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01.
arXiv (CS.CV) 2026-06-18

VidCRAFT3: Camera, Object, and Lighting Control for Image-to-Video Generation

Controllable image-to-video (I2V) generation transforms a reference image into a coherent video guided by user-specified control signals. While precise control over camera motion, object motion, and lighting is essential for high-fidelity creation, existing methods often treat these factors independently. This overlooks the physical coupling among viewpoint, geometry, and illumination in dynamic scenes, leading to visual inconsistencies such as mismatched shadows and perspective drift under simultaneous changes. We present VidCRAFT3, a unified and flexible I2V framework that explicitly models cross-factor interactions among geometry, motion, and illumination, enabling both independent and joint control over camera motion, object motion, and lighting direction. Image2Cloud provides explicit 3D geometric priors for accurate camera motion control. ObjMotionNet encodes sparse object trajectories into multi-scale motion features to guide realistic object motion. A Spatial Triple-Attention Transformer integrates lighting direction through lighting cross-attention for consistent relighting. To address the scarcity of jointly annotated data, we construct the VideoLightingDirection (VLD) dataset with accurate per-frame lighting direction annotations, and introduce a three-stage progressive training strategy that enables robust learning without fully joint annotations. Extensive experiments demonstrate that VidCRAFT3 achieves state-of-the-art performance in control precision and visual coherence across diverse scenarios.

03.
arXiv (CS.CL) 2026-06-11

An Ontology-Guided Multi-Anchor Graph Retrieval Framework for Traffic Legal Liability Determination

Traffic law liability determination is critical for assigning legal penalties, requiring the simultaneous identification of interdependent statutory provisions across multiple legal dimensions. However, existing retrieval-augmented generation methods suffer from a multi-dimensional retrieval bottleneck: single axis architectures compress complex legal queries into a single pathway, causing interdependent statutory dimensions to be overlooked. To address this, we propose OMAGR, an ontology-guided framework that decomposes queries into ontology-aligned anchors and executes parallel graph retrieval across each dimension, ensuring independent retrieval across dimensions before fusion. To evaluate the proposed method, we created the TrafficLaw-QA dataset, an expert-validated benchmark dataset containing 200 questions and 527 legal provisions. Results show that TrafficOmni-RAG outperforms baselines on Context Precision and Faithfulness metrics. The findings demonstrate that parallel multi-anchor retrieval effectively resolves the multi-dimensional retrieval bottleneck, offering a promising direction for traffic law liability determination research.

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

CADO: From Imitation to Cost Minimization for Heatmap-based Solvers in Combinatorial Optimization

arXiv:2602.08210v2 Announce Type: replace Abstract: Heatmap-based solvers have emerged as a promising paradigm for Combinatorial Optimization (CO). However, we argue that the dominant Supervised Learning (SL) training paradigm suffers from a fundamental objective mismatch: minimizing imitation loss (e.g., cross-entropy) does not guarantee solution cost minimization. We dissect this mismatch into two deficiencies: Decoder-Blindness (being oblivious to the non-differentiable decoding process) and Cost-Blindness (prioritizing structural imitation over solution quality). We empirically demonstrate that these intrinsic flaws impose a hard performance ceiling. To overcome this limitation, we propose CADO (Cost-Aware Diffusion models for Optimization), a streamlined Reinforcement Learning fine-tuning framework that formulates the diffusion denoising process as an MDP to directly optimize the post-decoded solution cost. We introduce Label-Centered Reward, which repurposes ground-truth labels as unbiased baselines rather than imitation targets, and Hybrid Fine-Tuning for parameter-efficient adaptation. CADO achieves state-of-the-art performance across diverse benchmarks, validating that objective alignment is essential for unlocking the full potential of heatmap-based solvers.

