversal symmetry in pristine nonmagnetic TMDs keeps the K+ and K- valleys degenerate, limiting device applications. In this work, we investigated the structural stability, electronic properties, and tunable valley polarization of V-alloyed MoTe2 monolayer, Mo0.75V0.25Te2, using first-principles density functional theory (DFT) calculations. Substitutional alloying of MoTe2 with V introduced magnetic exchange interaction, which, together with spin-orbit coupling (SOC), lifted the valley degeneracy at the unequal valleys. The alloyed structure was found to be energetically and dynamically stable due to the absence of imaginary phonon modes. In pristine MoTe2, SOC produced spin splittings of 34.0 meV and 218.9 meV in the conduction bands and valence bands, respectively, but no valley polarization was observed. In contrast, Mo0.75V0.25Te2 exhibited spontaneous valley polarization of 37.3 meV in the conduction band and 78.2 meV in the valence band. The valley polarization was further enhanced by external electric fields and biaxial strain. A transverse electric field along the crystal c axis produced the maximum valley splitting of 132.8 meV in the valence band, whereas biaxial tensile strain increased the valence band valley splitting up to 160.8 meV. The maximum conduction band valley splitting reached 54.4 meV under 2% biaxial compressive strain. These results demonstrated that V alloying, combined with electric-field and strain engineering, provides an effective strategy for achieving large and tunable valley polarization in MoTe2. Thus, Mo0.75V0.25Te2 can be considered a promising 2D platform for tunable valleytronic device applications, such as transistors and sensors.

14.
arXiv (CS.LG) 2026-06-18

MOLAR: Learning Multimodal Molecular Representations from Noisy Labels

arXiv:2606.18390v1 Announce Type: new Abstract: Motivation: Noisy labels are a common challenge in molecular property prediction because molecular annotations are often obtained from assays, curated databases, or weak annotation pipelines rather than directly observed clean biological states. Treating recorded labels as reliable supervision can cause models to memorize corrupted observations and learn misleading molecular evidence. In multimodal molecular representation learning, this issue can be amplified by graph-text fusion or alignment, which may propagate label-induced errors across modalities. Results: We propose MOLAR, a noise-aware framework for learning multimodal molecular representations from noisy labels. MOLAR separates latent clean-property inference from recorded-label observation: graph and text views contribute residual evidence to a clean-property distribution, and a categorical label-observation channel maps this distribution to recorded labels for training. This formulation derives posterior label reliability and modality-specific molecular evidence from the model. Experiments on naturally noisy molecular benchmarks and controlled label-flipping benchmarks show that MOLAR consistently outperforms representative baselines. Visualization analyses further show that MOLAR provides interpretable reliability and modality-evidence diagnostics.

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

Helping Figures Tell their Story! Paper-Grounded Video Generation Explaining Complex Scientific Figures

Scientific figures compress complex pipelines into a single canvas, yet understanding them requires paper-grounded, step-by-step narration aligned with visual highlights a capability missing from current video generation systems and benchmarks. To address this, we introduce paper-grounded figure-to-video generation: generating narrated, region-grounded walkthrough videos from a figure and its paper. We propose MINARD (Multimodal Interpretation of Narrated Architecture via Region Decomposition), a pipeline that generates paper-grounded narrations and sequentially grounds them to figure regions. We also release FigTalk, a benchmark with new sequential and component-level grounding metrics derived. On FigTalk, MINARD generates humanlike, paper-faithful narrations and outperforms narration-conditioned figure spatial grounding compared to existing approaches in both automatic and human evaluation

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

Adiabatically-induced Kawaguchi geometry and jerk in quantum-classical systems

arXiv:2606.16037v1 Announce Type: new Abstract: Adiabatically eliminating the quantum degrees of freedom in a mixed quantum-classical system produces an effective force in the classical equation of motion. The elimination can be made to any order in the adiabatic parameter, generating a series of higher order forces. By applying a sequence of near-identity unitary transformations to the quantum state, we derive a hierarchy of increasingly accurate effective actions for the classical variables. The third order Euler-Lagrange equation is non-Newtonian as the force depends on the jerk, the third order time derivative of position. We find that the third order terms induce a special kind of Kawaguchi geometry on the space of classical variables. This geometry is characterized by an almost symplectic structure and a differential line element that depends on the acceleration in addition to the velocity. Our results can be used to efficiently capture higher order nonadiabatic effects in molecular dynamics simulations.

