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01.
arXiv (quant-ph) 2026-06-11

Holographic Complexity, Extremality, and Cosmic Censorship

arXiv:2604.20170v2 Announce Type: replace-cross Abstract: We propose a holographic complexity origin for the third law of black-hole mechanics and weak cosmic censorship. In both complexity equals action and complexity equals volume prescriptions, the relative complexity between subextremal and extremal AdS black holes diverges logarithmically. For overcharged RN-AdS, explicit calculations in both prescriptions show that the near-singularity action terms are power-law divergent or finite, while the maximal-volume contribution is finite. Thus, the extremal-to-naked relative complexity also diverges, obstructing finite-time transitions.

02.
arXiv (quant-ph) 2026-06-12

Proper and improper mixed states serve as different prior beliefs for quantum state retrodiction

arXiv:2502.10030v2 Announce Type: replace Abstract: A mixed quantum state can be taken as capturing an unspecified form of ignorance; or as describing the lack of knowledge about the true pure state of the system ("proper mixture"); or as arising from entanglement with another system that has been disregarded ("improper mixture"). These different views yield identical density matrices and therefore identical predictions for future measurements. But when used as prior beliefs for inferring the past state from later observations ("retrodiction"), they lead to different updated beliefs. This is a purely quantum feature of Bayesian agency. Based on this observation, we establish a framework for retrodicting on any quantum belief and we prove a necessary and sufficient condition for the equivalence of beliefs. We also illustrate how these differences have operational consequences in quantum state recovery.

03.
Nature (Science) 2026-06-24

Genetic technologies to enhance crop nutritional value under climate change

At present, more than 700 million people live with caloric hunger, and more than two billion suffer from micronutrient deficiencies, known as ‘hidden hunger’. From an agricultural viewpoint, three major objectives need to be worked towards simultaneously to achieve zero hunger (the United Nations Sustainable Development Goal 2): (1) enhanced yield; (2) higher vitamin and mineral density to sustain recommended daily intake (multi-biofortification); and (3) enhanced climate-change resilience. Although the Green Revolution increased global calorie production, it exacerbated hidden hunger by prioritizing high yield over nutritional quality. Stress from global climate change has been shown to reduce the densities of several micronutrients. CRISPR–Cas, which allows genome editing with extremely high precision, has emerged as a groundbreaking breeding technology that has already been adopted by many countries. Here we examine how CRISPR–Cas-based approaches could be used to achieve biofortification targets by enhancing micronutrient densities to the levels necessary to alleviate dietary vitamin and mineral deficiencies. Given the limited time frame available to achieve zero hunger, we argue that CRISPR–Cas technologies should be combined with metabolic engineering based on transformation and other technologies. We also consider untapped resources beyond metabolic pathways and current CRISPR–Cas methodologies to address one of the most important societal issues of the twenty-first century. This Review reflects on the joint power of genetic technologies, including untapped CRISPR–Cas techniques to combat hidden hunger and improve crop resilience, and argues in favour of their combined use to overcome these societal challenges.

04.
arXiv (CS.CV) 2026-06-16

Mitigating Visual Hallucinations in Multimodal Systems through Retrieval-Augmented Reliability-Aware Inference

Multimodal large language models (MLLMs) have demonstrated strong capabilities in vision-language understanding and natural-language response generation. However, these systems can still produce overconfident predictions and hallucination-like outputs, particularly when the visual evidence is weak, ambiguous, or semantically inconsistent. Most existing approaches focus on improving multimodal representation alignment or retrieval-augmented generation, while providing limited mechanisms to quantify instance-level prediction reliability or identify incorrect visual outputs. This work proposes a retrieval-augmented reliability-aware inference framework for trustworthy multimodal visual understanding. The proposed framework constructs an external visual evidence database using pretrained visual embeddings and nearest-neighbor retrieval over normalized feature representations. Retrieved evidence is used to estimate prediction trustworthiness through multiple reliability indicators, including similarity strength, class-support agreement, evidence margin, entropy-based uncertainty, and an aggregate reliability score. Based on these signals, a decision gate determines whether the system should accept the prediction, answer with caution, or abstain/fallback when evidence is insufficient. A multimodal response-generation layer then produces a final user-facing response conditioned on the reliability decision. Experiments on ImageNet-100 demonstrate that the proposed reliability-aware framework improves accepted prediction accuracy from 85.84\% to 88.88\% at 89.04\% coverage. The hallucination-like accepted wrong-answer rate is reduced from 14.16\% to 11.12\%. These results show that integrating retrieval evidence, reliability estimation, and selective decision gating can improve calibration and reduce overconfident visual errors without retraining large multimodal models.

