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

Reliability of Probabilistic Emulation of Physical Systems

arXiv:2606.12997v1 Announce Type: new Abstract: Two dominant approaches have emerged for generating probabilistic forecasts of physical systems: generative models, such as diffusion or flow matching; and ensembles of deterministic models with stochasticity injected, trained using the continuous ranked probability score (CRPS) loss. While both approaches have demonstrated strong predictive accuracy, the reliability of their uncertainties has not been systematically assessed. We address this gap by developing a framework to evaluate both approaches across diverse 2D spatiotemporal physical systems, under matched model size and computational budget. We assess the reliability of probabilistic emulation by inspecting the empirical coverage of predictive intervals, while also considering accuracy and computational efficiency metrics. CRPS-trained ensembles typically achieve more reliable uncertainties on both single-step prediction and autoregressive rollouts, demonstrating better coverage than the standard alternative of training generative models in a latent space. Moreover, the CRPS approach offers significantly faster inference. When generative models are trained in ambient rather than a compressed latent space, which is often infeasible for high-dimensional problems, they exhibit comparable coverage to CRPS-trained ensembles, though with substantially larger inference latency. In contrast, when CRPS-trained ensembles are trained in latent space they do not show a marked degradation in coverage with respect to ambient space. Both generative models and CRPS-trained ensembles demonstrate good predictive accuracy. To facilitate future research and application, we release AutoCast, a modular framework implementing both generative models and CRPS-trained ensembles, alongside AutoSim, a flexible dataset generation package for rapid prototyping.

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

QueryMarket: Cost-Aware Online Active Learning in Data Markets

arXiv:2606.17805v1 Announce Type: new Abstract: Data acquisition is a major bottleneck for learning in real-time streams: analysts must decide on the fly which labels to purchase while respecting a rolling budget. However, existing online active learning rarely unifies pricing, information gain, and rolling budget constraints under concept drift. We introduce QueryMarket, a market-inspired framework that queries each incoming data point based on its estimated utility to the model and its price. Within this framework, we propose OVBAL (online variance-based active learning), which integrates data pricing with information-driven selection by estimating each sample's marginal utility via a D-optimality criterion with exponential forgetting and executing cost-aware purchases under rolling budget constraints. OVBAL yields a simple, fully online decision rule that adapts to nonstationary streams and heterogeneous label costs. Experiments on synthetic data and a real-world solar power generation forecasting task show that OVBAL is particularly effective under seller-centric pricing and yields a more favorable long-run error-cost trade-off in the real-world task under both pricing schemes.

03.
medRxiv (Medicine) 2026-06-22

Generative Artificial Intelligence in Psychotherapy Practice: A Global Online Survey of Mental Health Professionals' Adoption

Background: Generative artificial intelligence (GenAI) tools, including large language model (LLM)-based platforms such as ChatGPT, Google Gemini, and Microsoft Copilot, are being adopted across healthcare settings with increasing speed. Despite the increasing popularity of GenAI, empirical data on the extent and nature of adoption by mental health clinicians in routine psychotherapy practice globally remain scarce. Objective: This study aimed to characterize current use patterns of GenAI tools among a global sample of practicing mental health professionals, including prevalence of use, specific tools employed, clinical and administrative purposes served, perceived effect on workload, and the institutional context shaping adoption (e.g., encouragement, prohibition, and training). Methods: We administered a cross-sectional online survey to a global convenience sample of licensed mental health professionals who provide psychotherapy as part of the scope of their practice (i.e., psychotherapists, psychologists, counsellors, nurses, and psychiatrists). Participants were recruited via professional networks, purposely avoiding the use of social media platforms. Within the survey, we captured GenAI use behaviors in psychotherapy contexts, and demographic and professional background data. Descriptive statistics were analyzed for all variables. Multivariate logistic regression was used to examine demographic and professional predictors of GenAI use. Results: A total of 766 mental health professionals who provide psychotherapy from 30 countries completed the survey. Of these, 54.6% (n=418) reported having purposely used at least one GenAI tool in psychotherapy clinical practice. ChatGPT was the most frequently used tool (354/418, 84.7%). The most commonly reported clinical purpose was assisting with treatment planning (175/418, 41.9%), followed by managing administrative tasks (173/418, 41.4%) and generating psychoeducational materials for clients (166/418, 39.7%). 82.8% of AI users reported that these tools reduced their overall work burden. Only 18.1% (139/766) of respondents reported institutional encouragement to use AI tools, while 81.1% (621/766) reported not having received any professional training on AI use. Predictors of AI adoption included younger age and rural practice setting. Conclusions: In this global convenience sample survey, GenAI use among mental health professionals in psychotherapy settings is widespread, concentrated in a wide variety of clinical and administrative tasks. Formal training and institutional guidance substantially lag behind current adoption patterns. These findings highlight an urgent need for evidence-based competency frameworks, regulatory clarity, and professional education to support safe and ethically informed integration of AI into clinical mental health practice.