05.
arXiv (math.PR) 2026-06-16

Delayed acceptance sampling with Hamiltonian proposal subchains for random field materials inference

arXiv:2606.14743v1 Announce Type: cross Abstract: This paper focuses on accelerating Markov chain Monte Carlo sampling in Bayesian inverse problems in which forward model evaluations dominate the computational cost. It builds on several established ingredients previously used in related scenarios: delayed acceptance, neural network surrogate models, Hamiltonian proposals, and proposal subchains. The main framework is the delayed-acceptance Metropolis-Hastings algorithm of Christen and Fox (2005). The first-stage proposal distribution is constructed from a subchain of Hamiltonian trajectories targeting the surrogate posterior. For each fixed surrogate model, the Hamiltonian subchain and delayed-acceptance correction define a kernel invariant with respect to the exact posterior. In the present work, the surrogate is updated only during a burn-in phase, after which the production run uses a fixed surrogate model. The sampling framework is implemented in Python using parallel processes. Several chains are generated in parallel and share a single surrogate model trained during burn-in on all collected data. The forward model is treated as a black box; therefore, the application area is broad. However, the main motivation is efficient solution of geotechnical inverse problems with material properties represented by Gaussian random fields. In this study, the sampling framework is applied to a geotechnical inverse problem in which hydraulic conductivity and porosity are modeled as non-stationary Gaussian random fields approximated using truncated Karhunen-Loeve expansions. Based on a precomputation, the truncation dimensions are chosen separately for hydraulic conductivity and porosity. The forward model outputs are pore pressure values at control points and selected observation times. These are compared with in situ pore pressure measurements collected over one year during the Tunnel Sealing Experiment in an underground laboratory in Canada.

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

Human Cognition in Machines: A Unified Perspective of World Models

This report of world models distinguishes prior works by the cognitive functions they innovate. Many works claim an almost human-like cognitive capability in their world models. To evaluate these claims requires a proper grounding in first principles from human and machine cognition theory. In moving towards human-like world models we present a conceptual unified framework for world models that fully incorporates all the cognitive functions (i.e., memory, perception, language, reasoning, imagining, motivation, and metacognition) and identify gaps in existing research as a guide for future states of the art. In particular, we find that motivation (especially intrinsic motivation) and metacognition remain drastically under-researched, and we propose concrete directions to address these gaps informed by active inference and global workspace theory. We also introduce epistemic world models, a new category encompassing agent frameworks for scientific discovery that operate over structured knowledge. Our taxonomy, applied to video, embodied, and epistemic world models, suggests research directions where prior taxonomies have not.

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

BioAutoML-NAS: An End-to-End AutoML Framework for Multimodal Insect Classification via Neural Architecture Search on Large-Scale Biodiversity Data

Insect classification is important for agricultural management and ecological research, as it directly affects crop health and production. However, this task remains challenging due to the complex characteristics of insects, class imbalance, and large-scale datasets. To address these issues, we propose BioAutoML-NAS, the first BioAutoML model using multimodal data, including images, and metadata, which applies neural architecture search (NAS) for images to automatically learn the best operations for each connection within each cell. Multiple cells are stacked to form the full network, each extracting detailed image feature representations. A multimodal fusion module combines image embeddings with metadata, allowing the model to use both visual and categorical biological information to classify insects. An alternating bi-level optimization training strategy jointly updates network weights and architecture parameters, while zero operations remove less important connections, producing sparse, efficient, and high-performing architectures. Extensive evaluation on the BIOSCAN-5M dataset demonstrates that BioAutoML-NAS achieves 96.81% accuracy, 97.46% precision, 96.81% recall, and a 97.05% F1 score, outperforming state-of-the-art transfer learning, transformer, AutoML, and NAS methods by approximately 16%, 10%, and 8% respectively. Further validation on the Insects-1M dataset obtains 93.25% accuracy, 93.71% precision, 92.74% recall, and a 93.22% F1 score. These results demonstrate that BioAutoML-NAS provides accurate, confident insect classification that supports modern sustainable farming.

