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

PLaID++: A Preference Aligned Language Model for Targeted Inorganic Materials Design

arXiv:2509.07150v4 Announce Type: replace Abstract: Reinforcement Learning from Verifiable Rewards (RLVR) has emerged as a promising approach to improve correctness in LLMs, however, in many scientific problems, the objective is not necessarily to produce the correct answer, but instead to produce a diverse array of candidates which satisfy a set of constraints. We study this challenge in the context of materials generation. To this end, we introduce PLaID++, an LLM post-trained for stable and property-guided crystal generation. We find that performance hinges on our crystallographic representation and reward formulation. First, we introduce a compact, symmetry-informed Wyckoff text representation which improves computational efficiency and encourages generalization from physical priors. Second, we demonstrate that temperature scaling acts as an entropy regularizer which counteracts mode collapse and encourages exploration. By encoding symmetry constraints directly into text and guiding model outputs towards desirable chemical space, PLaID++ generates structures that are thermodynamically stable, unique, and novel at a $\sim$50\% greater rate than prior methods and conditionally generates structures with desired space group properties. Our work demonstrates the potential of adapting post-training techniques from natural language processing to materials design, paving the way for targeted and efficient discovery of novel materials.

02.
medRxiv (Medicine) 2026-06-19

Hyperleukocytosis and outcomes in pediatric B-cell acute lymphoblastic leukemia: A report from the REDIAL Consortium

Hyperleukocytosis (white blood cell [WBC] count >100 000/uL) at diagnosis is an important prognostic risk factor in pediatric acute lymphoblastic leukemia (ALL), though its significance with contemporary therapy is unclear. We analyzed 1 826 pediatric ALL patients from a multi-institution cohort to determine whether hyperleukocytosis independently predicts outcomes using multivariable Cox proportional hazard modeling. Hyperleukocytosis occurred in 211 patients (12%), with 121 having B-ALL, and showed no prognostic significance in T-ALL patients. In B-ALL, 5-year event-free survival (EFS) was 65% versus 89% for non-hyperleukocytosis patients, and overall survival (OS) was 78% versus 93%. After adjustment for age, cytogenetic risk, central nervous system disease status, and treatment site, hyperleukocytosis remained an independent predictor of end-of-induction minimal residual disease (MRD) positivity (odds ratio 2.53 [95% confidence interval [CI]: 1.71-3.94; p

03.
arXiv (CS.AI) 2026-06-16

DualGauge: Automated Joint Security-Functionality Benchmarking of Specification-Only Code Generation by LLMs and Coding Agents

arXiv:2511.20709v2 Announce Type: replace-cross Abstract: Large language models (LLMs) and LLM-based coding agents are now used to generate code from natural-language specifications, yet ensuring such code is both functionally correct and secure remains a challenge. We present DualGauge, the first fully automated framework for jointly evaluating correctness and security of specification-only code generation, supported by DualGauge-Bench, a language-agnostic benchmark of 307 coding tasks each paired with functional and security tests derived from the same specification. Evaluating 10 representative LLMs across Python, C++, and JavaScript, we find that functional correctness substantially overestimates reliable code generation: even the strongest model remains below 15% joint security-functionality success in every language. Common model-side factors–scale, extended thinking, quantization, instruction tuning, and code specialization–do not reliably improve joint performance, suggesting secure-and-correct code generation does not simply emerge from stronger coding capability. Evaluation of 3 leading agentic coding systems (Codex, OpenHands, and Claude Code) shows that iterative scaffolding provides no advantage over direct (LLM-based) generation on specification-only tasks. A qualitative audit reveals failures concentrate at the output contract boundary and in guards that exist but are insufficient–patterns that only joint benchmarking reliably exposes.