04.
bioRxiv (Bioinfo) 2026-06-21

Expanding the GUSome: Structure-guided identification and characterization of gut microbial β-glucuronidases

The gut microbiome-encoded {beta}-glucuronidase (GUS) enzymes have a significant effect on human physiology through their deglucuronidation activity on endogenous and exogenous glucuronides. GUS activity also significantly influences the pharmacokinetics, efficacy and toxicity of various drugs including chemotherapeutic drugs. Given their crucial role in drug metabolism, GUS enzymes have emerged as promising targets for therapeutic intervention. Here, we have identified and characterized 79 unique GUS enzymes through a structure-guided approach. Structural modelling of these GUS enzymes revealed a conserved core and active-site residues with significant variations in the number and nature of the C-terminal domains. A new classification system based on the number and type of additional C-terminal domains is presented for the GUS proteins. Further, GUS enzymes have been categorized into different loop categories linked to their substrate preferences. The relationship between domain architecture and loop-type is explored by sequence similarity network analysis. We could successfully express, purify and validate GUS processing capability of a panel of identified GUS proteins. The nature of oligomer organization has been deciphered by SEC and DLS studies. Further, we have identified additional GUS enzymes capable of processing SN-38G, glucuronidated form of anticancer drug, irinotecan. These newly identified GUS enzymes will offer valuable insights into gut microbial GUS diversity and their role in understanding the population-specific drug-induced adverse effects on human health.

05.
arXiv (CS.CL) 2026-06-18

Narrative Theory-Driven LLM Methods for Automatic Story Generation and Understanding: A Survey

Applications of narrative theories using large language models (LLMs) deliver promising methods in automatic story generation and understanding tasks. Our survey examines how natural language processing (NLP) research uses LLM methods to engage with diverse concepts from narrative studies. We use established distinctions from narratology to categorise ongoing efforts and discover the following: \redtext{(a) narrative texts come from diverse sources beyond just literature, (b) theoretical synthesis and validation are potential outcomes, (c) generation tasks lag behind understanding in several ways: theoretical application, post-training methods, exploring non-fiction narratives and addressing narrative levels beyond fabula and discourse.} For future directions, instead of the pursuit of a single, generalised benchmark for `narrative quality', we believe that progress can benefit from efforts that focus on the following: defining and improving theory-based metrics for individual narrative attributes; continue conducting large-scale, theory-driven literary/social/cultural analysis; generating narratives in situated contexts; and continuing experiments where outputs can be used to validate or refine narrative theories. This work provides a contextual foundation for more systematic and theoretically informed narrative research in NLP by providing an overview to ongoing research efforts and the broader narrative studies landscape.

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

Pixels to Proofs: Probabilistically-Safe Latent World Model Control via Parallel Conformal Robust MPC

We present SLS^2, a framework for safe feedback motion planning from pixels using robust model predictive control (MPC) in learned latent world models. Our approach trains an action-conditioned joint-embedding world model with compact Markovian latent states, enabling efficient gradient-based trajectory optimization through learned latent dynamics. To enforce safety for the true system despite imperfect latent predictions, we inform a GPU-accelerated system level synthesis (SLS) robust MPC scheme with conformal prediction to obtain calibrated latent error bounds and robust latent-space constraint sets. We further learn and conformalize a latent constraint checker, allowing the SLS planner to impose probabilistic safety constraints during closed-loop execution. We evaluate our method on vision-based control tasks, where it improves both goal-reaching performance and safety over latent world-model and safe-planning baselines.