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

Through the PRISM: Preference Representation in Intermediate States of Video Diffusion Models

Evaluating video generation with clean, pixel-based reward models disconnects evaluation from the noisy diffusion process and incurs massive VAE decoding costs. In this paper, we challenge this paradigm by asking a fundamental question: Can a powerful video generator inherently discriminate preferences directly from noisy latents? To answer this, we introduce PRISM (Preference Representation in Intermediate States of Diffusion Models). PRISM employs a lightweight Query-based Aggregation head with a frozen video diffusion backbone to decode preference signals from noisy latents. Surprisingly, PRISM not only achieves SOTA preference accuracy but also unlocks strong noise-robustness, which enables early-stage Best-of-$N$ sampling. This allows for filtering suboptimal candidates at the very beginning of denoising, drastically reducing computation while boosting video quality. We also reveal a strong positive correlation between a backbone's generative performance and its inherent evaluative power, enabling self-improving video backbones.

10.
arXiv (quant-ph) 2026-06-15

QCI Connect: A Modular Full-Stack Quantum Computing Platform

arXiv:2606.14456v1 Announce Type: new Abstract: In a world of various competing quantum computing architectures, hardware-agnostic, full-stack platforms are necessary to bring the full power of quantum computing hardware to domain experts via the cloud. QCI Connect and its Software Development Kit provide a reference architecture for a full-stack platform with a modular design and open-source interface definitions, built to facilitate a community-driven application ecosystem. Here, we present its overall design and features, central interfaces, and lessons learned, both for users of the platform and as a reference guide for future developments.

11.
arXiv (CS.LG) 2026-06-12

Self-Guidance: Enhancing Neural Codecs via Decoder Manifold Alignment

arXiv:2606.12940v1 Announce Type: cross Abstract: Neural speech codecs based on Vector-Quantized VAEs (VQ-VAEs) are core audio tokenizers for speech LLMs, yet their reconstruction fidelity is bottlenecked by quantization error. Modifying the quantizer or increasing model capacity are common fixes, but they complicate downstream language modeling. Our core idea is to align the decoder's internal feature manifolds when processing both the quantized tokens and their original continuous embeddings, using a lightweight feature-mapping loss. This requires minimal training overhead and no inference-time changes. Applied to XCodec2, self-guidance improves all reconstruction metrics, achieving state-of-the-art low-bitrate performance. Notably, it enables a 4x codebook reduction without fidelity loss, which downstream TTS experiments show significantly improves LLM-based synthesis by simplifying the token modeling space. Multiple statistical observations and visualizations corroborate the enhanced internal manifold alignment in the decoder. Extensive experiments confirm its generality across various inductive biases. Self-guidance thus establishes an efficient, broadly applicable method for high-fidelity neural audio coding.

12.
arXiv (math.PR) 2026-06-16

Mean-field BSDEs with non-Lipschitz coefficients and double mean reflections

arXiv:2510.11228v2 Announce Type: replace Abstract: The present paper is devoted to the study of mean-field backward stochastic differential equations (MFBSDEs) with double mean reflections whose generators are not Lipschitz continuous. With the help of the Skorokhod problem and some a priori estimates for MFBSDEs, we establish the existence and uniqueness results for doubly mean reflected MFBSDEs.

13.
PLOS Medicine 2026-05-14

Antibody fine specificity correlates with protection from malaria for the RTS,S vaccine in young African children: A post hoc analysis of a phase IIb randomised controlled trial

Authors:

