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01.
medRxiv (Medicine) 2026-06-15

Routine use of oral iron for people with heart failure and iron deficiency in primary care; retrospective cohort study

Authors:
Maharajan↗Jones↗Bankhead↗Erone↗Haynes↗Katumba↗Li↗Maynard↗Roy↗Shah↗Stanworth↗Smith↗…

Aims: Iron deficiency is common among people with heart failure and associated with morbidity and mortality. While intravenous iron improves clinical outcomes, oral iron continues to be prescribed in routine practice despite limited evidence of benefit. Methods: We completed a retrospective primary care cohort study (2016 to 2021) to investigate the proportion of people with an incident diagnosis of heart failure who had iron deficiency identified (defined as ferritin

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02.
arXiv (CS.LG) 2026-06-16

Convex Approximation of Two-Layer ReLU Networks for Hidden State Differential Privacy

Authors:
Rob Romijnders↗Antti Koskela↗

arXiv:2407.04884v4 Announce Type: replace Abstract: The hidden state threat model of differential privacy (DP) assumes that the adversary has access only to the final trained machine learning (ML) model, without seeing intermediate states during training. However, the current privacy analyses under this model are restricted to convex optimization problems, reducing their applicability to multi-layer neural networks, which are essential in modern deep learning applications. Notably, the most successful applications of the hidden state privacy analyses in classification tasks have only been for logistic regression models. We demonstrate that it is possible to privately train convex problems with privacy-utility trade-offs comparable to those of 2-layer ReLU networks trained with DP stochastic gradient descent (DP-SGD). This is achieved through a stochastic approximation of a dual formulation of the ReLU minimization problem, resulting in a strongly convex problem. This enables the use of existing hidden state privacy analyses and provides accurate privacy bounds also for the noisy cyclic mini-batch gradient descent (NoisyCGD) method with fixed disjoint mini-batches. Empirical results on benchmark classification tasks demonstrate that NoisyCGD can achieve privacy-utility trade-offs on par with DP-SGD applied to 2-layer ReLU networks.

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

SPARK: Spatial Policy-driven Adaptive Reinforcement learning for Knowledge distillation

Authors:
Mohamed Jismy Aashik Rasool↗Shabir Ahmad↗Gisong Oh↗Teag Kuen Whangbo↗

Low-bit quantization enables deployment of image restoration (IR) networks on resource-constrained devices, but introduces rounding noise that disproportionately degrades high-frequency regions such as edges and fine textures. Existing knowledge distillation (KD) methods apply distillation signals uniformly across all spatial locations, overlooking the varying reconstruction difficulty across image regions. To address this, we propose SPARK (Spatial Policy-driven Adaptive Reinforcement Learning for Knowledge Distillation), a framework that adaptively allocates distillation effort using a lightweight reinforcement learning (RL) policy network. At each training step, a difficulty feature extractor computes four signals, namely Laplacian variance, pixel variance, student reconstruction error, and teacher-student knowledge gap, which are fed into a compact policy CNN that produces a stochastic spatial weight map to modulate the KD loss during quantization-aware training (QAT). SPARK is IR task-agnostic, adds no inference cost, and integrates into any existing QAT pipeline without architectural changes. Experiments on benchmark datasets demonstrate that SPARK consistently outperforms PTQ, QAT, and state-of-the-art (SOTA) KD approaches across multiple student architectures, achieving reconstruction quality closest to the full-precision teacher under significant computational constraints.