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

Beyond the Blood Draw: Explainable Machine Learning for Non-Invasive Dysglycemia Risk Screening

arXiv:2606.16056v1 Announce Type: new Abstract: Dysglycemia, encompassing both prediabetes and diabetes, affects huge numbers of adults worldwide, yet many of them remain undiagnosed. We developed and validated machine-learning (ML) models for non-invasive screening of dysglycemia risk that require no laboratory tests. Pooling data from the National Health and Nutrition Examination Survey (NHANES) 2017–2023 (n=14,352), we trained six ML models with stratified 5-fold cross-validation and compared them with two established clinical risk scores. LightGBM achieved the highest area under the receiver operating characteristic curve (AUC=0.820, 95% CI: 0.806–0.835), outperforming the Finnish Diabetes Risk Score (0.745) and American Diabetes Association Risk Test (0.783). SHAP analysis identified age, race/ethnicity, and waist-to-height ratio as the most influential predictors. Subgroup analyses confirmed consistent performance across demographic strata (AUC: 0.735–0.832). These results demonstrate the feasibility of explainable, laboratory-free dysglycemia screening for deployment in community settings and self-tracking health applications.

09.
arXiv (CS.CL) 2026-06-19

Benchmarking Agentic Review Systems

A new class of agentic review systems are emerging as a remedy to the pressure placed on peer review systems by AI-assisted research, but it is unclear how they should be evaluated. We evaluate two open-source systems (OpenAIReview and coarse), one proprietary system (Reviewer3), and a zero-shot baseline, across six LLMs spanning frontier and efficient models. First, we study whether AI reviews on ICLR/NeurIPS papers track with papers' quality as approximated by external signals such as citations and acceptance decisions. Every system performs above chance in pairwise accuracy, and the best is OpenAIReview + GPT-5.5 at 83.0%. Second, to test whether systems can catch errors with known ground truth, we construct a perturbation benchmark that injects four categories of errors into papers across eight arXiv subject classes and measure detection recall. The strongest configuration (OpenAIReview + GPT-5.5) catches 71.6% of injected errors, leaving substantial room for improvement. The union of detections across six models reaches 83.3% recall, suggesting different models detect different errors and better harness design can potentially increase performance. Beyond these benchmarks, we study a public deployment of OpenAIReview with real users. Votes on its comments skew positive at 1.44 to 1, and the most common complaints are about false positives and minor nitpicks. Together, by evaluating full review systems backed by state-of-the-art models on real research papers, we show that while AI reviews still have room for improvement, they can already track human quality judgments well, catch important errors, and earn positive feedback from real users.

10.
arXiv (CS.LG) 2026-06-12

Simultaneous Latent Budget Trees for Stratified Classification

arXiv:2606.13295v1 Announce Type: cross Abstract: In the era of Explainable Artificial Intelligence, there is a renewed focus on single trees for their ease of interpretation. This paper introduces Simultaneous Latent Budget Trees, a probabilistic machine learning framework for classification trees in the presence of a stratification factor such as a temporal, spatial, or demographic variable, acting as a control variable or potential confounder. Standard tree growth procedures are not designed to optimize a conditional split rule. A model-based split rule is proposed in which child nodes are interpreted as latent components of a simultaneous mixture model, such as the Simultaneous Latent Budget Model and its constrained versions, fitted to the parent node. Mixing parameters drive the observations, differently for each group, to the child nodes whereas latent budgets parameters update the response classes profile of each level of the control variable. Parameters are estimated by least squares considering a neural network perspective of the model. An informative tree structure can be interactively visualized with interpretation aids on the node and the paths, including visual pruning and decision tree selection procedure. Suitable measures are proposed to handle an unbalanced response class distribution. The proposed methodology is applied to investigate gender-related differences in disease progression of Amyotrophic Lateral Sclerosis. The SLBT library with the various tree-based algorithms is available in the linked GitHub repository.

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

Montreal Forced Aligner and the state of speech-to-text alignment in 2026

The Montreal Forced Aligner (MFA) was released in 2016 and has since become the most widely used tool for forced alignment in research and industry. In the decade since, MFA has undergone substantial development, including expanded coverage across more languages and dialects using larger open-source datasets, harmonized IPA dictionaries, model adaptation, cross-language phone remapping, and support utilities. This paper documents MFA 3.0's developments since version 1.0 and evaluates MFA's performance across English, Japanese, and Korean, benchmarked against classic and neural forced aligners. MFA 3.0 achieves state-of-the-art or near state-of-the-art performance across all four benchmark datasets with mean boundary errors below 15 ms. Adaptation and cross-language remapping are effective for languages outside MFA's training distribution, and pronunciation probability modeling and phonological rules provide gains in specific conditions.