by Alessia Hysa, D. Herbert Opi, Joshua Waterhouse, Sandra Chishimba, Jessica L. Horton, Natalie Kingston, Hans J. Netter, David Wetzel, Michael Piontek, Gaoqian Feng, Jahit Sacarlal, Carlota Dobaño, Liriye Kurtovic, James G. Beeson Background The RTS,S/AS01 malaria vaccine was recently approved for implementation in children, but only provides modest and short-lived efficacy against malaria. RTS,S targets a portion of the Plasmodium falciparum (Pf) circumsporozoite protein (CSP), comprising the central NANP-repeat region and C-terminal domain. Mechanisms of immunity and correlates of protection for the RTS,S vaccine are not well defined, hindering progress towards generating highly effective CSP-based vaccines. Methods and findings We investigated epitope specificity and cross-reactivity of vaccine-induced antibodies to six peptides representing CSP epitopes in the N-terminal and central NANP-repeat region. We evaluated antibody reactivity in preclinical mouse vaccine studies, among CSP-specific monoclonal antibodies (mAbs), and in a large RTS,S phase IIb clinical trial in young children 1–4 years old (n = 735).The preclinical mouse vaccine studies and CSP-specific mAbs were used to initially evaluate IgG responses to the six peptides. Mice immunised with the central NANP-repeat region had IgG with cross-reactivity to an epitope in the N-terminal region. Additionally, we demonstrated that a single CSP-specific mAb could display cross-reactivity to several CSP epitopes. Through post hoc quantification and analysis of antibody responses in the RTS,S phase IIb clinical trial, we found that a subset of children generated IgG with specificity for a short NANP-repeat epitope (NANP2; amino acid sequence: NANPNANP) and cross-reactivity to an N-terminal epitope (J1; amino acid sequence: KQPADGNPDPNANPN). Notably, children with high IgG responses to NANP2 and J1 had a significantly reduced risk of clinical malaria, compared to children with low responses (IgG to NANP2 (aHR: 0.838 (95% CI [0.716, 0.981]; p = 0.028)) and J1 (aHR: 0.718 (95% CI [0.611, 0.844]; p 

14.
medRxiv (Medicine) 2026-06-16

Cardiac positronium lifetime in human PET: a reproducible right-left ventricular contrast that is not explained by blood oxygenation

Background. Ortho-positronium (o-Ps) lifetime, now measurable in vivo on long-axial-field-of-view (LAFOV) PET/CT, has been proposed as a biomarker of tissue oxygenation and hypoxia. Because o-Ps lifetime is dominated by tissue free-volume structure while the oxygen- specific contribution is small, whether an in-vivo lifetime contrast reflects oxygenation rather than anatomy is an open, identifiability-limited question. Aim. To test the oxygenation hypothesis directly using the heart's natural arterial/venous oxygenation contrast, with a built-in anatomical control. Methods. We re-analysed a public [82Rb]Cl human cardiac LAFOV PET/CT dataset (5.30 x 10^8 evaluated three-photon events). Per-compartment o-Ps lifetimes were extracted with a background-plus-two-component exponentially-modified-Gaussian (EMG) model. The list-mode to image mapping and right/left ventricle (RV/LV) identity were established lifetime-free (the mapping reproduces the provider's reconstructed image at block-correlation 0.998 and wins a joint multi-organ alignment panel). We applied a confound battery: registration stress test, blood-core vs wall, lung-air and wall-myocardium partial-volume, tissue density; and a structure/position-matched control (pulmonary artery, deoxygenated, vs aorta, oxygenated). An isotope-matched 82Rb uniform-quartz reference bounded the instrument's positional behaviour. All results were produced by two independent analysis pipelines. Results. RV o-Ps lifetime exceeded LV by delta tau = +0.304 ns (RV 1.700 +/- 0.172, LV 1.396 +/- 0.130 ns; about 1.4 sigma), in the oxygen-expected direction; the contrast was stable across +/-16 mm registration perturbation (sign preserved in 100% of 342 shifts) and resided in the blood core, not the wall. However, the matched-vessel control was null: pulmonary artery minus aorta = -0.011 +/- 0.344 ns. Lung-air and wall-myocardium partial-volume were disfavoured, and the effect fell within the isotope-matched 82Rb instrumental positional envelope (about 0.1-0.35 ns over 40 mm in uniform material). Conclusion. On this single subject, the cardiac o-Ps lifetime contrast does not provide a clean readout of blood oxygenation: an oxygenation effect of the observed (about 0.3 ns) magnitude is ruled out by the matched control, while a small physiological effect cannot be excluded. We provide a reusable confound-control battery for evaluating future in-vivo o-Ps oxygenation claims. Multi-subject replication with anatomy decoupled from oxygenation is required.

