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01.
medRxiv (Medicine) 2026-06-22

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

作者:
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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02.
arXiv (CS.LG) 2026-06-16

Scalable and Interpretable Representation Alignment with Ordinal Similarity

作者:
Diogo Soares↗Pankhil Gawade↗Andrea Dittadi↗Ewa Szczurek↗

arXiv:2606.16379v1 Announce Type: new Abstract: Evaluating representation similarity is fundamental to representation learning. However, existing metrics suffer from significant limitations: they lack interpretability due to shifting baselines, lack robustness to outliers, and are computationally intractable for large datasets, forcing reliance on heuristic approximations. To address this, we develop an ordinal-similarity framework, instantiated by the Triplet (TSI) and Quadruplet (QSI) Similarity Indices, which measure alignment by quantifying the consistency of ordinal relationships. We theoretically demonstrate this formulation is inherently interpretable, robust to outliers, and computationally efficient. Finally, we establish a formal equivalence between TSI and local neighborhood alignment, measured by Mutual Nearest Neighbors. Empirically, we validate these properties and show that ordinal similarity offers a scalable approach to measuring alignment, enabling practitioners to better understand and design representations.

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03.
arXiv (CS.CV) 2026-06-18

A Controlled Benchmark of Quantum-Latent GAN Augmentation for Brain MRI

作者:
Syed Mujtaba Haider↗Silvia Figini↗

Medical image classification is often constrained by limited labeled data, motivating generative augmentation; recently, quantum generative models have been proposed for this purpose, frequently reporting accuracy gains. However, such claims are typically based on single training runs, do not match the parameter budgets of the quantum and classical generators, and do not characterize the data regime in which any benefit appears. We present a controlled benchmark that isolates the contribution of a quantum generator to brain-MRI augmentation. Images are encoded into a KL-regularized latent space in which a conditional Wasserstein GAN with gradient penalty is trained using either a variational quantum generator or a classical generator of near-identical parameter count (1648 vs. 1632). Synthetic samples are decoded and used to augment a pretrained classifier across labeled data fractions from 5% to 100%, evaluated over eight random seeds with paired significance testing (with multiple-comparison correction) and with intraset diversity and latent-distribution analyses. Across all fractions, no augmentation variant significantly outperforms real-data-only training, and the quantum and classical generators are statistically indistinguishable. Any low-data benefit behaves as regularization rather than faithful data expansion:synthetic samples are off distribution and severely mode collapsed precisely where data is scarce, and the quantum generator is no more diverse thanits classical counterpart. We release the protocol as a testbed for rigorous evaluation of quantum generative augmentation in medical imaging.

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04.
arXiv (CS.CL) 2026-06-12

Reward Modeling for Multi-Agent Orchestration

作者:
King Yeung Tsang↗Zihao Zhao↗Vishal Venkataramani↗Haizhou Shi↗Zixuan Ke↗Semih Yavuz↗Shafiq Joty↗Hao Wang↗

Multi-Agent Systems (MAS) built on Large Language Models (LLMs) require effective orchestration to coordinate specialized agents, yet training such orchestrators is hindered by limited supervision and high computational cost. We propose Orchestration Reward Modeling (OrchRM), a self-supervised framework for evaluating orchestration quality without human annotations. OrchRM leverages intermediate artifacts from multi-agent executions to construct win-lose pairs for Bradley-Terry reward model training. Unlike existing MAS test-time scaling and orchestrator training frameworks that rely on costly sub-agent rollouts, OrchRM operates directly at the orchestration level, enabling efficient and high-performing reward-guided orchestrator training and MAS test-time scaling. OrchRM improves training efficiency by up to 10x in token usage while improving MAS test-time scaling performance by up to 8% in accuracy. These gains consistently transfer across multiple domains, including mathematical reasoning, web-based question answering, and multi-hop reasoning, demonstrating orchestration-level reward modeling as a scalable direction for robust multi-agent orchestration. Code will be available at https://github.com/Wang-ML-Lab/OrchRM.

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05.
arXiv (CS.AI) 2026-06-11

Towards Responsibly Non-Compliant Machines

作者:
Marija Slavkovik↗Marie Farrell↗Louise Dennis↗Michael Fisher↗Simon Kolker↗Emily C. Collins↗

arXiv:2606.12147v1 Announce Type: new Abstract: We consider the problem of engineering autonomous intelligent agents that are capable to responsibly not comply with user requests. We argue that machine non-compliance comes in many different forms, and sketch the issues we should pursue on the road of accomplishing responsibly non-compliant intelligent machines. We anchor responsible non-compliance in justifications for task refusal, pathways to override the non-compliance, as well as careful tracking of security risks and liability transfers.