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

UniDexTok: A Unified Dexterous Hand Tokenizer from Real Data

Dexterous hands are essential for fine-grained manipulation, but their hardware designs vary substantially across embodiments. Differences in kinematics, joint definitions, and degrees of freedom make it difficult to define a shared state representation compared with parallel grippers. As a result, dexterous-hand data remains fragmented and difficult to use for joint training. In this work, we propose the Unified Dexterous Hand Model (UDHM), which maps human and robot hand states into a shared 22-DoF semantic interface. Based on UDHM, we introduce UniDexTok, a retargeting-free state tokenizer that learns embodiment-conditioned discrete tokens from standardized real joint states. UniDexTok provides a unified representation for heterogeneous dexterous hands without relying on retargeting or simulation data. Compared with the recent baseline UniHM, UniDexTok reduces MPJAE from 15.63 degrees to 0.16 degrees and MPJPE from 18.51 mm to 0.18 mm, corresponding to error reductions of 98.98% and 99.03%, respectively. These results improve reconstruction from centimeter-scale to sub-millimeter accuracy. Experiments further show that data from other embodiments improves target-embodiment reconstruction accuracy, demonstrating the benefit of cross-embodiment tokenization. UniDexTok also shows strong zero-shot and few-shot reconstruction ability when new dexterous hands are introduced.

07.
arXiv (CS.AI) 2026-06-16

PANDA: An LLM-Enhanced Performance-Driven Analog Design Framework Bridging Design Intent and Layout Generation

arXiv:2606.15052v1 Announce Type: cross Abstract: Traditional design of analog circuits heavily relies on manual interventions across topology, sizing, and layout, with prior automation addressing stages in isolation. In this work, we propose PANDA, an LLM-enhanced framework that bridges high-level design intent to final layout by actively managing cross-stage dependencies through guided topology synthesis, substructure-aware sizing, and constraint-driven layout generation. This shifts automation from algorithm-centric execution to intent-centric co-design, reducing turnaround time from days or weeks to hours while improving design performance.

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

Avoiding Exponential Blow-Up in Distributive Lattice Submodular Minimization

作者:

Submodular function minimization has gained a lot of interest in recent years. They are highly applicable in the area of Computer Vision and Machine Learning. Often such applications require to work with submodular functions defined on distributive lattice. Current best way of dealing with it is using a transformation which extrapolates the submodular function for the respective boolean lattice. It makes optimization system too inefficient due to enlargement of the working space. Quantitatively, the expanded space has additional exponential (in set size) number of elements. We propose a generic framework for dealing with distributive lattice which only works within distributive lattice. Our framework allows one to use already established submodular function minimization algorithms for boolean lattice. In our experiment, we show the huge improvement in terms of running time over tranditional methods for handling distributive lattice.

09.
arXiv (CS.AI) 2026-06-17

Brep2Shape: Boundary and Shape Representation Alignment via Self-Supervised Transformers

arXiv:2602.07429v2 Announce Type: replace-cross Abstract: Boundary representation (B-rep) is the industry standard for computer-aided design (CAD). While deep learning shows promise in processing B-rep models, existing methods suffer from a representation gap: continuous approaches offer analytical precision but are visually abstract, whereas discrete methods provide intuitive clarity at the expense of geometric precision. To bridge this gap, we introduce Brep2Shape, a novel self-supervised pre-training method designed to align abstract boundary representations with intuitive shape representations. Our method employs a geometry-aware task where the model learns to predict dense spatial points from parametric Bézier control points, enabling the network to better understand physical manifolds derived from abstract coefficients. To enhance this alignment, we propose a Dual Transformer backbone with parallel streams that independently encode surface and curve tokens to capture their distinct geometric properties. Moreover, the topology attention is integrated to model the interdependencies between surfaces and curves, thereby maintaining topological consistency. Experimental results demonstrate that Brep2Shape offers significant scalability, achieving state-of-the-art accuracy and faster convergence across various downstream tasks.Code is available at this repository: https://github.com/thuml/Brep2Shape.