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

Cluster sizes in subcritical soft Boolean models

arXiv:2404.13730v2 Announce Type: replace Abstract: We consider the soft Boolean model, a model that interpolates between the Boolean model and long-range percolation, where vertices are given via a stationary Poisson point process. Each vertex carries an independent Pareto-distributed radius and each pair of vertices is assigned another independent Pareto weight with a potentially different tail exponent. Two vertices are now connected if they are within distance of the larger radius multiplied by the edge weight. We determine the tail behaviour of the Euclidean diameter and the number of points of a typical maximally connected component in a subcritical percolation phase. For this, we present a sharp criterion in terms of the tail exponents of the edge-weight and radius distributions that distinguish a regime where the tail behaviour is controlled only by the edge exponent from a regime in which both exponents are relevant. Our proofs rely on fine path-counting arguments identifying the precise order of decay of the probability that far-away vertices are connected.

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

On Regret Bounds of Thompson Sampling for Bayesian Optimization

arXiv:2603.09276v2 Announce Type: replace-cross Abstract: We study a widely used Bayesian optimization method, Gaussian process Thompson sampling (GP-TS), under the assumption that the objective function is a sample path from a GP. Compared with the GP upper confidence bound (GP-UCB) with established high-probability and expected regret bounds, most analyses of GP-TS have been limited to expected regret. Moreover, whether the recent analyses of GP-UCB for the lenient regret and the improved cumulative regret upper bound can be applied to GP-TS remains unclear. To fill these gaps, this paper shows several regret bounds: (i) a regret lower bound for GP-TS, which implies that GP-TS suffers from a polynomial dependence on $1/\delta$ with probability $\delta$, (ii) an upper bound of the second moment of cumulative regret, which directly suggests an improved regret upper bound on $\delta$, (iii) expected lenient regret upper bounds, and (iv) an improved cumulative regret upper bound on the time horizon $T$. Along the way, we provide several useful lemmas, including a relaxation of the necessary condition from recent analysis to obtain improved regret upper bounds on $T$.

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

Optimal Calibration of Quantum Network Links

arXiv:2606.18167v1 Announce Type: new Abstract: The reliable distribution of entanglement is essential for the effective operation of quantum networks. Due to fundamental differences between quantum and classical communication systems, it is necessary to develop specialised algorithms and protocols that also account for quantum-specific constraints. In this work, we focus on the issue of recalibration. As suggested by recent experimental studies, the process of local entanglement generation in a quantum link degrades over time due to environmental changes that have to be estimated and compensated via a calibration operation, during which the link is not available. Therefore, in such a quantum network, every link alternates between an activation period, during which it operates normally, and a calibration period, during which it cannot participate in the end-to-end entanglement distribution, thereby creating a trade-off between link quality (the fidelity of generated pairs, which decays during activation) and availability (the fraction of time the link is usable, which calibration reduces). We develop analytically a protocol for optimally assigning activation periods to each link in linear quantum repeater chains, subject to any general end-to-end fidelity requirements and local initial fidelity thresholds. Building on this foundation, we extend to general quantum networks, where multiple paths may cross at common links, proposing a heuristic approach evaluated in simulations and compared with a benchmark, numerical approach, and theoretical bounds.