17.
arXiv (CS.AI) 2026-06-18

From Memorization to Parameter Interference: How Overtraining Experts Harms Model Merging

arXiv:2506.14126v2 Announce Type: replace-cross Abstract: Modern deep learning is increasingly characterized by the use of open-weight foundation models that can be fine-tuned on specialized datasets. This has led to a proliferation of expert models and adapters, often shared via platforms like HuggingFace and AdapterHub. Model merging has recently emerged as an effective way to leverage these existing resources, enabling the composition of capabilities from different model checkpoints. A natural pipeline has thus formed to harness the benefits of transfer learning and amortize sunk training costs: models are pre-trained on general data, fine-tuned on specific tasks, and then multiple checkpoints are merged to obtain a more capable model. A prevailing assumption is that improvements at one stage of this pipeline propagate downstream, leading to gains at subsequent steps. In this work, we challenge that assumption by examining how expert fine-tuning affects model merging. We show that long fine-tuning of experts that optimizes for their individual performance leads to degraded merging performance across vision and language modalities, multiple model scales, and both fully fine-tuned and LoRA-adapted models. We trace this degradation to the memorization of a small set of difficult examples that dominate late fine-tuning steps. This causes negative parameter interference and encodes knowledge that is forgotten during merging. Finally, we demonstrate that task-dependent aggressive early stopping strategies can significantly improve model merging performance.

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

Think Again or Think Longer? Selective Verification for Budget-Aware Reasoning

Test-time reasoning is increasingly used as a serving-time control knob, but extra reasoning is not uniformly valuable: it can repair failed attempts, waste compute on already-correct answers, or introduce harmful answer changes. We study this as a deployment allocation problem rather than a new-verifier problem. We introduce \sevra, Selective Verification for Reasoning Allocation, a serving-layer controller that decides whether to preserve a frozen solver's initial answer or invoke active verification. Using a frozen Qwen3-4B solver, we log intervention outcomes and train recoverability-aware gates from serving-visible attempt state. On \mathfive, selective verification reaches 76.3\% accuracy, compared with 75.5\% for always verifying, while reducing post-generation tokens by 26.8\% and harmful flips from 2.2\% to 1.0\%. However, an 8,192-token initial solve reaches 76.0\% accuracy with 28\% fewer total model tokens, showing that selective recovery is useful but not the best tested cost frontier. In frozen transfer to \gsm, the selective policy verifies only 3.0\% of examples, improves accuracy from 93.4\% to 94.5\%, and reduces verification tokens by 91.2\% relative to always verifying; again, a longer initial solve matches its accuracy with fewer realized tokens. On CommonsenseQA, always-on verification hurts, while Self-Consistency@5 improves accuracy at about five times the realized token cost. The resulting deployment rule is: tune the initial budget first, then use selective recovery when explicit checks, bounded retries, auditability, or regression-risk control matter.

19.
arXiv (CS.CV) 2026-06-17

DRIVESPATIAL: A Benchmark for Spatiotemporal Intelligence in VLMs for Autonomous Driving

Spatiotemporal intelligence in autonomous driving (AD) requires an agent to integrate multi-view observations into a coherent scene representation, maintain object continuity across viewpoints and time, and reason about spatial relations, interactions, and future dynamics. However, existing AD vision-language benchmarks largely focus on single-view, static, ego-centric, or single-source question answering, leaving it unclear whether current Vision-Language Models (VLMs) can truly construct and reason over dynamic driving scenes. We introduce DriveSpatial, a benchmark of 15.6K human-verified QA pairs across 20 tasks from five large-scale AD datasets. DriveSpatial evaluates four abilities: Cognitive Scene Construction, Multi-view Relational Understanding, Temporal Reasoning, and Generalization. Unlike prior benchmarks, DriveSpatial is generated from a dynamic multi-relational scene graph that encodes object states, spatial relations, interactions, camera visibility, and temporal correspondences, enabling QA pairs that enforce genuine cross-view and spatiotemporal reasoning. Evaluating 15 representative VLMs reveals a substantial human-model gap: the strongest model trails humans by 28.4 points, with Cognitive Scene Construction emerging as the key bottleneck. Further diagnostics show that language-only prompting is insufficient, while explicit BEV grounding consistently improves performance. These results suggest that current VLMs lack the scene-construction ability needed for reliable spatiotemporal driving intelligence. DriveSpatial and its construction pipeline will be released to support future research.