10.
arXiv (CS.LG) 2026-06-11

Flow Matching with In-Context Priors for Out-of-Distribution Brain Dynamics

arXiv:2606.11833v1 Announce Type: new Abstract: Flow matching and diffusion models enable conditional generation across domains ranging from images to proteins, with recent extensions to out-of-distribution contexts. Yet generative models of neural time series have largely remained restricted to categorical conditioning, precluding compositional and zero-shot generalization. In this work, we propose a per-timestep conditioned diffusion transformer for generating realistic fMRI brain dynamics during unseen cognitive tasks by injecting both compositional language and optional spatial priors in-context. Such zero-shot generation could enable counterfactual neuroscience by supporting in-silico design and evaluation of novel cognitive experiments before empirical validation. Leveraging this model, we evaluate across hundreds of held-out task conditions and characterize predictive performance in relation to the training manifold. From language alone, the model recovers region-specific recruitment across tasks and held-out spatial activation patterns. Spatial priors, when available, complement the text pathway by anchoring generation in regions of task space where language alone degrades, while retaining the compositional structure needed for counterfactual task specification. To our knowledge this is the first generative model of whole-cortex fMRI dynamics for unseen cognitive tasks, advancing counterfactual neuroscience and data-driven experimental design.

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

MolSight: Molecular Property Prediction with Images

Every molecule ever synthesised can be drawn as a 2D skeletal diagram, yet in modern property prediction this universally available representation has received less focus in favour of molecular graphs, 3D conformers, or billion-parameter language models, each imposing its own computational and data-engineering overhead. We present $MolSight$, the first systematic large-scale study of vision-based Molecular Property Prediction (MPP). Using 10 vision architectures, 7 pre-training strategies, and $2\,M$ molecule images, we evaluate performance across 10 downstream tasks spanning physical-property regression, drug-discovery classification, and quantum-chemistry prediction. To account for the wide variation in structural complexity across pre-training molecules, we further propose a $chemistry-informed curriculum$: five structural complexity descriptors partition the corpus into five tiers of increasing chemical difficulty, consistently outperforming non-curriculum baselines. We show that a single rendered bond-line image, processed by a vision encoder, is sufficient for competitive molecular property prediction, i.e. $chemical insight from sight alone$. The best curriculum-trained configuration achieves the top result on $5 of 10$ benchmarks and top two on $all 10$, at $$80$\times$ lower$$ FLOPs than the nearest multi-modal competitor.

12.
bioRxiv (Bioinfo) 2026-06-23

Model-based inference of gene expression noise from single-cell RNA-sequencing data

The heterogeneity of expression levels among genetically identical cells, termed gene expression noise, is a property of the gene expression process whose importance in the biology of organisms and their evolution is increasingly recognized. Measuring gene expression noise requires single-cell expression data, as obtained from single-cell RNA sequencing (scRNASeq). Its estimation, however, is challenging owing to (i) the presence of technical noise in addition to biological noise, and (ii) the heterogeneity of cell types in the sampled population. We propose a maximum-likelihood framework to infer biological noise from scRNASeq data, while accounting for technical noise, dropout probabilities, and distinct cell sequencing depths. We demonstrate the parameter identifiability using simulations and that the resulting noise estimates are uncorrelated from the mean gene expression, and therefore do not need extra correction in downstream analyses, easing intra- and inter- genome comparisons. Using two technical replicates of scRNASeq data from the wild yeast *Saccharomyces paradoxus*, we show that expression noise can be inferred in a reproducible manner.

13.
arXiv (CS.CV) 2026-06-16

Sub-Semantic Image Segmentation

Images can be segmented based on visual cues (i.e., texture segmentation) or into objects (i.e., semantic segmentation). We propose a new category of sub-semantic image segmentation that blurs the line between the two. In sub-semantic image segmentation, language is not used to name whole objects. Instead, it is used to partition an image into stable appearance patterns that can be described by language. To do that, we couple a general-purpose vision-language model to SAM 3, a promptable segmentation backbone whose native text pathway can ground rich descriptions into masks. Simple coupling fails for a number of reasons that we identify in the paper, and we overcome them by introducing DETECTURE that resolves three concrete failure modes – language leakage between texture regions, prompt competition inside the segmentation backbone, and semantic distortion at the language-to-mask interface. Since there is no dataset of sub-semantic image segmentation, we introduce one, termed TextureADE. The new dataset is derived from the ADE20K dataset using a system we designed. We compare DETECTURE to a number of baselines and find that it achieves the strongest performance on several datasets using different metrics. Code is available at https://github.com/Scientific-Computing-Lab/TextureDetecture.