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04.
bioRxiv (Bioinfo) 2026-06-22

PanRes: A database of latent and acquired antimicrobial resistance allowing 3D-based protein homology search

Authors:
Vojtkova↗Baltusis↗Martiny↗H.-M↗Baral↗Pyrounakis↗Beleon↗Freitag↗Pico-Tomas↗Kaas↗R. S↗Petersen↗…

Antimicrobial resistance databases are central to genomic surveillance, but resistance determinants remain distributed across resources with different scopes, structures, and annotations. We developed PanRes, a curated resistance database of 11,717 genes integrating acquired and latent determinants of antibiotic, biocide, and metal resistance within a unified ontology. We predicted representative protein structures and clustered them by structural similarity, grouping proteins into 598 structurally conserved clusters coherent despite sequence divergence. Their structure-guided alignments were used to build Hidden Markov Models (HMMs) for remote homology search. In wastewater metagenomes from seven European cities, PanRes 3D-based HMMs expanded detection beyond high-confidence BLAST, with 35.2% of retained hits identified only by the HMMs and generally showing greater divergence from known proteins. For beta-lactamases, several proteins retained beta-lactamase-like folds and catalytic geometry despite weak sequence similarity. PanRes is available through an interactive web platform (https://panres.rambio.dk/), a structure-informed resource for exploring the whole resistome.

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05.
arXiv (CS.AI) 2026-06-16

Shachi: A Modular, Controllable Framework for LLM-Based Agent-Based Modeling of Emergent Collective Behavior

Authors:
So Kuroki↗Yingtao Tian↗Kou Misaki↗Takashi Ikegami↗Takuya Akiba↗Yujin Tang↗

arXiv:2509.21862v3 Announce Type: replace Abstract: How collective behaviors emerge from the interactions of individual LLM-driven agents is a central question in artificial life, yet controlled study of these emergent dynamics has been hindered by the lack of a principled simulation framework for systematic experimentation. To address this, we introduce Shachi, a principled methodology and modular framework that decomposes an agent's cognition into core components: Configuration for intrinsic identity, Memory for contextual continuity, and Tools for extended capabilities, all orchestrated by an LLM reasoning engine. This decomposition treats each cognitive component as an independently controllable variable, enabling perturbation studies that trace how micro-level cognitive traits propagate into population-level dynamics. We investigate behavioral patterns across a 10-task benchmark spanning three levels of collective complexity. Shachi enables memory transfer across environment transitions, producing history-dependent behavioral shifts, and allows agents to simultaneously inhabit multiple environments, revealing cross-environment interference invisible in single-environment studies. Furthermore, in a real-world U.S. tariff shock case study, locally interacting agents with individually controlled cognitive components produce macro-level market dynamics directionally consistent with observed real-world outcomes. Our work provides a rigorous, open-source simulation framework for LLM-based ABM, aimed at fostering cumulative scientific inquiry into the emergent collective behaviors of interacting artificial agents.

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

PrototypeNAS: Rapid Design of Deep Neural Networks for Microcontroller Units

Authors:
Mark Deutel↗Simon Geis↗Axel Plinge↗

arXiv:2603.15106v2 Announce Type: replace Abstract: Enabling efficient deep neural network (DNN) inference on edge devices with different hardware constraints is a challenging task that typically requires DNN architectures to be specialized for each device separately. To avoid the huge manual effort, one can use neural architecture search (NAS). However, many existing NAS methods are resource-intensive and time-consuming because they require the training of many different DNNs from scratch. Furthermore, they do not take the resource constraints of the target system into account. To address these shortcomings, we propose PrototypeNAS, a zero-shot NAS method to accelerate and automate the selection, compression, and specialization of DNNs to different target microcontroller units (MCUs). We propose a novel three-step search method that decouples DNN design and specialization from DNN training for a given target platform. First, we present a novel search space that not only cuts out smaller DNNs from a single large architecture, but instead combines the structural optimization of multiple architecture types, as well as optimization of their pruning and quantization configurations. Second, we explore the use of an ensemble of zero-shot proxies during optimization instead of a single one. Third, we propose the use of Hypervolume subset selection to distill DNN architectures from the Pareto front of the multi-objective optimization that represent the most meaningful tradeoffs between accuracy and FLOPs. We evaluate the effectiveness of PrototypeNAS on 12 different datasets in three different tasks: image classification, time series classification, and object detection. Our results demonstrate that PrototypeNAS is able to identify DNN models within minutes that are small enough to be deployed on off-the-shelf MCUs and still achieve accuracies comparable to the performance of large DNN models.