04.
arXiv (CS.CL) 2026-06-11

Debiasing Without Protected Attributes: Latent Concept Erasure from Textual Profiles

Most fairness research in NLP assumes direct access to protected attributes such as gender, race, or nationality. In practice, however, such information is often unavailable due to privacy constraints, missing metadata, or legal restrictions, even though models may infer it from indirect textual cues. This raises a key question: can debiasing succeed without direct access to sensitive attributes? We propose H-SAL, which performs post-hoc concept and attribute erasure using self-description text as an implicit debiasing signal. To support this setting, we introduce a multi-domain Stack Exchange-based fairness benchmark for helpfulness prediction that includes both explicit and implicit signals, enabling comparison between standard debiasing with protected labels and debiasing without access to sensitive information. Across encoder and decoder-only language models, we find that implicit self-description often matches or outperforms explicit-label-based debiasing. Our results broaden representation-level fairness research and provide a new benchmark for studying debiasing under realistic data constraints.

05.
arXiv (math.PR) 2026-06-24

Optimal Couplings of Levy Processes in the Class of Immersion Couplings

arXiv:2606.24290v1 Announce Type: new Abstract: We study the optimal coupling problem for Levy processes on R^d with respect to the quadratic cost. For any two such processes with finite second moments, we prove that the optimal Levy coupling constructed in Kang and Lim (2025), which was previously shown to be optimal among Feller couplings, is in fact optimal among the larger class of immersion couplings. The proof makes use of a characterization of immersion couplings, which is equivalent to the classical martingale preservation definition but more convenient for our purposes. The construction is based on two fundamental ingredients: the existence of an optimal coupling within the class of Levy couplings, and a dual formulation of the associated optimization problem. While both results were previously established in Kang and Lim (2025), we provide here simpler and more transparent proofs relying only on optimal transport between infinitely divisible measures and a generalized minimax principle. These arguments are self-contained and may be of independent interest.

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

Aligned but Stereotypical? How System Prompts Shape Demographic Bias in LLM-Based Text-to-Image Models

Text-to-image (T2I) systems increasingly rely on Large Language Model (LLM)-based text conditioning to interpret and expand user prompts. While this improves prompt understanding and text-image alignment, we find that it can also introduce implicit demographic assumptions, even when demographic attributes are unspecified. To systematically investigate this behavior across varying levels of prompt ambiguity and complexity, we construct a comprehensive benchmark covering diverse prompt settings. Evaluations on eight recent T2I models show that LLM-based systems consistently exhibit stronger demographic skew than non-LLM-based baselines. We further analyze system prompts, a component unique to LLM-based T2I systems that guides prompt interpretation and expansion. Our analyses show that these instructions strongly influence text embeddings, which subsequently leads to biased image generations. Motivated by these findings, we propose FairPro, a training-free debiasing framework that adaptively generates fairness-aware instructions while preserving user intent. Experiments demonstrate that FairPro substantially reduces demographic disparities while maintaining prompt fidelity.

07.
arXiv (CS.AI) 2026-06-11

Implicit Neural Representations of Individual Behavior

arXiv:2606.12200v1 Announce Type: cross Abstract: We study policy representation learning from unlabeled multi-policy behavioral data. Each episode is generated by a fixed policy, but policy labels are unavailable. This setting appears in robotics play, demonstrations, games, racing, and other datasets where heterogeneous behaviors are mixed without annotations. We introduce Behavioral INR, a self-supervised generative model that adapts implicit neural representations (INRs) from vision to behavior. Instead of mapping coordinates to RGB values, Behavioral INR represents a policy as a state-action function mapping states to subsequent actions. An episode-level latent modulates this function through FiLM layers, yielding a generative prior over policies and allowing policy identity to be inferred without supervision. Because INRs treat each datapoint as samples from an underlying function, the same model naturally accommodates variable episode lengths and different sampling granularities, as in vision INRs with different image resolutions. We also define policy-level out-of-distribution (OOD) shifts along state-distribution and action-distribution axes, which arise when policies overlap in states or actions but are not captured by standard behavioral OOD settings based only on new agents or environments. We evaluate on synthetic Gaussian random field data, MuJoCo demonstrations with controlled OOD splits, and real-world chess, Formula 1 racing, robotics, and Seek-Avoid datasets. Behavioral INR most consistently improves policy identifiability in the hardest continuous state-action settings, especially when longer episodes, more policies, and OOD splits reduce the usefulness of marginal shortcuts; amortized history encoders remain competitive when policy identity can be recovered from symbolic repetition or low-dimensional action statistics. We release code and checkpoints.