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

Hierarchical Fine-Grained Aerial Object Detection

作者:
Yan Zhang↗Fang Xu↗Wen Yang↗Gui-Song Xia↗

Fine-grained aerial object detection, driven by the intrinsic granularity of real-world object categories, is crucial for advanced scene understanding in remote sensing. Existing methods largely inherit the paradigm of coarse-grained object detection, relying solely on single-label supervision and thus struggling to distinguish model-level categories with subtle structural differences. However, for each specific model (e.g., Boeing 787), structured prior knowledge such as attributes and hierarchies offers discriminative semantics across multiple granularities. Motivated by this, we present ExpertDet, a scheme that incorporates expert-informed cues to enhance fine-grained aerial object detection. Specifically, we design Vision-aware Masked Attribute Modeling (VMAM), which aligns attribute semantics with visual structures by reconstructing randomly masked attributes from visual cues, enabling the detector to capture subtle structural distinctions. We further propose Hierarchical Visual Instance Promotion (HierVIP), which builds a visual prototype tree based on hierarchical relations and imposes taxonomy-aware constraints to preserve cross-level semantic continuity while enhancing category discrimination. Moreover, we curate a new fine-grained object detection benchmark for Precise recognition of model-specific Ships and Planes from aerial imagery, PSP, covering 106 ship classes and 30 airplane models, respectively, featuring the most extensive collection of model-specific categories among existing aerial object detection datasets to date. We benchmark state-of-the-art object detection algorithms on the PSP benchmark. Extensive evaluation demonstrates that ExpertDet consistently outperforms other fine-grained competitors across hierarchy levels. The dataset, benchmark, and code are available at https://nnnnerd.github.io/PSP-Benchmark/.

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07.
arXiv (CS.CL) 2026-06-15

Non-Parametric Machine Text Detection via Multi-View Gaussian Processes

作者:
Aleem Khan↗Nicholas Andrews↗

Adversarial conditions such as paraphrasing and targeted style transfer sharply degrade the accuracy of machine text detectors. A document, however, carries multiple complementary signals (e.g., stylistic features, likelihood and rank-order features, and structural features), and an attack that suppresses one may leave others intact. While a parametric classifier can learn to combine these features given sufficient supervision, classifiers are prone to making confidently incorrect predictions when the distribution shifts (e.g., novel attacks or unseen language models). To address this, we propose a multi-view, non-parametric detection framework that extracts complementary feature views from the same document and aggregates per-view evidence through a Gaussian process ensemble. By aggregating evidence across views, an adversary must simultaneously defeat multiple independent axes of detection, substantially raising the cost of evasion. The Gaussian process formulation additionally provides calibrated probabilities and principled abstention on out-of-distribution inputs, supporting reliable deployment in high-stakes settings. We evaluate on three benchmarks spanning diverse generators and attacks: the DetectRL and RAID benchmarks, and the PAN2025 shared task and demonstrate that our multi-view detector maintains strong performance under the considered attacks, outperforming existing approaches against held out attacks.

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08.
arXiv (CS.CV) 2026-06-12

Modality Forcing for Scalable Spatial Generation

作者:
Bardienus Pieter Duisterhof↗Deva Ramanan↗Jeffrey Ichnowski↗Justin Johnson↗Keunhong Park↗

Text-to-image (T2I) models contain rich spatial priors. Synthesizing photorealistic, cluttered scenes requires an understanding of geometry, including perspective and relative scale. Prior works adapt T2I models to leverage this prior for depth prediction, but they require dense depth data and involve complex recipes. We propose Modality Forcing, a simple, scalable post-training recipe for joint image-depth generation using a single DiT trained on sparse depth data. Modality Forcing enables conditional and joint generation of image and depth in any permutation by assigning separate noise levels per modality. Per-modality decoders let us train on sparse, real-world depth and achieve strong, generalizable depth prediction. We further show that Modality Forcing inherits the scalability of T2I pre-training: by training a set of T2I models from scratch (370M to 3.3B parameters), we find that larger models trained on more image data produce more accurate depth. Our strongest model is competitive with state-of-the-art monocular depth estimators and reduces AbsRel by 57% relative to existing joint image-depth generative models. These results provide strong evidence that image generation is a scalable pre-training objective for spatial perception. https://modality-forcing.github.io/

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

SurgVista: Long-Horizon Surgical World Modeling with Plausible Instrument-Tissue Dynamics