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

Your Agent Has a Genome: Sequence-Level Behavioral Analysis and Runtime Governance of LLM-Powered Autonomous Agents

Authors:

arXiv:2606.15579v1 Announce Type: new Abstract: We propose Base Sequence Analysis, a framework that encodes the runtime behavior of LLM-powered autonomous agents into compact symbolic sequences using a four-letter alphabet: X (Explore), E (Execute), P (Plan), and V (Verify). Drawing an analogy to genomic sequence analysis, we apply n-gram pattern mining, Markov transition matrices, and point-biserial correlation to 347 real-world execution traces collected from a production ReAct agent system over 8 days. Our analysis reveals that (1) the trigram P-X-P is the only statistically significant high-risk pattern, lowering success rate by 10.4%; (2) P-ratio is the strongest negative predictor of success (r=-0.256, pV transition probability is only 2.1%, indicating a systemic verification deficit. Based on these findings, we design Governor, a three-layer runtime intervention system comprising a rule engine, a statistical accumulator, and a chi-square-based threshold adaptor. In a natural before/after deployment evaluation (N=101 vs. N=246), Governor achieves a +6.2% absolute increase in task success rate while simultaneously reducing average token consumption by 44%. To validate cross-system generality, we apply the XEPV encoding to 2,000 public SWE-agent trajectories on SWE-bench, confirming that exploration spirals and the E->V verification deficit replicate in an independent system. We outline six research directions including base sequence language models, cross-agent behavioral fingerprinting, and reward shaping, and release an open-source toolkit for reproducibility.

20.
arXiv (CS.CV) 2026-06-17

Reasoning Text-to-Video Retrieval for Operating Room Clips via Action-Driven Digital Twins

Text-to-video retrieval in operating rooms (OR) is an enabling technology for OR safety, as it allows stakeholders to retrieve and inspect recordings of specific events. However, because the most safety-critical events may not follow the common structure, to unlock its full potential text-to-video retrieval must be able to handle implicit queries that require reasoning to identify the right video (e.g., the step right before clipping). However, existing methods rely on global embeddings that cannot reason over such queries. We propose OR3, a text-to-video retrieval method that converts clips into action-driven digital twins (ActDTs), grouping concurrent subject-action-object triplets under non-overlapping temporal intervals. Moreover, rather than cross-modal matching through paired encoders, OR3 performs imagination-based retrieval where an LLM generates hypothetical ActDTs from queries. This enables intra-modal matching via a single encoder trained with ActDT-tailored hard negatives. Finally, evidence-grounded refinement revises imagined ActDTs based on discrepancies with top candidates to capture procedure-specific patterns. We construct a benchmark from MM-OR with 276 implicit queries across four reasoning categories over 386 clips from robotic knee procedures. OR3 achieves 57.6 R@1 and 77.3 R@5, outperforming the strongest baseline. These results demonstrate that OR3 enables fine-grained discrimination between visually similar OR video clips through temporal action reasoning.

21.
medRxiv (Medicine) 2026-06-17

Differential Determinants of Past Behavior and Future Intention Regarding Voluntary Blood Donation: A Cross-Sectional Study of Knowledge, Attitudes, and Practices in Qingdao, China

Background A persistent gap between motivation and action threatens voluntary blood supply. This study examined the publics knowledge, attitudes, and practices (KAP) regarding blood donation, with a particular focus on identifying the different determinants of past blood donation behavior and future willingness to donate. Methods Convenience sampling was used to conduct a cross-sectional survey among 1,058 eligible people in Qingdao, China, between July and November 2025. Data were collected via a self-designed KAP questionnaire. To find independent characteristics linked to previous behavior and future intention, respectively, multivariable binary logistic regression was used. Results Overall, 37.0% of participants (n=391) had a lifetime donation history, while 39.2% (n=415) intended to donate in the next 12 months. Past behavior was positively associated with older age (36-45 years: OR=6.84; 95% CI: 3.21-14.58), higher education (OR=2.06; 95% CI: 1.33-3.17), and interpersonal interaction channels (OR=1.45; 95% CI: 1.01-2.09) but hindered by safety concerns (OR=0.23; 95% CI: 0.16-0.34). Conversely, future intention was positively correlated with male sex (OR=1.69; 95% CI: 1.24-2.29), prior donation history (OR=2.69; 95% CI: 1.87-3.86), having family members or friends in need of blood (OR=2.75; 95% CI: 1.96-3.85), and traditional media exposure (OR=3.33; 95% CI: 2.18-5.10). Higher education was adversely correlated with future intention (OR=0.55; 95% CI: 0.38-0.79). Conclusion There is a substantial disparity between donation motivation and action. The determinants of past behavior and future intention are asymmetric, suggesting that stage-specific interventions are required, using social mobilization for initiating first-time donations, while employing family reciprocity and authoritative communication to sustain long-term engagement.