08.
arXiv (math.PR) 2026-06-19

Theory of uncertain probability: can we derive the probability density function of uncertain random experiments with continuously changing conditions?

Authors:

arXiv:2606.20169v1 Announce Type: new Abstract: This paper aims to explore the formation mechanism of probability distribution in situations where the differences among random experiments are distinguishable, and these differences continue to evolve along with the dynamic changes in conditions and their mechanisms of action. To this end, we are motivated to devise a new theoretical system – theory of uncertain probability (TUP) with Kolmogorov's system and nonlinear theories as special cases. TUP develops a novel model that integrates probability and uncertainty as well as the known and unknown to more accurately depict numerous typical random phenomena under more realistic assumptions, and thus provides appropriate tools for greater variety of real needs. It also allows for pioneering interpretation of the causal mechanisms underlying many important distributional characteristics and incorporation of pathwise property to distribution model.

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

T2S: A Rehearsal-Based Approach for Extraction-Resistant Model Watermarking

arXiv:2606.11698v1 Announce Type: cross Abstract: Model watermarking safeguards AI model intellectual property by embedding distinctive knowledge that induces unique behavioral signatures. The primary technical challenge lies in ensuring watermark robustness against various post-processing attacks on the watermarked model. Model extraction attacks emerge as the most severe threat, where adversaries exploit prediction outputs to train surrogate models that illegally replicate the original model's functionality. In this work, we propose a rehearsal-based watermark embedding framework to enhance the robustness of model watermarks against model extraction attacks. By simulating the extraction process, our method leverages the loss of a simulated stolen model on a trigger set as a training signal to fine-tune the watermark knowledge within the target model. This fine-tuning step encourages the watermark to be embedded in a way that boosts transferability, thereby increasing its chances of persisting and remaining detectable in stolen models. Comprehensive experiments conducted under diverse settings demonstrate that the proposed method significantly improves the robustness of model watermarks against both model extraction and subsequent watermark removal attacks.

10.
arXiv (CS.LG) 2026-06-15

Smoothing Dark Areas in Molecular Latent Diffusion

arXiv:2606.13955v1 Announce Type: new Abstract: Latent diffusion is a promising framework for scalable 3D molecular generation, but it requires a latent space that remains smooth, valid, and navigable beyond posterior samples. Existing molecular VAEs, however, are typically learned through reconstruction-based objectives, which do not guarantee such a latent space. We show that this leads to dark areas: regions of latent space that are reachable during diffusion sampling but decode to disconnected or chemically invalid molecules. Unlike in image generation, molecular decoding requires strict structural and chemical precision, so even small latent perturbations can produce catastrophic failures. We therefore propose TopVAE, a topology-optimized VAE that reduces dark areas by making the decoder internalize structural and chemical constraints during training, eliminating the need for test-time chemical correction. TopVAE greatly improves off-posterior robustness, and when paired with a standard DiT, achieves $77\%$ lower FCD-3D on QM9, the highest V&C, $52\%$ lower FCD-3D on GEOM-Drugs, and $1.29{\times}$ more stable and connected molecules on zero-shot scaffold inpainting.