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

MemPO: Self-Memory Policy Optimization for Long-Horizon Agents

Authors:
Ruoran Li↗Xinghua Zhang↗Haiyang Yu↗Shitong Duan↗Xiang Li↗Wenxin Xiang↗Chonghua Liao↗Xudong Guo↗Yongbin Li↗Jinli Suo↗

arXiv:2603.00680v4 Announce Type: replace Abstract: Long-horizon agents face the challenge of growing context size during interaction with environment, which degrades the performance and stability. Existing methods typically introduce the external memory module and look up the relevant information from the stored memory, which prevents the model itself from proactively managing its memory content and aligning with the agent's overarching task objectives. To address these limitations, we propose the self-memory policy optimization algorithm (MemPO), which enables the agent (policy model) to autonomously summarize and manage their memory during interaction with environment. By improving the credit assignment mechanism based on memory effectiveness, the policy model can selectively retain crucial information, significantly reducing token consumption while preserving task performance. Extensive experiments and analyses confirm that MemPO achieves absolute F1 score gains of 25.98 over the base model and 7.1 over the previous SOTA baseline, while reducing token usage by 67.58% and 73.12%. The code is released at https://github.com/TheNewBeeKing/MemPO.

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08.
bioRxiv (Bioinfo) 2026-06-10

A Unified Spatial AI Framework for Cross-Domain Tissue-State Analysis in Trauma, Oral, and Cardiovascular Pathology

Authors:
Pham↗T. D↗

Objective: To develop a cross-domain spatial AI framework for identifying conserved tissue-state organisation across trauma, oral disease, and cardiovascular tissue using spatial transcriptomic data. Methods: Four public spatial transcriptomic datasets spanning wound healing, periodontitis, oral squamous cell carcinoma, and cardiac tissue were integrated using recurrence modelling, graph-based spatial learning, fuzzy tissue-state analysis, and tensor decomposition. Cross-domain coupling, spatial fragmentation, recurrence structure, and permutation-based topological validation were evaluated. Results: Six conserved fuzzy tissue states were identified, dominated by extracellular matrix remodelling, fibroblast/stromal activation, endothelial signalling, and inflammatory pathways. Latent embedding analysis demonstrated strong overlap between trauma and oral domains, while cardiovascular tissue exhibited more compact spatial organisation. Oral inflammatory tissue showed the highest fragmentation, whereas cardiovascular tissue demonstrated greater recurrence coherence. Tensor decomposition identified conserved stromal-remodelling programmes across domains. Permutation testing confirmed significantly elevated graph modularity and reduced spatial entropy relative to null distributions. Conclusion: The proposed framework identified conserved spatial tissue-state architecture linking wound healing, oral pathology, and cardiovascular tissue despite differences in tissue origin, pathology, and acquisition technology. Significance: These findings demonstrate the potential of spatial AI for investigating conserved stromal and inflammatory microenvironmental organisation across clinically related disease systems and may support spatial biology research in trauma–oral–systemic health.

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09.
arXiv (quant-ph) 2026-06-12

Spectral analysis of equilibration: information leakage in isolated quantum systems

Authors:
Andr\'e T. Ces\'ario↗Marcos G. Alpino↗Reinaldo O. Vianna↗Tiago Debarba↗

arXiv:2606.12545v1 Announce Type: new Abstract: We develop a unified dynamical-spectral framework for equilibration in isolated quantum systems based on a subspace coarse-graining approach. Central to our formulation is the Leakage Fidelity Function (LFF), defined as the probability that a unitarily evolving state escapes the support of its initial subspace. This quantity provides a direct, operational measure of information flow and memory loss without invoking ensemble assumptions or perturbative arguments. We derive universal bounds on temporal fluctuations of the LFF, in terms of the spectral gap structure and the square of the effective dimension, evincing that large spectral delocalization suppresses fluctuations and guarantees equilibration on average. By introducing spectral power distributions and associated entropic measures, we establish a quantitative link between phase mixing, gap participation, and dynamical stability. We further investigate the equilibration timescale by connecting the LFF to quantum speed limits, thereby revealing the average time required for equilibration. Our results provide a state-dependent, geometrically transparent perspective on how spectral complexity and subspace information leakage jointly govern irreversibility in closed quantum many-body systems.