作者:
Wentao Pan↗Wuyang Li↗Shengyuan Liu↗Xinyu Liu↗Hengyu Liu↗Yixuan Yuan↗

Scaling robot policy learning for autonomous surgery is challenging, as expert demonstrations are expensive and in vivo exploration poses substantial safety risks. Surgical world models address this by generating realistic, action-conditioned future frames from an initial observation, but existing methods exhibit two persistent failure modes: spatial interaction incoherence, where visible instrument contact fails to induce spatially consistent tissue deformation, and temporal fidelity collapse, where prediction errors compound across autoregressive rollouts and progressively corrupt visual quality. We present SurgVista, a surgical world model that mitigates both failures through two training recipes. Deformation Consistency Regularization extracts scene-point trajectories from training videos and enforces cross-frame coherence through latent contrastive learning, strengthening physically consistent instrument-tissue dynamics. Drift Adaptation Training mitigates long-horizon drift by perturbing conditioning frames with online prediction residuals and photometric augmentations calibrated to long-horizon drift statistics, sustaining visual fidelity over extended rollouts. To enable rigorous evaluation, we further introduce SurgWorld-Bench, featuring diverse procedure types, long-range rollouts, and decoupled metrics for instrument-motion accuracy and tissue-response fidelity. Extensive experiments show that SurgVista consistently outperforms state-of-the-art methods across visual quality, temporal consistency, and interaction fidelity, with gains widening as the prediction horizon grows.

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10.
Nature (Science) 2026-06-10

A prognostic human brain network for diffuse midline glioma

作者:
Jai Sidpra↗

Diffuse midline gliomas (DMGs) are near-universally lethal tumours of the childhood central nervous system1,2. In animal models, DMGs form brain-wide integrated networks through neuron-to-glioma synapses3–6 and glioma-to-glioma gap junctional coupling3. This extensive connectivity robustly promotes the growth and invasion of DMG3–9 and other glial malignancies10–12 through paracrine mechanisms and direct neuron-to-glioma synapses. However, the organization and clinical implications of these connections in the living human brain remain to be elucidated. Here, we develop tumour network mapping to compute the brain-wide connectivity profile of DMG, defining a conserved brain network across pontine and thalamic DMG associated with patient short-term survival (DMG network). Tumour functional connectivity with the DMG network was independently predictive of patient overall survival across two external validation cohorts. Tumour growth mapped to DMG network-specific trajectories and peak in-network neurometabolic changes across development spatiotemporally aligned with the peak age incidence of DMG. Analyses of single-nucleus RNA sequencing data confirmed diverse synaptic gene enrichment in high-connectivity DMG. Strikingly, incidental surgical resection of high-connectivity thalamic DMG tissue conferred a significant survival advantage. Collectively, these data define a conserved and prognostically important brain network in children with DMG, consistent with the hypothesis that DMGs exploit otherwise healthy brain circuits to promote tumour growth. Tumour network mapping of diffuse midline glioma (DMG) defines a conserved and prognostically important brain network in children with DMG, consistent with the hypothesis that DMGs exploit otherwise healthy brain circuits to promote tumour growth.

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11.
arXiv (quant-ph) 2026-06-15

Quantum geometrical description of hole spin qubits far away from the $\Gamma$-point

作者:
Zolt\'an Gy\"orgy↗Dmitry Miserev↗Jelena Klinovaja↗Daniel Loss↗

arXiv:2606.14683v1 Announce Type: cross Abstract: Hole spin qubits provide one of the leading platforms for spin-based quantum computing due to their large intrinsic spin-orbit interaction (SOI), which enables fast electrical manipulation. The SOI of planar quantum dots has mostly been investigated in theoretical studies by examining the SOI already present in the two-dimensional hole gas (2DHG). Here, we study the SOI created by the in-plane confinement by deriving non-perturbative effective Hamiltonians numerically for hole spin qubits. We find that the quantum geometry of the 2DHG naturally emerges, leading to a meaningful non-perturbative definition of pseudospin valid far away from the $\Gamma$-point. The SOI of the 2DHG and of the in-plane confinement have different forms; therefore, they cannot be turned off simultaneously, ruining the perfect spin-orbit switch functionality of spin qubits. We construct effective Hamiltonians using the symmetry approach for various low-dimensional hole systems: (i) a heavy-hole confined in a SiGe/Ge/SiGe heterostructure, (ii) a light-hole confined in SnGe/Ge, (iii) a gate-defined nanowire in SiGe/Ge/SiGe, and (iv) a hole confined in a Ge/Si core/shell nanowire. The non-perturbative effective Hamiltonians provide results with excellent agreement with the full Hamiltonians.