14.
medRxiv (Medicine) 2026-06-10

Global and local genetic overlap among ME/CFS, irritable bowel syndrome and psychiatric traits: a hypothesis-generating analysis

作者:

Background. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and irritable bowel syndrome (IBS) frequently co-occur following infection, yet shared genetic architecture at the locus level has not been systematically characterised. Aims. To estimate global and local genetic correlations between ME/CFS (including infection-onset subgroup), IBS, major depressive disorder (MDD) and loneliness/isolation, and characterise ME/CFS cell-type heritability enrichment. Method. GWAS summary statistics: DecodeME (15,579 ME/CFS; 9,738 infection-onset), FinnGen R9 (9,296 IBS), PGC MDD Wave 2 (45,396) and UK Biobank loneliness (N=455,364). LDSC for global correlations; LAVA for local correlations across 2,495 loci; MAGMA for cell-type enrichment (Descartes Human atlas); coloc.abf for colocalisation. Results. All pairwise global correlations were significant after Bonferroni correction, including ME/CFS-all-MDD (rg=0.598, 95% CI 0.46-0.74) and ME/CFS-all-IBS (rg=0.573, 0.39-0.75). Of 4,232 local tests, 16 reached FDR

15.
arXiv (quant-ph) 2026-06-16

Quantum Algorithm for Open-System Battery Cathodes by Modeling Multiple Strongly Coupled Holstein Polarons with Chain-Mapped Caldeira-Leggett Dynamics

arXiv:2606.16017v1 Announce Type: new Abstract: Cathode lithiation occupies a chemical regime of tightly localized orbitals, narrow bandwidths, and strong electron-lattice coupling. The defining electrochemical observables (open-circuit voltage and differential capacity) are open-system, reservoir-equilibration quantities that closed-Hamiltonian quantum simulation cannot produce, set by exchange with electron, Li$^+$, and phonon baths. We present a fault-tolerant quantum algorithm that recovers them through a unitary chain-mapped Caldeira-Leggett embedding, rendering the baths Trotterizable. The resulting fourth-order Trotter step has a T-gate count polynomial in system size, validating its open-system dynamics against hierarchical equations of motion (HEOM) at strong coupling and the Lindblad limit at weak coupling. For single-carrier olivine LiFePO$_4$, a single voltage anchor on an otherwise DFT-fixed Hamiltonian places the differential-capacity peak within the $\pm5$ mV reproducibility of the experimental plateau. For multi-carrier spinel LiMn$_2$O$_4$, whose $1{:}1$ Mn$^{3+}$/Mn$^{4+}$ filling makes the inter-site Coulomb repulsion dynamically active, the same kernel yields a two-plateau voltage curve with a $125$ mV split, within $17\%$ of the observed $150$ mV. We deliver an end-to-end fault-tolerant resource estimate for such a multi-carrier, three-reservoir observable: $368$ logical qubits and $\sim3\times10^5$ T-gates per step, or $\sim1.7\times10^{12}$ T-gates for a full voltage curve (parallelizable over $\sim10^3$ trajectories), leaving the production-scale dynamical run as a milestone for future hardware. The same kernel reproduces macroscopic quantum coherence, two-band superconductivity, and the Mikheyev-Smirnov-Wolfenstein resonance without modification, placing dynamical battery chemistry and similar Hamiltonians within scope for fault-tolerant quantum simulation.

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

Spokes: Optimizing for Diverse Pretraining Data Selection

Diversity plays a critical role in data selection, improving performance under fixed data budgets by reducing redundancy and repetition. However, optimizing for diversity is inherently challenging, as it is a set-level property that depends on interactions between data points rather than individual examples. As a result, existing approaches typically rely on proxies or approximations, which often fail to ensure sufficiently diverse subsets. In this work, we directly optimize diversity by introducing a probabilistic diversification framework based on the G-Vendi score, optimized via exponentiated gradient descent. Our method produces subsets that are substantially more diverse than those obtained via random sampling, achieving a +489 increase in G-Vendi score on a 500k-sample subset. We evaluate our approach on FineWeb and DCLM, where it consistently outperforms existing methods. Notably, SPOKES (diversity-only) improves average downstream performance by +0.4 and +0.5 points over random sampling on DCLM and FineWeb, respectively. More importantly, jointly optimizing for both quality and diversity yields the strongest results: SPOKES achieves gains of +1.5 and +1.4 points on DCLM and FineWeb, outperforming all baselines, including semantic deduplication and quality filtering.