20.
arXiv (CS.CL) 2026-06-11

Measuring Epistemic Resilience of LLMs Under Misleading Medical Context

Large language models (LLMs) now reach expert-level scores on medical licensing exams, encouraging the assumption that high scores imply safe medical judgment while patients increasingly use them for health advice. We show this assumption is fragile: when misleading context is injected into questions that LLMs originally answer correctly, they abandon the correct answer. We call the ability to maintain correct judgment under adversarial context epistemic resilience, and introduce MedMisBench to measure it. MedMisBench contains 10,932 medical question items and 48,889 misleading context-option pairs spanning medical reasoning, agentic capability, and patient-journey evaluation. Across 11 model configurations, mean accuracy falls from 71.1% on original questions to 38.0% under focused misleading context, with 51.5% attack success. The most damaging injections are formal, rule-like fabrications: authority-framed falsehoods reach 69.5% attack success and exception-poisoning claims reach 64.1%. A 14-member clinical panel from 7 countries identified serious potential harm in 38.2% of reviewed cases. MedMisBench exposes a structural blind spot in LLM evaluation in medical settings: existing benchmarks measure what models know, but not whether they preserve correct medical judgment under misleading context.

21.
medRxiv (Medicine) 2026-06-16

Development of a symptom-based severity score anchored to health-related quality of life post-COVID-19 within the population-based EPILOC cohorts

Purpose Because simple symptom counts treat all symptoms as equally important and may not adequately capture the HRQoL impact of heterogeneous post-COVID-19 symptoms, we aimed to develop an HRQoL-anchored symptom severity score providing an interpretable measure of post-COVID-19 disease burden. Methods Baseline data from the population-based EPILOC and EPILOC Omicron surveys (adults aged 18-65 years) were used to develop a symptom-based severity score anchored to physical and mental HRQoL assessed with the SF-12. A two-stage modelling approach was applied to identify HRQoL-relevant symptoms and to derive symptom-specific weights for physical and mental component scores, incorporating 30 ordinal symptom severity variables. Symptom-specific weights were extracted to compute physical, mental, and composite severity scores. Score interpretation was examined using external reference measures, including EPILOC case status, self-reported health recovery, and functional consequences. Results A total of 19,004 participants (mean age 44.3 years, 59.6% female) were included. Sixteen symptoms contributed to the physical and eleven to the mental HRQoL score, with a limited subset accounting for most of the HRQoL loss. Severity scores were heavily right-skewed, with 50.6% of participants showing no measurable HRQoL impairment. Higher scores correlated with lower self-reported recovery, and increased probability of rehabilitation use and health-related changes in working time, supporting convergent and criterion-related validity. Conclusions This study introduces a transparent, HRQoL-anchored symptom severity score that measures graded post-COVID-19 burden beyond simple symptom counts. The score may be particularly suited for longitudinal assessment of recovery trajectories.

22.
arXiv (CS.CL) 2026-06-18

Language Models as Interfaces, Not Oracles: A Hybrid LLM-ML System for Pediatric Appendicitis

Large language models (LLMs) can make clinical decision support more accessible by interpreting free-text documentation, but their direct use as diagnostic engines is limited by sensitivity to prompts, information order, and plausible but incorrect outputs. Structured machine-learning models offer more stable risk prediction, yet they require tabular inputs that are difficult to integrate with narrative clinical workflows. We present ClaMPAPP (Clinical Language-assisted Machine-learning Pipeline for Appendicitis), a hybrid system that uses an LLM as an interface rather than as the final decision-maker. ClaMPAPP extracts schema-constrained clinical features from note-like narratives, applies deterministic plausibility checks, and passes validated features to an XGBoost classifier trained on clinical, laboratory, and ultrasound variables. We evaluated ClaMPAPP on two independent pediatric appendicitis cohorts from German hospitals and compared it with end-to-end LLM baselines, including open-source and proprietary models. To preserve ground truth while testing free-text input, narratives were generated from structured electronic health records through template rendering and constrained LLM rewriting, with additional sentence-order permutation to assess positional robustness. ClaMPAPP achieved the strongest overall diagnostic performance in both internal and external validation while minimizing missed appendicitis cases, the key safety concern in acute triage. End-to-end LLMs showed unstable sensitivity-specificity trade-offs and greater degradation under narrative reordering. These results support an LLM-as-interface, ML-as-predictor design that separates natural-language usability from predictive inference and provides a more auditable pathway for clinical decision support.