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10.
arXiv (quant-ph) 2026-06-11

Locally Acting Grover Mixers for Constraint-Preserving QAOA

Authors:
Minjin Choi↗Dongkeun Lee↗Junghee Ryu↗

arXiv:2606.11530v1 Announce Type: new Abstract: The Grover mixer quantum alternating operator ansatz (GM-QAOA) employs the Grover mixer to confine the quantum evolution to the feasible subspace defined by the problem. Its mixing unitary, however, requires a global multi-controlled phase-shift gate acting on all qubits, resulting in substantial circuit overhead on near-term quantum devices. In this work, we propose locally acting Grover mixers tailored to initial states that admit a product structure over disjoint qubit subsystems, which may be obtained by encoding only a subset of problem constraints into the initial state preparation. The proposed method preserves the search space defined by the initial state while significantly lowering implementation cost, as the global multi-controlled phase-shift gate is replaced with local operations on disjoint subsystems. Numerical simulations on the exact-cover problem and the traveling salesman problem (TSP) demonstrate that the proposed method achieves convergence behavior comparable to that of the original GM-QAOA, while using shallower circuits with fewer gates. We further compare two constraint encoding strategies for the TSP, encoding only a subset of constraints versus all constraints into the initial state preparation, and show that the former combined with the proposed mixer yields markedly more compact circuits at the point where comparable solution quality is achieved.

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

Approximate Structured Diffusion for Sequence Labelling

Authors:
Nicolas Floquet↗Joseph Le Roux↗Nadi Tomeh↗

Sequence labelling, a core task of Natural Language Processing (NLP), consists in assigning each token of an input sentence a label. From a Machine Learning point of view, sequence labelling is often cast as a Linear-Chain Conditional Random Field (CRF) parametrised by a neural network. While this approach gives good empirical results, CRFs assume a finite decision span (eg label bigrams) which can limit their expressivity and hurt performance when long-range dependencies are required. We show we can leverage diffusion to train a CRF conditioned on an entire label sequence, with the caveat that the condition is on a noisy version of labels. We show experimentally that this method, in conjunction with approximate CRF inference, improves label accuracy with a 16.5% error reduction for POS-tagging.

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

StagePilot: Stage-Level Planning for Long-Horizon Dialogue Simulation in Cybergrooming

Authors:
Heajun An↗Qi Zhang↗Minqian Liu↗Xinyi Zhang↗Sang Won Lee↗Lifu Huang↗Pamela J. Wisniewski↗Jin-Hee Cho↗

Cybergrooming is an evolving threat to youth, requiring proactive educational interventions. We address this by modeling dialogue progression as a structured planning problem over stage-wise interactions. We propose StagePilot, a dialogue framework that separates stage-level planning from response generation, in which the model selects the next stage under constrained transitions and generates responses conditioned on it, enabling coherent and realistic progression. Reinforcement learning is used to learn stage-level policies from offline data, optimizing for both emotional alignment and goal-consistent progression. Our empirical experiments show that StagePilot generates more structured, coherent dialogue trajectories and reduces conversational stagnation compared to baselines; notably, the IQL+AWAC variant reaches the final stage more often while maintaining over 70% positive or neutral responses, yielding a 43% relative improvement.