11.
arXiv (CS.AI) 2026-06-24

Detecting AI Coding Agents in Open Source: A Validated Multi-Method Census of 180 Million Repositories

arXiv:2606.24429v1 Announce Type: cross Abstract: Generative AI coding agents are entering the open-source supply chain, yet their diverse and often invisible traces leave their prevalence poorly understood. We introduce a multi-layered detection framework that integrates configuration-file scanning, commit-message analysis, author-identity matching, and bot-signature lookup across World of Code (180M+ Git repositories), classifying agent traces into four behavioral types. No single method captures more than a fraction of activity: multi-method detection identifies 850,157 Claude Code commits in one snapshot, of which bot-account lookup_the signal most adoption studies rely on_recovers only 28,154 (3.3%), a 30x relative-recall gap, so single-signal prevalence estimates are biased low by at least this factor. Every detection pattern is hand-validated (495 labels) with per-cell precision and Wilson confidence intervals. Across snapshots from December 2024 to April 2026, commit-attributed agents generate over 320,000 commits per month; Claude Code leads (886,122 commits across 17,295 projects) and dominates silent, configuration-file-only adoption (21,078 projects). Compared against an independent pull-request census (AIDev), the two channels capture nearly disjoint agent populations_a PR census misses 79% of commit-detected Claude Code adopters and essentially all Codex adopters_and different kinds of work: PR-deployed cloud agents (Codex, Cursor) surface as feature work, while commit-deployed in-editor agents (Claude Code, OpenHands, Aider) surface as maintenance. The observed work profile follows deployment and detection mode rather than the tool itself, so no single channel is representative.

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

Automating SKILL.md Generation for Computer-Using Agents via Interaction Trajectory Mining

arXiv:2606.20363v1 Announce Type: new Abstract: Explicit skill libraries make computer-using agents easier to inspect, but it remains unclear whether such libraries can be mined from interaction data in a way that improves downstream policies. We study this question through a three-stage pipeline that segments GUI trajectories, clusters segments into candidate skills, and trains a skill-aware policy from the resulting annotations. The mined clusters are readable on the source benchmark: five of eight clusters have at least 0.95 purity against InteraSkill Workflows labels. However, readability does not imply transfer. GRPO improves IW skill-step accuracy only from 18.5\% to 20.5\%, leaves BrowseComp+ essentially unchanged, and underperforms trivial frequency priors on key source-domain metrics. We therefore present the method as a diagnostic study: trajectory mining can expose inspectable skill structure, but the current boundary detector, orderless segment representation, and offline reward model are insufficient for reliable cross-domain policy improvement.

13.
arXiv (quant-ph) 2026-06-11

Necessary and Sufficient Conditions for Universal Gates with Pauli Strings and Beyond

arXiv:2606.12096v1 Announce Type: new Abstract: Any quantum computation consists of a sequence of unitary evolutions described by a finite set of Hamiltonians. For the case where this set consists of only products of Pauli operators, known as Pauli strings, we provide a necessary and sufficient condition for it to generate $\mathfrak{su}(2^n)$, i.e., to be universal for quantum computation on $n$ qubits. When combining Pauli strings with a general Hamiltonian, we show a sufficient (and in certain circumstances even necessary) condition for universality based on the Pauli-basis expansion of the Hamiltonian. As an application of these results, we prove two corollaries: (i) a necessary and sufficient condition for the universality of a general Hamiltonian given arbitrary single-qubit control on all qubits, and (ii) the universality of an XYZ Heisenberg Hamiltonian with local control of just two adjacent qubits.

14.
arXiv (math.PR) 2026-06-16

Riviera model with egoistical settlers

arXiv:2606.16791v1 Announce Type: cross Abstract: The Riviera model mimics a densifying settlement along the coastline. In the lattice version, houses are built sequentially in empty sites with the constraint that every newly built house has at least one empty neighboring site. The distribution of clusters of adjacent houses does not obey a closed set of evolutionary equations, but the void-cluster-void distribution does. We compute the latter and extract the cluster distribution from it. In the jammed state, when all voids have length one and the evolution ceases, the cluster distribution has a neat form and exhibits a factorial decay with the length of the cluster. To investigate finite systems, we employ a static approach directly treating jammed states. If the coastline is a finite segment, we determine the statistics of the number of empty sites in the jammed state (the average, variance, and higher cumulants). We also study a continuum version in which houses are built along the line so that each newly built house is sufficiently separated from at least one neighboring house.