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12.
arXiv (CS.AI) 2026-06-17

LoopCoder-v2: Only Loop Once for Efficient Test-Time Computation Scaling

作者:
Jian Yang↗Shawn Guo↗Wei Zhang↗Tianyu Zheng↗Yaxin Du↗Haau-Sing Li↗Jiajun Wu↗Yue Song↗Yan Xing↗Qingsong Cai↗Zelong Huang↗Chuan Hao↗…

arXiv:2606.18023v1 Announce Type: cross Abstract: Looped Transformers scale latent computation by repeatedly applying shared blocks, but sequential looping increases latency and KV-cache memory with the loop count. Parallel loop Transformers (PLT) alleviate this cost through cross-loop position offsets (CLP) and shared-KV gated sliding-window attention, making loop count a practical design choice. We therefore study PLT loop-count selection through a gain–cost view: an extra loop may refine representations, but CLP also introduces a positional mismatch at each loop boundary. We instantiate this study by training LoopCoder-v2, a family of 7B PLT coders with different loop counts, from scratch on 18T tokens, followed by matched instruction tuning and evaluation. Empirically, the two-loop variant delivers broad gains over the non-looped baseline across code generation, code reasoning, agentic software engineering, and tool-use benchmarks, improving SWE-bench Verified from 43.0 to 64.4 points and Multi-SWE from 14.0 to 31.0 points. In contrast, variants with three or more loops regress, revealing a strongly non-monotonic loop-count effect. Our diagnostics show that loop 2 provides the main productive refinement, while later loops yield diminishing, oscillatory updates and reduced representational diversity. Because the CLP-induced mismatch remains roughly fixed as refinement gains shrink, the offset cost increasingly dominates. This gain–cost trade-off explains PLT's saturation at two loops and provides diagnostics for loop-count selection.

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

Improving Pre-trained Adult Glioma Segmentation Models Using only Post-processing Techniques

作者:
Abhijeet Parida↗Daniel Capell\'an-Mart\'in↗Zhifan Jiang↗Nishad Kulkarni↗Krithika Iyer↗Austin Tapp↗Syed Muhammad Anwar↗Mar\'ia J. Ledesma-Carbayo↗Marius George Linguraru↗

Gliomas are the most common malignant brain tumors in adults and are among the most lethal. Despite aggressive treatment, the median survival rate is less than 15 months. Accurate multiparametric MRI (mpMRI) tumor segmentation is critical for surgical planning, radiotherapy, and disease monitoring. While deep learning models have improved the accuracy of automated segmentation, large-scale pre-trained models generalize poorly and often underperform, producing systematic errors such as false positives, label swaps, and slice discontinuities in slices. These limitations are further compounded by unequal access to GPU resources and the growing environmental cost of large-scale model training. In this work, we propose adaptive post-processing techniques to refine the quality of glioma segmentations produced by large-scale pretrained models developed for various types of tumors. We demonstrated the techniques in multiple BraTS 2025 segmentation challenge tasks, with the ranking metric improving by 14.9 % for the sub-Saharan Africa challenge and 0.9% for the adult glioma challenge. This approach promotes a shift in brain tumor segmentation research from increasingly complex model architectures to efficient, clinically aligned post-processing strategies that are precise, computationally fair, and sustainable.

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14.
arXiv (CS.AI) 2026-06-16

Cordyceps: Covert Control Attacks on LLMs via Data Poisoning

作者:
Zedian Shao↗Charles Fleming↗Teodora Baluta↗

arXiv:2605.26595v2 Announce Type: replace-cross Abstract: Large language models (LLMs) are often fine-tuned on uncurated text datasets that adversaries can poison. Existing poisoning attacks primarily rely on fixed trigger phrases that defenses such as outlier detection, clean-data regularization, or online monitoring can neutralize. In this paper, we propose a data poisoning method that teaches an LLM an information hiding scheme reliably and stealthily through semantic associations between shared knowledge such as facts or concepts and attacker-chosen phrases. The induced hiding scheme can encode and decode arbitrary malicious instructions, thus revealing a new and subtle poisoning-induced vulnerability: covert control attacks. We precisely characterize covert control attacks and evaluate them across $5$ LLMs, $3$ backdoor defenses, and $4$ prompt injection defenses. With a small poisoned fraction, covert control attacks outperform heuristic-based prompt injection attacks in average attack success rate by about $40\%$ relative to clean fine-tuned models. They also circumvent defenses based on detection and fine-tuning, maintaining up to $93\%$ attack success rate after backdoor defenses and up to $98\%$ after prompt injection defenses.