17.
arXiv (CS.CV) 2026-06-11

MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training

Despite recent progress in text-prompt-based medical image segmentation, existing LISA-like MLLM-based methods typically generate masks regardless of whether the target specified in the query is present, leading to hallucinated segmentation. In this work, we propose MedVeriSeg, a training-free query verification framework that enables LISA-like medical segmentation models to reject false segmentation queries. MedVeriSeg first quantifies the response quality between the [SEG] token and image features through a Similarity Response Quality Scoring Module. To further improve robustness, it employs a Lightweight Routed Multi-Agent Verification Module, which fuses quantitative score evidence with qualitative agent evidence to comprehensively verify the validity of the query. To support systematic evaluation, we construct MedVeriSeg-Bench, a benchmark designed for query verification in medical image segmentation. Experimental results demonstrate that MedVeriSeg effectively identifies false segmentation queries and reduces hallucinated segmentation, while maintaining a high acceptance rate for valid queries, thereby largely preserving the segmentation utility of LISA-like medical segmentation models.

18.
arXiv (quant-ph) 2026-06-17

Quantum mechanics in configuration space in context

arXiv:2606.17622v1 Announce Type: new Abstract: To enhance the way in which wave-particle duality is implemented in the modelling of quantum mechanical systems, Bukhari et al. [New J. Phys. 27, 084501 (2025)] recently introduced an alternative approach to quantum mechanics, namely quantum mechanics in configuration space. This formalism is based on a physically motivated quantisation of Newtonian mechanics and promotes the classical position-velocity states (x,v) to pairwise distinguishable quantum states. The resulting |x,v> states form the basis of the Hilbert space of individual quantum mechanical particles and evolve along classical trajectories. In this paper, we consider the modelling of a mechanical particle in free space and put quantum mechanics in configuration space into context. It is shown that this formalism increases the continuity between quantum and classical mechanics by avoiding a conceptual inconsistency associated with the definition of momentum in canonical quantisation. In addition, we emphasise that standard quantum mechanics and quantum mechanics in configuration space are based on two distinct formulations of classical mechanics.

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

Bridging Creative Intent and Visual Quality: Creator-Driven Recurrent Video Generation with Agentic Feedback Loops

Generative AI has made content creation increasingly accessible, but many AI-generated videos lack narrative coherence and creative direction, issues that become more substantial at longer durations. Unlike coding, where AI generation benefits from reliable feedback and techniques such as recurrent self-improvement, video generation requires subjective feedback about plot, scenes, and narrative, which naturally motivates approaches that incorporate human creative direction. We introduce CHIEF, a human-AI co-creation video generation framework that places the creator at the center of human-in-the-loop iterative video refinement, and supports them by providing automatic subjective feedback. The creator incorporates their creative direction by driving each iteration, while their revisions are incorporated by a specialized refiner agent. The feedback loop is generated by persona-conditioned multimodal LLMs that watch generated videos and produce subjective critique from the audience perspectives, providing feedback that self-evaluation alone cannot capture. To test the effectiveness of our proposed framework, we work with high school and college students with no prior filmmaking experience to create videos, from short 1-minute videos to a complete short 10-minute film with a complicated plot.

20.
arXiv (quant-ph) 2026-06-17

$\mathcal{PT}$-Symmetric Spin–Boson Model with a Continuous Bosonic Spectrum: Exceptional Points and Dynamics

arXiv:2512.20277v2 Announce Type: replace Abstract: This work studies a $\mathcal{PT}$-symmetric non-Hermitian spin–boson model, consisting of a non-Hermitian two-level system coupled to a continuous bosonic bath. The static properties of the system are analyzed through a projection method derived from the displacement operator. We find that only a single exceptional point (EP) emerges, in contrast to non-Hermitian spin–boson models with finite modes, which typically exhibit multiple EPs. Notably, only a single real eigenvalue is found before the EP, which differs markedly from typical non-Hermitian systems where a pair of real eigenvalues precedes the EP. The time evolution of observables is further investigated via the Dirac–Frenkel time-dependent variational principle. Compared to its Hermitian counterpart, the non-Hermitian model exhibits distinct dynamical signatures, most notably the emergence of oscillations with periodic amplified amplitude. In the $\mathcal{PT}$-unbroken phase, the system exhibits sustained oscillatory dynamics with suppressed decoherence, whereas in the $\mathcal{PT}$-broken phase, additional dissipative channels accelerate decoherence and drive rapid convergence toward a stable steady state. These results shed light on how $\mathcal{PT}$ symmetry protects coherent light–matter interactions in non-Hermitian quantum systems.