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

UniversalRAG: Retrieval-Augmented Generation over Corpora of Diverse Modalities and Granularities

Retrieval-Augmented Generation (RAG) has shown substantial promise in improving factual accuracy by grounding model responses with external knowledge relevant to queries. However, most existing approaches are limited to a text-only corpus, and while recent efforts have extended RAG to other modalities such as images and videos, they typically operate over a single modality-specific corpus. In contrast, real-world queries vary widely in the type of knowledge they require, which a single type of knowledge source cannot address. To address this, we introduce UniversalRAG, an any-to-any RAG framework designed to retrieve and integrate knowledge from heterogeneous sources with diverse modalities and granularities. Specifically, motivated by the observation that forcing all modalities into a unified representation space derived from a single aggregated corpus causes a modality gap, where the retrieval tends to favor items from the same modality as the query, we propose modality-aware routing, which dynamically identifies the most appropriate modality-specific corpus and performs targeted retrieval within it, and further justify its effectiveness with a theoretical analysis. Moreover, beyond modality, we organize each modality into multiple granularity levels, enabling fine-tuned retrieval tailored to the complexity and scope of the query. We validate UniversalRAG on 10 benchmarks of multiple modalities, showing its superiority over various modality-specific and unified baselines.

16.
arXiv (CS.AI) 2026-06-12

MLUBench: A Benchmark for Lifelong Unlearning Evaluation in MLLMs

arXiv:2606.12809v1 Announce Type: new Abstract: Multimodal large language models (MLLMs) are trained on massive multimodal data, making data unlearning increasingly important as data owners may request the removal of specific content. In practice, these requests often arrive sequentially over time, giving rise to the challenging problem of MLLM Lifelong Unlearning. However, most existing benchmarks are limited in scale and scope, failing to capture the complexities of MLLM lifelong unlearning. To fill this gap, we introduce the MLUBench, a large-scale and comprehensive benchmark featuring 127 entities across 9 classes under lifelong unlearning requests. We perform extensive experiments using MLUBench and reveal that existing unlearning methods suffer from severe, cumulative degradation. More critically, we further identify the unique challenge of this problem: unlike in unimodal models, MLLM lifelong unlearning is constrained by the need to preserve multimodal alignment. Continually unlearning from one modality could degrade the entire model. To alleviate this challenge, we propose LUMoE, an effective method. Experiments demonstrate that LUMoE significantly mitigates the degradation problem faced by baselines. The source code and the MLUBench dataset are open-sourced in https://github.com/lihe-maxsize/Lifelong_Unlearning_main.

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

RoSE: Round-robin Synthetic Data Evaluation for Selecting LLM Generators without Human Test Sets

LLMs are powerful generators of synthetic data, which are used for training smaller, specific models. This is especially valuable for low-resource languages, where human-labelled data is scarce but LLMs can still produce high-quality text. However, LLMs differ in how useful their outputs are for training. Selecting the best LLM as a generator is challenging because extrinsic evaluation requires costly human annotations (which are often unavailable for low-resource languages), while intrinsic metrics correlate poorly with downstream performance. We introduce Round robin Synthetic data Evaluation (RoSE), a proxy metric for selecting the best LLM generator without human test sets. RoSE trains a small model on the outputs of a candidate generator (LLM) and then evaluates it on generated synthetic examples from all other candidate LLMs. The final RoSE score is the mean performance of this small model. Across six LLMs, eleven languages, and three tasks (sentiment, topic, intent), RoSE identifies the optimal generator more often than any other intrinsic heuristics. RoSE outperforms intrinsic heuristics and comes within 0.76 percentage points of the optimal generator baseline. This result is measured in terms of downstream performance, obtained by training a small model on the chosen generator's outputs (optimal vs. proxy metric selected) and evaluating it on human-labelled test data. Additionally, RoSE is the only metric to achieve a positive correlation with performance on human test data.