12.
arXiv (quant-ph) 2026-06-11

Quantum optimal control of the Dicke manifold in dipolar Rydberg atom arrays

arXiv:2606.02283v2 Announce Type: replace Abstract: The ability to engineer and control quantum states of many-body systems is a central challenge in quantum information science. For a register of $N$ qubits, the full Hilbert space dimension grows exponentially as $2^N$, rendering generic state preparation and control infeasible without exploiting structure or symmetry. A particularly important and physically motivated restriction is to the fully symmetric subspace, spanned by the Dicke states, which are simultaneous eigenstates of collective spin $J=N/2$. Ensembles of Rydberg atoms interacting via electric dipoles in two-dimensional tweezer arrays form a promising platform for achieving such control. However, the finite range of dipole-dipole interactions poses a challenge to generating and controlling the Dicke manifold because the Hamiltonian incurs leakage from the computational subspace. To counteract this leakage, we perform quantum optimal control algorithms on a truncated Hilbert space according to our newly developed method of ``irrep distillation'' (IRD), which captures the process by which the symmetric subspace couples to leakage error-spaces, using only linear-scaling Hilbert dimension. We implement gradient ascent pulse engineering (GrAPE) on control schemes with little or no local addressing, to generate resourceful states like Greenberger-Horne-Zeilinger, Dicke, and extremal quantum states. We benchmark each scheme of IRD-GrAPE for its quantum speed limit (QSL), as well as exactly testing pulse fidelities on small system sizes and predicting fidelities using higher-order IRD on larger systems.

13.
arXiv (CS.CV) 2026-06-15

Context-aware Modality-Topology Co-Alignment for Multimodal Attributed Graphs

Multimodal Attributed Graphs (MAGs) model real-world entities by coupling graph topology with heterogeneous attributes such as text and images. They support graph-centric tasks requiring structural and class-discriminative representations, and modality-centric tasks requiring fine-grained cross-modal correspondence. However, existing MAG methods often rely on fixed graph contexts or uniformly fused representations, causing task-agnostic propagation and over-compressed fusion that hinder diverse task requirements and modality-specific evidence preservation. To address this, we propose CoMAG, a unified MAG backbone that learns task-adaptive reliable contexts and modality-preserving alignment within them. CoMAG first conducts Reliable Context Learning by estimating edge reliability from multimodal semantic consistency, complementing raw topology with semantic neighbors, and selecting context components through a task-aware gate. It then performs Modality-preserving Hop-token Alignment by maintaining modality-specific multi-hop trajectories, matching modality-hop tokens across modalities, and decoupling shared and private representations. Thus, CoMAG produces graph and modality representations from one forward pass while retaining modality-specific cues. We further analyze stable propagation, over-smoothing mitigation, and modality-collapse control. Experiments on nine OpenMAG datasets compare CoMAG with feature-only, graph-only, multimodal, and unified MAG baselines across graph-level prediction, modality matching, and graph-conditioned generation. Results show that CoMAG achieves the best reported performance, demonstrating that task-adaptive reliable contexts and modality-preserving alignment improve structural prediction, cross-modal matching, and graph-conditioned generation while retaining sparse edge-linear complexity.

14.
arXiv (CS.LG) 2026-06-12

Strategic PAC Learnability via Geometric Definability

arXiv:2605.13426v3 Announce Type: replace Abstract: Strategic classification studies learning settings in which individuals can modify their features, at a cost, in order to influence the classifier's decision. A central question is how the sample complexity of the induced (strategic) hypothesis class depends on the complexities of the underlying hypothesis class and the cost structure governing feasible manipulations. Prior work has shown that in several natural settings, such as linear classifiers with norm costs, the induced complexity can be controlled. We begin by showing that such guarantees fail in general - even in simple cases: there exist hypothesis classes of VC dimension $1$ on the real line such that, even under the simplest interval neighborhoods, the induced class has infinite VC dimension. Thus, strategic behavior can turn an easy learning problem into a non-learnable one. To overcome this, we introduce structure via a geometric definability assumption: both the hypothesis class and the cost-induced neighborhood relation can be defined by first-order formulas over $\mathbb{R}_{\mathtt{exp}}$. Intuitively, this means that hypotheses and costs can be described using arithmetic operations, exponentiation, logarithms, and comparisons. This captures a broad range of natural classes and cost functions, including $\ell_p$ distances, Wasserstein distance, and information-theoretic divergences. Under this assumption, we prove that learnability is preserved, with sample complexity controlled by the complexity of the defining formulas.