23.
arXiv (quant-ph) 2026-06-24

Dimensionality Reduction of QAOA Parameter Space with Kernel PCA for Max-Cut

arXiv:2606.23718v1 Announce Type: new Abstract: The Quantum Approximate Optimization Algorithm (QAOA) is a leading variational algorithm for combinatorial optimization on near term quantum devices. As circuit depth increases, the number of optimization parameters grows, making the search landscape increasingly nonlinear and difficult to optimize. Previous studies have shown that optimal QAOA parameters often lie on a low dimensional manifold that can be approximated using Principal Component Analysis (PCA) at shallow circuit depths. However, the effectiveness of PCA decreases at higher depths because the underlying parameter manifold becomes increasingly nonlinear. In this work, we investigate Kernel Principal Component Analysis (KPCA) with a radial basis function kernel as a nonlinear dimensionality reduction technique for QAOA parameter optimization. The model is trained using 200 graphs from each of 3 graph families, namely Erdos-Renyi, Barabasi-Albert, and Watts-Strogatz, with graph sizes ranging from 7 to 10 nodes. Performance is evaluated on 30 test graphs containing 12 nodes at circuit depths 1, 2, 4, and 8. Experimental results demonstrate that KPCA consistently outperforms PCA at deeper circuit depths across all graph families. At depth 8, KPCA achieves approximation ratios above 0.86, while PCA declines to approximately 0.81 to 0.83. Both methods reduce the number of quantum circuit evaluations by more than 93 percent relative to unrestricted QAOA optimization. These findings suggest that nonlinear kernel methods more effectively capture the structure of the QAOA parameter manifold and provide a practical approach for scaling variational quantum optimization to deeper circuits.

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

Bridging the Manifold Gap: Riemannian Residual Line Search for One-Step Image Editing

One-step diffusion editors are fast because they avoid inversion and iterative optimization, but a single transport update must be aggressive enough to realize the target prompt and conservative enough to preserve the source image–and no fixed update strength satisfies both demands across edit types. We treat this tension as a post-hoc candidate-selection problem on top of energy-field transport rather than as a new editing model. Our proposed method, Riemannian Residual Line Search, first builds a stronger edit by estimating the local time curvature of the prompt-delta field and projecting the corrected direction back onto the update norm of the original first-order energy-field transport estimation. It then forms a small residual path from the source image to this strong edit, retains the original first-order output as one candidate, and picks the final image by maximizing target-prompt CLIP alignment. On a 700-sample PIE-Bench++ evaluation across 10 edit type IDs, our method achieves state-of-the-art (SOTA) performance among current one-step update algorithms.

25.
arXiv (CS.CV) 2026-06-16

iTRIALSPACE: Programmable Virtual Lesion Trials for Controlled Evaluation of Lung CT Models

We introduce iTRIALSPACE, a programmable evaluation framework for controlled assessment of lung CT models. Standard benchmarks are static retrospective collections that entangle lesion size, lobe prevalence, anatomy, and acquisition context, making it difficult to determine what structurally drives model accuracy. iTRIALSPACE addresses this limitation by composing real clinical CTs and lesion profiles into controlled virtual lesion trials through a four-stage pipeline: multidataset nodule profiling, explicit trial specification, anatomy-aware mask insertion, and ControlNet-conditioned CT synthesis. The framework is built on a unified 54-attribute nodule-profile dataset spanning 13,140 annotated nodules from seven public CT sources and instantiated as 13 trial modes. We evaluate iTRIALSPACE in a 55,469-sample Virtual Lesion Study spanning three medical VLMs, four spatialguidance conditions, and three clinical tasks. Across all 13 modes, the synthetic substrate remains within the real-to-real FID baseline, and synthetic performance rankings transfer strongly to real clinical data ($\rho$ = 0.93, p < 10$^{-15}$). Controlled trial modes expose findings unavailable to fixed-distribution benchmarks, including shortcut-driven size prediction collapse under lobe-equalized sampling and hostto-donor variance ratios of 8.9x and 3.3x in twin-cross analysis. These results position iTRIALSPACE as an auditable evaluation infrastructure for controlled, falsifiable testing beyond static retrospective benchmarks.