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13.
arXiv (CS.CV) 2026-06-12

OpenMedQ: Broad Open Pretraining for Medical Vision-Language Models

Authors:
Ibrahim Gulluk↗Max Van Puyvelde↗Olivier Gevaert↗

We present OpenMedQ, a medical vision-language model pretrained on the broadest fully-open medical mix to date: 14 datasets totaling ~3.35M pretraining samples spanning pathology, radiology, microscopy, and text-only clinical QA. OpenMedQ reaches state-of-the-art BLEU-1 on PathVQA (75.9), beating Med-PaLM M variants up to 562B parameters (~80x larger), and matches the best reported VQA-MED BLEU-1 (64.5). Its vision encoder, transferred to 8 unseen medical classification benchmarks under an identical downstream recipe, obtains the highest average macro-F1 (0.757) among BiomedCLIP (0.745), PMC-CLIP (0.745), PubMedCLIP (0.746), and a from-scratch baseline (0.616). We release our code and an interactive demo is publicly available as a reproducible baseline for the community.

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14.
arXiv (quant-ph) 2026-06-11

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

Authors:
Isaac D. Smith↗Hans J. Briegel↗Hendrik Poulsen Nautrup↗

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.

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15.
arXiv (CS.AI) 2026-06-17

DeMaVLA: A Vision-Language-Action Foundation Model for Generalizable Deformable Manipulation

Authors:
Taiyi Su↗Jian Zhu↗Tianjian Wang↗Youzhang He↗Zitai Huang↗Jianjun Zhang↗Chong Ma↗Hanyang Wang↗Tianjiao Zhang↗Munan Yin↗Weihao Ding↗Yi Xu↗…

arXiv:2605.31286v2 Announce Type: replace-cross Abstract: Real-world household robots require Vision-Language-Action (VLA) foundation models that can acquire reusable manipulation skills across diverse objects, task conditions, and household environments. Deformable-object folding is a representative challenge, requiring robots to handle clothing items from random initial states across varying categories, geometries, materials, and scenes. However, existing VLA systems commonly train separate policies for different object categories, while naively mixed multi-task training often suffers from task interference and degraded performance. To move beyond category-specific folding policies, we introduce DeMaVLA, a VLA foundation model for generalizable Deformable Manipulation. DeMaVLA adopts a VLM backbone with an action expert and formulates continuous action generation using flow matching. To improve efficiency, the action expert is constructed by pruning every other transformer layer while preserving layer-wise alignment with the VLM backbone, reducing training and inference cost. DeMaVLA is first pre-trained on approximately 5,000 hours of selected real-world dual-arm demonstrations to acquire general manipulation priors. It is then post-trained on mixed folding data that aggregates self-collected demonstrations and corrective trajectories from real-robot failures across multiple folding tasks through a human-in-the-loop Data Aggregation~(DAgger) pipeline. Experiments show that DeMaVLA achieves competitive performance on RoboTwin 2.0 and strong real-world results on our household folding benchmark. These results highlight the value of scalable real-world data, efficient action generation, and corrective learning for general-purpose VLA policies in deformable-object manipulation.

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

Fast Nonparametric Conditional Independence Testing via Two-Stage Regression

Authors:
Eric V. Strobl↗

arXiv:2606.18011v1 Announce Type: cross Abstract: Constraint-based causal discovery relies on repeated conditional independence tests, but fast nonparametric tests often sacrifice calibration, especially when variables depend on the conditioning set through nonlinear relationships. We introduce BLITZ (Broad-to-Local Independence Testing via residualiZation), a nonparametric conditional independence test designed to run well under a second while maintaining the accuracy needed for the thousands of queries performed by constraint-based causal discovery algorithms. BLITZ first removes broad smooth dependence on the conditioning set using low-order polynomial regression, then applies a small nonlinear feature map and residualizes those features with shallow tree regressions. The resulting statistic tests residual cross-covariance, with a moment-matched chi-square approximation to the null distribution. We show theoretically that the two-stage design reduces the effective complexity faced by the tree residualizers, allowing shallow trees to control residual conditional-mean bias while avoiding excessive overfitting. In simulations, BLITZ provides better null calibration than fast kernel, random-feature, and regression-based competitors while remaining among the fastest methods tested. In causal discovery experiments on synthetic graphs and flow-cytometry data, BLITZ yields more reliable endpoint orientations among retained adjacencies and competitive structural recovery. These results suggest that broad-to-local residualization is a practical route to calibrated, scalable nonparametric conditional independence testing for causal discovery.