18.
PLOS Medicine 2026-05-21

U = U for all: Advancing equity in HIV prevention

by Thiago S. Torres, Paula M. Luz Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U = U). However, U = U literacy remains unevenly understood and shared, and stigmas persist. Equitable and accurate awareness of U = U requires culturally tailored interventions, improved provider education, and supportive policy environments beyond biomedical evidence alone. Suppression of HIV with antiretrovirals eliminates HIV transmission risk, summarized as Undetectable = Untransmittable (U=U). However, U=U literacy remains unevenly understood and shared, and stigmas persist. In this Perspective, Thiago Torres and Paula Luz outline what is needed to improve equity and accuracy in global awareness and education of U=U.

19.
arXiv (quant-ph) 2026-06-11

Lowest order Carleman linearization for low Reynolds long-term behaviour of fluid flow simulations

arXiv:2605.23380v2 Announce Type: replace Abstract: It is shown that the lowest (second) order truncation of the Carleman linearization of the fluid equations (C2) recovers the late stage of the evolution, namely the steady-state solution, although to a decreasing degree of accuracy at increasing Reynolds number. This asymptotic property is first proved analytically for the decaying logistic with external forcing and then shown to hold to a significant degree of accuracy also for the more complex case of two-dimensional Kolmogorov-like fluid flow at low Reynolds numbers, below $Re \sim 10$. This time-asymptotic property may open interesting prospects for the quantum simulation of low-Reynolds steady-state fluid flows.

20.
arXiv (quant-ph) 2026-06-19

Benchmark of quantum algorithms for ground state preparation in the presence of noise

arXiv:2606.20551v1 Announce Type: new Abstract: We compare the performance of representative cooling, adiabatic, and optimization algorithms for ground-state preparation in the presence of noise. Using an exactly solvable family of quadratic fermionic Hamiltonians subject to depolarizing noise, we derive the scaling of the achievable relative energy as a function of the noise rate and support these results with numerical simulations. The Hamiltonian exhibits two phases, separated by a quantum phase transition. As expected, the performance of the different algorithms depends on the phase: adiabatic evolution is favorable in the trivial phase, while a multi-frequency cooling algorithm, as proposed in [1], becomes competitive or superior in the topological phase, where gap-closing limits adiabatic protocols. We further present numerical results for the quantum approximate optimization algorithm [2], showing that it performs competitively with cooling in the trivial phase but is typically outperformed in the topological regime. Finally, we show that for this model the cooling protocol exhibits enhanced robustness to parameter imperfections, highlighting its potential advantage for realistic implementations of noisy quantum state preparation. The analytical approach developed here, in conjunction with numerical validation, establishes an extendable approach to benchmarking ground-state preparation algorithms.

21.
bioRxiv (Bioinfo) 2026-06-20

A network approach to DNA methylation clocks

Biological age predicts health and lifespan better than chronological age, but remains difficult to measure. One leading molecular proxy for biological age is DNA methylation, which underlies age predictors known as "clocks". These clocks use penalized linear regression to predict chronological age from methylation levels using selected cytosine–guanine pairs (CpGs) along DNA. Although they predict chronological age within a few years and track mortality risk, there are several issues. Different clocks share a vanishingly small number of CpG sites, many of which show weak associations with age. Also, the clocks often do not transfer across methylation array platforms. This paper takes a network approach to better understand these issues. By using 12 public datasets from human blood, we build a co-methylation network of the sites that show the strongest age correlation. After pruning weak links, we find that it has a small number of large modules of covarying CpGs surrounded by many small modules and singleton sites. These modules are biologically interpretable, as they are associated with CpG island contexts and enriched for distinct Gene Ontology functions. We also map five established clocks onto this network (Horvath, Hannum, AltumAge, Skin & Blood, and Han) and find that they select some CpGs from the same module. This suggests that they are more similar than they appear. The network structure also suggests new ways to build clocks. A simple clock that retains one CpG per module matches the performance of established clocks. A second one, built from module-level principal components, outperforms all five established clocks in three validation cohorts and is transferable across array platforms (Illumina Infinium Methylation 450K or EPIC arrays). Overall, the network perspective shifts attention from individual CpG sites to modules of covarying sites. This perspective helps explain why DNA methylation clocks perform so well despite their differences and provides a more systematic approach for developing the next generation of aging biomarkers.