23.
medRxiv (Medicine) 2026-06-16

Physiological Aging of the Respiratory System (PARS): from development to application

Background: Aging has a critical role in lung changes and the outcome of lung disease. Several lung aging equations have been proposed to measure deviation from physiological aging of the respiratory system. In this study, we aimed to develop a single measure of accelerated lung aging and show its application as a measure of lung aging. Method: We used a pre-bronchodilator pulmonary function test (PFT) from NHANES adult participants recruited from 2007 to 2011. We applied Klemera-Dubal Method (KDM) to four PFT measurements, FEV1, FVC, FEF25-75, and PEF, to calculate a measure of lung biological aging. Physiological Aging of the Respiratory System (PARS) was calculated from the residual method vs. chronological age. We tested the construct validity of PARS by measuring its association with risk factors of lung health. The prognostic validity was measured using a survival analysis. Sampling weights were applied to all analyses. Results: In 14,123 adult participants, the mean (SD) of accelerated lung age (PARS) was 0 (8.2) years. Participants with a history of asthma and emphysema had 4- and 10-year higher PARS. Cigarette smoking, lower socioeconomic status, black race, higher serum cadmium, and lower serum selenium and magnesium were associated with higher PARS. During 116 months of follow-up, PARS was associated with a higher mortality (HR = 1.06, 95%CI: 1.05-1.07 per year). Females with higher PARS had a higher risk of death (P for interaction < 0.001). Results were consistent across different subgroups and sensitivity analyses. Conclusion: PARS is a noninvasive lung aging marker and can be applied as a single measure of lung accelerated aging in the adult population. Its strong construct and predictive validity support its future application among different populations with and without lung disease.

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

Towards Multi-Agent-Simulation-Based Community Note Evaluation

arXiv:2606.18268v1 Announce Type: cross Abstract: Community-based fact-checking that relies on cross-consensus is expanding rapidly on social media platforms. However, the delay and low-ratio of cross-consensus community fact-checks rated by human contributors remains a significant challenge. To address this, we first created ComRate, a large-scale dataset comprising 2.5 million community notes and over 209 million ratings sourced from $\mathbb{X}$. We then propose MultiCom, a persona-guided multi-agent rating framework for community note evaluation. MultiCom simulates diverse rater population by clustering contributors in a matrix-factorized rater space and prompting persona agents to generate structured assessments based on the official community notes rating schema. These agents output structured and explainable judgments, such as confidence, agreement signals and reasons. An out-of-fold calibrated aggregation algorithm combines features such as raw votes and diagnostic reason signals for reliable prediction. Extensive evaluations demonstrate that MultiCom outperforms alternative methods, achieving an average accuracy of 84.7% (balanced accuracy 68.3%, macro-F1 60.1%) on the evaluation set.

25.
arXiv (CS.CL) 2026-06-15

The Culture Funnel: You Can't Align What isn't in the Data

Current cultural alignment approaches focus on inference-time interventions, assuming models already contain sufficient cultural knowledge. We argue modern LLM pipelines suffer from a cultural data funnel. Using a multidimensional tagging framework across pretraining, fine-tuning, alignment, and reasoning datasets, we show explicit cultural signals decline sharply during post-training, while geographically concentrated, task-specialized data dominates. Multilinguality enhances geographic diversity of cultural knowledge but does not ensure balanced representation. Our tags improve downstream cultural benchmark performance, demonstrating that advances require shifting focus in training data pipelines. To facilitate future research, we release our culturally tagged dataset with 5.6M samples at https://huggingface.co/datasets/CohereLabs/CultureMarkers.