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

Pass@K Policy Optimization: Solving Harder Reinforcement Learning Problems

Authors:
Christian Walder↗Deep Karkhanis↗

Reinforcement Learning (RL) algorithms sample multiple n>1 solution attempts for each problem and reward them independently. This optimizes for pass@1 performance and prioritizes the strength of isolated samples at the expense of the diversity and collective utility of sets of samples. This under-utilizes the sampling capacity, limiting exploration and eventual improvement on harder examples. As a fix, we propose Pass-at-k Policy Optimization (PKPO), a transformation on the final rewards which leads to direct optimization of pass@k performance, thus optimizing for sets of samples that maximize reward when considered jointly. Our contribution is to derive novel low variance unbiased estimators for pass@k and its gradient, in both the binary and continuous reward settings. We show optimization with our estimators reduces to standard RL with rewards that have been jointly transformed by a stable and efficient transformation function. While previous efforts are restricted to k=n, ours is the first to enable robust optimization of pass@k for any arbitrary k

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18.
arXiv (quant-ph) 2026-06-11

On the Addressability Problem on CSS Codes

Authors:
J\'er\^ome Guyot↗Samuel Jaques↗

arXiv:2502.13889v4 Announce Type: replace Abstract: Recent discoveries in asymptotically good quantum codes have intensified research on their application in quantum computation and fault-tolerant operations. This study focuses on the addressability problem within CSS codes: we ask what circuits might implement logical gates on strict subsets of logical qubits. With some notion of fault-tolerance, we prove several impossibility results: for CSS codes with non-zero rate, one cannot address a logical $H$, $HS$, $SH$, or $\mathsf{CNOT}$ to any non-empty strict subset of logical qubits using a circuit made only from 1-local Clifford gates. Furthermore, we show that one cannot permute the logical qubits in a code purely by permuting the physical qubits, if the rate of the code is (asymptotically) greater than 1/3 and the distance is at least 3. We can show a similar no-go result for $\mathsf{CNOT}$s and $\mathsf{CZ}$s between two such high-rate codes, albeit under a more restrictive assumption on the circuit, which we call "global" (though recent addressable CCZ gates use global circuits). This work pioneers the study of distance-preserving addressability in quantum codes, mainly by considering automorphisms of the code. This perspective offers new insights and potential directions for future research. We argue that studying this trade off between addressability and efficiency of the codes is essential to understand better how to do efficient quantum computation.

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

ARIADNE: Agnostic Routing for Inference-time Adapter DyNamic sElection

Authors:
Enrico Cassano↗Micha{\l} Brzozowski↗Zuzanna Dubanowska↗Paolo Mandica↗Neo Christopher Chung↗

arXiv:2606.19079v1 Announce Type: new Abstract: The increasing deployment of parameter-efficient fine-tuning (PEFT) has led to model ecosystems in which a single backbone is paired with many task-specialized adapters. In this setting, inference-time queries often arrive without task labels, requiring the system to automatically select the most appropriate adapter from a growing and heterogeneous adapter pool. Existing routing methods either depend on access to adapter internals, such as weight decompositions or gradient-based statistics, or require additional router training, which limits scalability and portability as new adapters are added. We introduce ARIADNE, a training-free, adapter-agnostic routing framework for dynamic adapter selection at inference time. ARIADNE represents each adapter through a set of centroids computed from embeddings of its training set, capturing the data distribution associated with that adapter. Given an unlabeled input, it selects an adapter by measuring proximity to these centroids in latent space. Because routing is performed entirely in the input embedding space, ARIADNE is compatible with arbitrary PEFT methods and requires no modification to the adapters or training procedures. Primarily evaluated with Llama 3.2 1B Instruct on 23 diverse NLP tasks, ARIADNE recovers 97.44% of the upper bound performance. Scaling to 44 tasks, it achieves 89.7% average selection accuracy, without additional training or access to adapter internals.