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

Compact graphs and quantum automorphisms

arXiv:2606.13928v1 Announce Type: new Abstract: Compact graphs are graphs for which the fractional automorphism polytope has no genuinely fractional vertices. This paper proposes a quantum analogue of this idea by evaluating the fundamental magic unitary of the quantum automorphism group on states, which we show to produce a closed convex set of doubly stochastic matrices sitting between the classical automorphism polytope and the full fractional automorphism polytope. Our main result is that the natural quantum analogue of compactness is classical, that is, a quantum compact graph is classically compact. We also relate this set to the quantum orbital algebra and obtain a hierarchy of classical and quantum compactness pseudo notions. The framework recovers familiar consequences of compactness through commutants and suggests quantum analogues of generous transitivity and distance-transitivity. We also isolate examples and open problems indicating where quantum symmetries may strictly refine the classical compactness theory.

16.
arXiv (quant-ph) 2026-06-12

Unifying spacetime approaches to quantum mechanics

arXiv:2606.12539v1 Announce Type: new Abstract: Recent efforts to formulate quantum mechanics in a way that treats space and time on a more equal footing have led to a large variety of spacetime-oriented approaches. In this work we present a detailed study of spacetime states, the objects that play the role of quantum states in the recently introduced framework of spacetime quantum mechanics, and show that the main proposals in the literature are different manifestations of the same underlying object. Path integrals, quantum states over time, pseudo-density matrices, the Page and Wootters mechanism, superdensity operators, and timelike-entanglement proposals all arise from spacetime states through particular evaluations, reduced information, linear maps, or quantum channels. This unification provides explicit mathematical representations of these formalisms, reveals relations among them, and clarifies the spacetime information each one captures. We also study the broader relevance of the spacetime-state point of view for Leggett-Garg inequalities, OTOCs, temporal tensor networks, fermionic systems, relativistic QFTs, quantum reference frames, and classical physics, together with additional insights and perspectives revealed by the common unifying framework.

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

R1-SyntheticVL: Is Synthetic Data from Generative Models Ready for Multimodal Large Language Model?

In this work, we aim to develop effective data synthesis techniques that autonomously synthesize multimodal training data for enhancing MLLMs in solving complex real-world tasks. To this end, we propose Collective Adversarial Data Synthesis (CADS), a novel and general approach to synthesize high-quality, diverse and challenging multimodal data for MLLMs. The core idea of CADS is to leverage collective intelligence to ensure high-quality and diverse generation, while exploring adversarial learning to synthesize challenging samples for effectively driving model improvement. Specifically, CADS operates with two cyclic phases, i.e., Collective Adversarial Data Generation (CAD-Generate) and Collective Adversarial Data Judgment (CAD-Judge). CAD-Generate leverages collective knowledge to jointly generate new and diverse multimodal data, while CAD-Judge collaboratively assesses the quality of synthesized data. In addition, CADS introduces an Adversarial Context Optimization mechanism to optimize the generation context to encourage challenging and high-value data generation. With CADS, we construct MMSynthetic-20K and train our model R1-SyntheticVL, which demonstrates superior performance on various benchmarks.

18.
arXiv (CS.CL) 2026-06-16

EvoMemBench: Benchmarking Agent Memory from a Self-Evolving Perspective

Recent benchmarks for Large Language Model (LLM) agents mainly evaluate reasoning, planning, and execution. However, memory is also essential for agents, as it enables them to store, update, and retrieve information over time. This ability remains under-evaluated, largely because existing benchmarks do not provide a systematic way to assess memory mechanisms. In this paper, we study agent memory from a self-evolving perspective and introduce EvoMemBench, a unified benchmark organized along two axes: memory scope (in-episode vs. cross-episode) and memory content (knowledge-oriented vs. execution-oriented). We compare 15 representative memory methods with strong long-context baselines under a standardized protocol. Results show that current memory systems are still far from a general solution: long-context baselines remain highly competitive, memory helps most when the current context is insufficient or tasks are difficult, and no single memory form works consistently across all settings. Retrieval-based methods remain strong for knowledge-intensive settings, whereas procedural and long-term memory methods are more effective for execution-oriented tasks when their stored experience matches the task structure. We hope EvoMemBench facilitates future research on more effective memory systems for LLM-based agents. Our code is available at https://github.com/DSAIL-Memory/EvoMemBench.