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

Where Will They Go? Modelling Multimodal Pedestrian Manoeuvres from Ego-centric Videos

Pedestrian trajectory prediction from an ego-centric camera is challenging since it depends on complex interactions with vehicles and scene context, as well as the intention of the pedestrian. By modelling correlation and intent from the historical and future trajectories of the pedestrian, it will usually result in a multimodal (i.e. multiple modes) distribution. Existing stochastic predictors often sample multiple futures from a single unimodal distribution, which can yield sub-optimal 'mixed-mode' trajectories that lie between distinct motion patterns and become implausible in real scenes. In this paper, we propose MMPM, a mode-aware framework that separately models future trajectory distributions into semantically meaningful modes based on the pedestrian's crossing behavior. MMPM consists of two modules: behavior-aware Pedestrian Interaction Module (PIM) that jointly captures pedestrian-vehicle and pedestrian-environment interactions by introducing gaze, head and hand gesture, and a CVAE-based Mode-aware Trajectory Predictor (MTP) module to model the future trajectory distributions on two modes, crossing and non-crossing the road, separately. A query-based decoder further enforces mode consistency during decoding. Experiments on PIE and JAAD datasets show that our method surpasses state-of-the-art baselines. Our proposed MTP is model-agnostic, which can be integrated into existing frameworks such as BiTrap-NP and SGNet-ED to further improve future trajectory prediction performance. We additionally introduce a data-driven validation protocol that matches predictions to spatio-temporally consistent ground-truth trajectories, demonstrating improved frame-wise displacement errors over previous work.

23.
medRxiv (Medicine) 2026-06-22

Use of the Pharmacy First service in England in the first 12 months: geographic variation and health system context

Objectives: The Pharmacy First (PF) service was introduced across England from 31 January 2024 to expand the clinical role of community pharmacies and improve access to primary care. This paper describes use of PF in its first 12 months, in terms of uptake, access routes, consultation outcomes, geographic variations, service costs and antimicrobial supply. Methods: A descriptive analysis of all PF consultations submitted for payment to NHS Business Services Authority in England between 31 January 2024 and 31 January 2025. Pharmacy-level consultation data were linked to national data on population, location and pharmacy characteristics. PF use was examined using population-standardised consultation rates and consultations per pharmacy. Results: During the first year of implementation, 2,205,731 PF consultations were recorded as delivered across 11,349 pharmacies, with payment of GBP123 million to pharmacies. Uptake increased steadily over time. Most consultations were for acute sore throat (33%) and uncomplicated urinary tract infection (27%), with corresponding antibiotics, phenoxymethylpenicillin and nitrofurantoin being the most supplied. Most people self-referred (74%) into the service, with 95% of consultations managed without onward referral. Substantial geographic variation was observed. Northern regions had higher use based on the eligible population. The South East and Midlands had higher activity per pharmacy. London showed a distinct pattern, with higher self-referral into the service, lower medication supply and higher referral to other healthcare services. Higher consultation volume was weakly associated with pharmacy characteristics, including opening hours, pharmacy type and retail setting, and local context, in terms of socio-economic and geographic factors. Conclusions: PF had immediate uptake and is operating primarily as a direct-access model for common acute conditions. Findings suggest that PF is contributing to improved access to care and may shift demand away from general practice. However, the service uptake appears to be shaped by geographic location, proximity to other healthcare services and pharmacy characteristics.