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20.
medRxiv (Medicine) 2026-06-22

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

Authors:
Meng↗Sonnex↗Pehlivanli↗Allen↗Dolan↗Glover↗Goulding↗Higgins↗Mays↗Taylor↗Thornley↗Avery↗…

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.

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21.
arXiv (CS.LG) 2026-06-12

Hölder++: Improving the Quality-Coherence Trade-off in Multimodal VAEs

Authors:
Huyen Vo↗Mar\'ia Mart\'inez-Garc\'ia↗Isabel Valera↗

arXiv:2606.13381v1 Announce Type: new Abstract: Existing approaches for multimodal variational autoencoders (VAEs) face a trade-off between generative quality and coherence-i.e., they struggle to generate realistic and diverse samples that, at the same time, are semantically consistent across modalities. A recent work shows that using a simple approximation to Hölder pooling as an aggregation method improves coherence over the SOTA MMVAE+, despite assuming a single shared representation across all modalities. Yet, it slightly compromises sample diversity. Inspired by this insight, we propose Hölder++, a novel multimodal VAE that improves the generative quality-coherence trade-off through: (i) the first implementation of Hölder pooling without any approximation for multimodal VAEs; (ii) an extended architecture that models distinct shared and private (i.e., modality-specific) representations (Hölder+); and (iii) hierarchical inference that further enhances the disentanglement between the shared and private representations (Hölder++). Our experiments corroborate that Hölder++ consistently improves the generative quality-coherence trade-off, yields more structured latent spaces, and learns shared representations that are informative for downstream tasks.

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22.
arXiv (CS.LG) 2026-06-19

A Hybrid GNN-FEM Framework for Phase-Field Fracture Simulation. Physics-Preserving Hybridization for Generalizable Surrogate Modeling

Authors:
Hyeonbin Moon↗Yongjin Choi↗Seunghwa Ryu↗

arXiv:2606.19378v1 Announce Type: new Abstract: Scientific machine learning (SciML) has emerged as a promising approach for accelerating simulations of complex physical systems, yet achieving physically consistent and generalizable predictions for nonlinear, history-dependent problems remains a central challenge. In this study, we propose a hybrid GNN–FEM framework for efficient and generalizable phase-field fracture modeling. While phase-field approaches provide a robust variational framework for simulating complex crack evolution, their high computational cost limits practical applications because they require solving coupled, nonlinear, and history-dependent systems within an incremental finite element procedure. To address this challenge, a graph neural network surrogate is integrated into the conventional staggered scheme, replacing the phase-field update at each load increment while retaining the FEM-based displacement solver to enforce mechanical equilibrium and boundary conditions. By preserving the incremental solution structure, the framework remains consistent with history-dependent fracture evolution without requiring the surrogate to approximate the full solution trajectory. This selective surrogate strategy emphasizes the identification of a physically meaningful and incrementally structured learning target, rather than relying on brute-force data generation to learn the full fracture process. The proposed framework achieves strong generalization across varying geometries, loading conditions, material properties, and discretizations through dimensionless feature design, a graph-based formulation on mesh-based domains, and a physics-informed loss derived from the governing phase-field equation. Numerical experiments demonstrate that the hybrid approach reduces computational cost while maintaining accuracy compared with conventional FEM, and exhibits robust predictive performance across diverse problem settings.