19.
bioRxiv (Bioinfo) 2026-06-11

AGZArank: Investigating epitope-conditioned antibody binder ranking with structure-derived synthetic supervision

Computational antibody design methods can generate large libraries of candidate binders for a target epitope, but prioritizing which candidates to test experimentally remains a major bottleneck. Existing scoring approaches, including physics-based affinity estimators, structure-prediction-derived confidence measures, and inverse-folding likelihood models, provide useful proxy signals but are not explicitly optimized for early enrichment of binders among many structurally similar candidates. Here we investigate epitope-conditioned antibody binder ranking as a dedicated learning problem and introduce AGZArank, a geometric deep learning framework trained with structure-derived synthetic supervision based on normalized pseudo-energy targets. On a benchmark of 45 experimentally validated antibody-antigen interfaces, AGZArank recovered the true binder within the top ten candidates in 44.4% of cases and showed stronger generalization on post-2021 structures than ProteinMPNN, ESM-IF, and PRODIGY. Ablation experiments indicate that ranking performance depends primarily on training scale and alignment between the optimization objective and retrieval-based evaluation, rather than architectural complexity alone. These results support candidate prioritization as a distinct and tractable problem in computational antibody design.

20.
arXiv (CS.CV) 2026-06-16

All Eyes on the Workflow: Automated and Efficient Event Discovery from Video Streams

Disciplines such as business process management and process mining aid organizations by discovering insights about processes on the basis of recorded event data. However, an obstacle to process analysis is data multi-modality: for instance, data in video form are not directly interpretable as events. Existing approaches rely on a dictionary of activity label as input, cannot provide frame-by-frame labeling explanations, or rely on superseded computer vision techniques. In this work, we present SnapLog, an approach to extract event data from videos by converting frames to feature vectors using image embeddings and performing temporal segmentation through frame-wise similarity matrices. A generalized few-shot classification is then used to assign labels to the video segments, yielding labeled, timestamped sub-sequences of frames that are interpretable as events. Conventional process mining techniques can be used to analyze the resulting data. We show that our approach produces logs that accurately reflect the process in the videos.

21.
arXiv (CS.CL) 2026-06-19

Closing the Calibration Gap in Semantic Caching

Semantic caching cuts LLM inference costs by serving a cached response to semantically similar queries. Standard practice evaluates these systems using PR-AUC, a metric that only measures how well scores rank and ignores whether they are usable at a fixed threshold. We show this mismatch leads to systematically poor deployment choices, as models with the highest PR-AUC are often the worst in operation. We introduce Precision-Cache Hit Ratio (P-CHR) AUC, a cache-aware metric that measures precision across cache utilization levels, and Calibration Retention Rate (CRR), which captures how much offline ranking quality survives at deployment. We decompose the operational gap between offline and deployed quality into a recoverable calibration component and an irreducible structural component fixed by the dataset's positive rate. Our experiments show that the calibration gap is governed by the training objective rather than data scale, and post-hoc calibration only partially closes it. Ultimately, model selection for semantic caching is a calibration problem, not a ranking one, and measuring it is the first step to closing the gap.

22.
arXiv (CS.CL) 2026-06-11

Judging Against the Reference: Uncovering Knowledge-Driven Failures in LLM-Judges on QA Evaluation

While large language models (LLMs) are increasingly used as automatic judges for question answering (QA) and other reference-conditioned evaluation tasks, little is known about their ability to adhere to a provided reference. We identify a critical failure mode of such reference-based LLM QA evaluation: when the provided reference conflicts with the judge model's parametric knowledge, the resulting scores become unreliable, substantially degrading evaluation fidelity. To study this phenomenon systematically, we introduce a controlled swapped-reference QA framework that induces reference-belief conflicts. Specifically, we replace the reference answer with an incorrect entity and construct diverse pairings of original and swapped references with correspondingly aligned candidate answers. Surprisingly, grading reliability drops sharply under swapped references across a broad set of judge models. We empirically show that this vulnerability is driven by judges' over-reliance on parametric knowledge, leading judges to disregard the given reference under conflict. Finally, we find that this failure persists under common prompt-based mitigation strategies, highlighting a fundamental limitation of LLM-as-a-judge evaluation and motivating reference-based protocols that enforce stronger adherence to the provided reference.