24.
medRxiv (Medicine) 2026-06-17

A multistate model of frailty progression after severe infections in adults >=65 years in England: a matched-cohort study

Background Evidence on frailty progression following severe infections is limited. We compared rates of transition to greater frailty or death between adults with and without severe infection in England. Methods We conducted a matched-cohort study among adults aged [≥]65 years (1,452,117: median age 76 years, 45% male) in Clinical Practice Research Datalink Aurum (2006-2019). Adults with severe infection (hospitalised primarily due to infection) were matched on calendar time to individuals without severe infection on age, sex, and primary care practice. The admission date was used as index date and same was assigned to matched unexposed adults. We measured frailty using Electronic Frailty Index, a proportion of 36 health deficits in validated categories (Fit 0-0.12, Mild >0.12-0.24, Moderate >0.24-0.36, Severe >0.36). In a time-varying Markov multistate model, we focused on forward transitions from baseline or intermediate frailty states to higher states or death. For each transition, we used Cox regression to estimate cause-specific transition hazard ratios (HR) with 95% confidence intervals (CIs), comparing adults with and without severe infection. We adjusted for baseline frailty score, age, sex, deprivation, harmful alcohol use, smoking, and primary care infection history 5 years before index date. We estimated state occupancy probabilities, and expected length of stay (ELOS) in each state at year five among adults with and without severe infection. We explored effect modification by infection type. Results Across all transitions, severe infection was associated with higher adjusted hazards of transitioning to worsening frailty or death, HR, 95% CI: (fit to: mild[1.56, 1.54-1.58], moderate[2.51, 1.79-3.51], death[4.57, 4.50-4.65]; mild to: moderate[1.52, 1.50-1.53], severe[1.90, 1.43-2.52], death[2.67, 2.64-2.70]; moderate to: severe[1.40, 1.38-1.42], death[1.87, 1.85-1.90]; severe to death[1.48, 1.46-1.50]). Transition hazard ratios were strongest for lower respiratory tract infections, followed by sepsis, urinary tract infections, meningitis/encephalitis, gastroenteritis, and skin and soft tissue infections. At five years, adults with severe infection had higher probabilities of transitioning to greater frailty or death across all transitions and lower ELOS in each frailty state than those without severe infection. Interpretation Severe infections may accelerate frailty deterioration in older age. Prevention through vaccination, early detection, and prompt management may help mitigate this decline.

25.
arXiv (math.PR) 2026-06-11

Percolation on hierarchical lattices

arXiv:2606.11503v1 Announce Type: new Abstract: We consider independent Bernoulli percolation on top of sequences of hierarchical graphs. Given a graph $G_{1}$ with two distinguished vertices $a_{1}$ and $b_{1}$, the hierarchical graph with seed $G_{1}$ is the sequence $\big( G_{k} \big)_{k \geq 1}$ resulting from the inductive procedure, where the graph $G_{k+1}$ is obtained from $G_{k}$ by replacing each of its edges with a copy of $G_{1}$, attached by the vertices $a_{1}$ and $b_{1}$. We prove that, under sharp hypotheses, percolation on these graphs presents a unique phase transition. Second, we establish the existence of several critical exponents in this context, such as the critical exponents for the correlation length $\nu$, the surface tension $\mu$, the one-arm exponent $\alpha_{1}$. Several results are also obtained for their infinite counterpart $G_\infty$, which is the Benjamini-Schramm limit of $G_k$: uniqueness of the infinite cluster, continuity of $\theta(p)$, existence of the percolation-probability exponent $\beta$ and scaling relations for the critical exponents $\alpha_1$, $\nu$ and $\beta$. Furthermore, we analyze noise sensitivity for crossing functions in $G_{k}$ and establish sharp noise sensitivity in this setting. Finally, we propose a setup where it is possible to verify the locality hypothesis, stating that the critical threshold for percolation is a local property, while critical exponents are determined by the global geometry of the graph. As a consequence of the techniques developed here, we also provide a necessary and sufficient condition for the existence of a unique fixed point for the map $p \mapsto \mathbb{E}_p[g]$ in $(0,1)$, where $g:\{0,1\}^n \to \{0,1\}$ is a nontrivial monotone Boolean function.