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23.
medRxiv (Medicine) 2026-06-15

CDH13 is associated with cellular viability after exposure to ionizing radiation using genome-wide screening

Authors:
Schmidt↗H.-L↗Ohlei↗Herwest↗Salewsky↗Bertram↗Demuth↗

Background: It is well known that genetic variants contribute to cellular sensitivity to chemotherapeutic agents and ionizing radiation (IR). The aim of this study was to identify single nucleotide polymorphisms (SNPs) and genes associated with the spectrum of normal cellular sensitivity of lymphoblastoid cell lines (LCLs) towards ionizing radiation and mitomycin C (MMC). Methods: In a first step, we determined the viability of LCLs established from male participants of the Berlin Aging Study II (BASE-II) aged >=62 years following treatments with increasing doses of IR (n=137 cell lines) or MMC (n=140 cell lines) using the alamarBlue assay. Results from intra-experimental triplicates and three independent experiments for each cell line and treatment were used to calculate the area under the curves (AUCs) representing the specific sensitivity to IR and MMC of each LCL. The data from these experiments were subsequently used as outcomes in genome-wide association studies (GWASs). In addition, we calculated polygenic risk scores (PGS) from UK Biobank GWAS results for four cancer-related phenotypes and assessed the extent to which the variance in the IR and MMC sensitivity is explained by these PGS. Results: The GWAS analyses revealed one variant, rs74728080, located in CDH13 on chromosome 16, to show genome-wide significant (p < 5 x 10-8, beta = 2.81) association with cellular viability after treatment with IR. In the GWAS on MMC sensitivity the most interesting signal was elicited by SNP rs113978558 in an intron of the PLD5 gene on chromosome 1 (p = 9.232 x 10-8; beta = 1.44). Several other SNPs with statistically suggestive (i.e., p < 1 x 10-5) evidence of association with IR or MMC sensitivity were identified. PGSs calculations from GWAS of four cancer-related traits in UKB explained ~5% and ~3% of phenotypic variance in IR- and MMC-induced cell viability, respectively. Conclusion: The genome-wide significant association of rs74728080 with IR sensitivity and the location of this variant in CDH13 is interesting and functionally highly plausible given its known involvement in oxidative-stress response and function as tumor suppressor. Taken together, our novel data suggest that CDH13 may be genuinely involved in regulating cellular IR sensitivity.

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24.
arXiv (math.PR) 2026-06-12

Non-commutative Law of iterated logarithm

Authors:
Sourav Panja↗\'Eric Ricard↗Diptesh Saha↗

arXiv:2509.22037v2 Announce Type: replace-cross Abstract: We prove optimal non-commutative analogues of the classical Law of Iterated Logarithm (LIL) for both martingales and sequences of independent (non-commutative) random variables. The classical martingale version was established by Stout [Sto70b] and the independent case by Hartman-Wintner [HW41]. Our approach relies on a key exponential inequality essentially due to Randrianantoanina [Ran24] that improves that from Junge and Zeng [JZ15]. It allows to derive an optimal non-commutative Stout-type LIL just as in [Zen15], from that martingale result we then deduce a non-commutative Hartman-Wintner type LIL for independent sequences of random variables.

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

Deep Q-Learning on Hölder Spaces

Authors:
Qian Qi↗

arXiv:2606.16846v1 Announce Type: cross Abstract: We study the operator-theoretic core of Q-learning in continuous-time stochastic control with continuous states and actions. In value-based reinforcement learning, each Q-learning or DQN update is built from a Bellman optimality target; our analysis isolates this target in a diffusion setting and studies its regularity and approximation complexity. Under uniform ellipticity and Hölder-regular coefficients, we show that a Bellman update maps bounded inputs into an anisotropic regularity class, smoothing the state variable while leaving only Lipschitz dependence on the action variable. This yields a compact family of Bellman iterates and motivates a tensor-product DeepONet architecture adapted to the mixed regularity of the problem. We then derive explicit approximation and resource bounds, together with a stiffness–complexity trade-off as the time step $\delta \to 0$. The resulting theory makes a direct contribution to Q-learning theory at the level of Bellman target regularity and approximation in continuous stochastic control. At the same time, we do not claim a full convergence theorem for practical sampled Q-learning with exploration, replay, and stochastic gradient updates.

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