23.
arXiv (CS.CV) 2026-06-16

CoMNeT: A MedNeXt-CorrDiff Framework for Volumetric Brain Tumor Segmentation

Accurate brain tumor segmentation from multiparametric magnetic resonance imaging (MRI) is critical for treatment planning, response assessment, and quantitative neuro-oncology research. However, automated segmentation remains a difficult task in computer vision because of variation in tumor appearance and MRI protocols across patient scans. Moreover, clinically important regions such as enhancing tumor (ET) and tumor core (TC) are often small relative to the full brain volume, furthering increasing the difficulty of achieving high voxel-level precision. In this paper, we show that combining a modern 3D convolutional segmentation model with corrective diffusion-based refinement and ensembling improves volumetric glioma segmentation on the UTSW-Glioma dataset. We propose CoMNeT, a MedNeXt-CorrDiff framework that uses four MRI modalities as input and predicts ET, TC, and whole tumor (WT) regions for automated brain tumor segmentation. MedNeXt is used as the primary segmentation model with Global Response Normalization for feature learning, while CorrDiff is trained as a postprocessing residual refinement method to correct errors in the probability maps before final thresholding. Using five-fold cross-validation, CoMNeT achieved the highest Dice score for most tumor regions, with ET, TC, WT, and average Dice scores of 0.7543 +/- 0.0261, 0.6806 +/- 0.0166, 0.9049 +/- 0.0128, and 0.7798 +/- 0.0184, respectively. CoMNeT outperformed two selected baseline models: SegResNet (0.7555 +/- 0.0190 average Dice) and standalone MedNeXt (0.7697 +/- 0.0154 average Dice). Our findings support the use of corrective diffusion and fold-level probability ensembling as practical additions to existing state-of-the-art 3D convolutional models for automated glioma segmentation.

24.
medRxiv (Medicine) 2026-06-15

Nocturnal Respiratory Rate and Variability Predict Long-term Mortality in Stable Outpatients with Cardiovascular Disease

Background: Respiratory rate (RR) predicts short-term mortality in acute care settings, yet its prognostic significance in clinically stable outpatients remains poorly defined. Objectives: To determine whether the median and variability of nocturnal respiratory rate (NRR) are independently associated with long-term cardiovascular and all-cause mortality in outpatients with cardiovascular disease. Methods: We analyzed overnight chest belt waveforms from elective polysomnography in 5,679 older adults with cardiovascular disease enrolled in the Sleep Heart Health Study (SHHS). NRR was quantified at 30-second resolution, and per-subject median NRR and within-night variability (standard deviation) were derived. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate associations with cardiovascular and all-cause mortality over 3-year and 15-year follow-up periods, adjusting for demographic characteristics, cardiopulmonary comorbidities, and sleep apnea severity. Results: Higher median NRR and greater NRR variability were each associated with increased cardiovascular and all-cause mortality. Combining these metrics identified a high-risk group characterized by elevated median and high variability of NRR, with approximately five-fold higher 3-year all-cause mortality compared with a low-risk group; this association remained significant in Cox models (unadjusted HR: 2.61; 95% CI: 1.65, 4.14; p

25.
medRxiv (Medicine) 2026-06-17

Reverse engineering of motor unit discharge in multiple sclerosis reveals heterogeneity of voluntary motor commands

Central nervous system injury causes motor deficits through derangement of excitatory, inhibitory, and/or neuromodulatory inputs to motoneurons, the three fundamental components of motor commands. Typically, study of pathologic neural control in humans is restricted to only one of the three. Chardon et al. (2024) presented a fundamentally new approach to comprehensively study all components by reverse engineering motor unit firing patterns. We apply their framework to motor unit firing patterns from 89 people with multiple sclerosis (MS) and 34 controls to study excitatory, inhibitory, and neuromodulatory contributions to pathologic motor output. Disruptions to all components are plausible in MS, a disease hallmarked by heterogeneity in nearly all aspects. Accordingly, we found abnormalities in MS for all three components. Notably, neuromodulation included both high and low extremes. Our results suggest that pathophysiology of motor commands in MS varies among patients, a finding fundamentally different from other studied populations showing relative consistency.