23.
arXiv (quant-ph) 2026-06-16

Experimental realization of the complete seven-phase Anderson-localization landscape

arXiv:2606.14825v1 Announce Type: cross Abstract: Anderson localization has evolved far beyond the conventional dichotomy between extended and localized states. Modern localization theory predicts a complete transport hierarchy comprising extended, critical, and localized phases together with all coexistence phases among them, forming a seven-phase Anderson-localization landscape. Despite its fundamental importance, this hierarchy has never been experimentally realized within a single system. Here we realize the complete seven-phase Anderson-localization landscape in a one-dimensional Floquet photonic lattice. By engineering quasiperiodic hopping profiles containing inhomogeneously distributed hopping zeros, we generate critical states and enable their coexistence with extended and localized sectors. The resulting transport regimes are directly resolved through their distinct spatiotemporal dynamics, including ballistic expansion, confined critical oscillations, and persistent localization. We observe all seven phases, including the elusive triply coexisting extended-critical-localized phase, and experimentally track the phase transitions connecting them. Our results establish the first complete experimental map of the Anderson-localization landscape and provide a unified platform for investigating mobility edges, multifractality, and programmable coherent transport.

24.
Nature Medicine 2026-06-12

General-purpose large language models outperform specialized clinical AI tools on medical benchmarks

Specialized clinical artificial intelligence (AI) tools are entering medical practice despite scarce independent evaluation. We quantitatively evaluate two clinical AI tools, OpenEvidence and UpToDate Expert AI, built on large language models (LLMs) against three frontier LLMs: GPT-5.2, Gemini 3.1 Pro and Claude Opus 4.6. Our evaluation has three stages: (1) 500 MedQA questions testing medical knowledge, (2) 500 HealthBench items measuring alignment with clinicians and (3) the real clinical queries (RCQ) benchmark, built from 100 de-identified queries from physicians to a general-purpose language model in a live clinical environment. For the RCQ benchmark, 12 US clinicians performed randomized, blinded review of model outputs, producing 1,800 model–question annotations. Frontier LLMs outperformed clinical AI tools in all three evaluations. Clinical AI tools performed comparably to auto-enabled Google Search AI Overview on the RCQ. These findings highlight the need for independent, real-world evaluation of AI tools before they enter clinical settings. In an independent evaluation, frontier large language models outperformed specialized clinical artificial intelligence tools on medical knowledge, clinician alignment and real-world clinical queries.

25.
medRxiv (Medicine) 2026-06-17

Cross-Device Adaptation of Mirai for Mammography-Based Breast Cancer Risk Prediction

Fine-tuning can adapt pretrained medical imaging models to new clinical datasets, but device-specific domain shifts may limit generalizability. We evaluated Mirai, a mammography-based deep learning model for breast cancer risk prediction, in a large screening cohort containing Hologic and General Electric (GE) full-field digital mammography systems, including GE Premium View (GE PV) and Tissue Equalization (GE TE) post-processing software. Native Mirai showed lower performance on TE images than on Hologic or PV images. Fine-tuning on TE images improved TE performance, particularly for short-term risk prediction, but substantially reduced performance on Hologic images, consistent with catastrophic forgetting. To mitigate this effect, we developed a device-invariant model using interleaved multi-device sampling and conditional adversarial training. This approach largely restored Hologic performance while maintaining improved TE performance, providing better robustness across heterogeneous imaging platforms. Comparison of cumulative and annual risk AUCs over a five-year time horizon further showed that performance gains were driven mainly by short- and intermediate-term predictions. These findings highlight both the value and dangers of device-specific fine-tuning and support balanced domain-adaptation strategies for deploying mammography-based risk models across diverse clinical imaging environments.