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15.
arXiv (CS.CL) 2026-06-11

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

作者:
Dongryeol Lee↗Yerin Hwang↗Taegwan Kang↗Minwoo Lee↗Younhyung Chae↗Kyomin Jung↗

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

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

Reverse Flow Matching: A Unified Framework for Online Reinforcement Learning with Diffusion and Flow Policies

作者:
Zeyang Li↗Sunbochen Tang↗Navid Azizan↗

arXiv:2601.08136v2 Announce Type: replace Abstract: Diffusion and flow policies are gaining prominence in online reinforcement learning (RL) due to their expressive power, yet training them efficiently remains a critical challenge. A fundamental difficulty that distinguishes online RL from standard generative modeling is the lack of direct samples from the target Boltzmann distribution defined by the Q-function. To address this, two seemingly distinct families of methods have been proposed for diffusion policies: a noise-expectation family, which uses a weighted average of noise as the training target, and a gradient-expectation family, which employs a weighted average of Q-function gradients. However, it remains unclear how these objectives are formally related, or whether they can be synthesized into a more general formulation. In this paper, we propose a unified framework, reverse flow matching (RFM), which rigorously addresses the problem of training diffusion and flow models without direct target samples. By adopting a reverse inferential perspective, we formulate the training target as a posterior mean estimation problem given an intermediate noisy sample. Crucially, we introduce Langevin Stein operators to construct zero-mean control variates, deriving a general class of estimators that share the same expectation. We show that existing noise-expectation and gradient-expectation methods are simply two specific instances within this broader class. This unified view yields two key advancements: it extends the capability of targeting Boltzmann distributions from diffusion to flow policies, and it enables the principled combination of Q-value and Q-gradient information to form an effective estimator, thereby improving training efficiency and stability. We instantiate RFM to train a flow policy in online RL and demonstrate improved performance on continuous-control benchmarks compared to diffusion policy baselines.

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

The Discrete-Log Clock: How a Transformer Learns Modular Multiplication

作者:
Huu Danh Nguyen↗

arXiv:2606.17399v1 Announce Type: cross Abstract: When small transformers grok modular multiplication, prior work reports that the learned embedding has a "dense" Fourier spectrum requiring all frequencies. This contrasts with modular addition, where only a sparse set of key frequencies suffices. We show this density is an artifact of analyzing in the wrong basis. The natural Fourier transform for multiplication is not the standard additive DFT but the multiplicative character transform, which decomposes functions on the multiplicative group $(\mathbb{Z}/p\mathbb{Z})^*$ into its irreducible representations. Applying this transform to a grokked transformer trained on $a \cdot b \bmod 113$, we find the embedding spectrum becomes highly sparse (Gini coefficient 0.58 vs. 0.07 in the additive basis) with only 4 key frequencies carrying significant energy. Furthermore, 96.9% of MLP neurons are cleanly tuned to a single multiplicative frequency, and neuron activation heatmaps reveal 2D-periodic structure when reordered by the discrete logarithm. These results demonstrate the transformer reduces multiplication to addition in discrete-log space, implementing a "Discrete-Log Clock" algorithm analogous to Nanda et al.'s Clock algorithm for addition. The methodology generalizes: matching the analysis basis to the algebraic structure of the task reveals interpretable structure where standard tools see noise.

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18.
medRxiv (Medicine) 2026-06-15

Entity-Aware Generation of Synthetic Clinical Progress Notes for Prostate Cancer using Large Language Model

作者:
Rey-Blanes↗Veredas-Morente↗Moreno-Barea↗F. J↗Veredas↗

Objectives: This study investigates large language models (LLMs) for clinical entity projection across substantial textual transformation. Specifically, we evaluate whether entities annotated in Spanish prostate cancer case reports can be preserved and explicitly projected when the source narratives are transformed into hospital-style clinical progress notes. Entity projection is treated as a generation-driven task, allowing paraphrase, condensation and narrative reorganisation, providing that clinically relevant entities remain recoverable as structured annotations. Methods: A corpus of 109 Spanish prostate cancer case reports was annotated using a silver-standard pipeline combining Spanish biomedical named-entity recognition with rule-based prostate-specific antigen (PSA) and Gleason extractors. The resulting silver-standard annotations were validated on a subset of generated notes against a gold-standard consensus produced by medical experts in prostate cancer. Four LLMs were evaluated for note generation and entity projection: GPT-5.4 Nano, Qwen 3.5:35B-A3B, GLM5 and Claude Sonnet 4.6. Entity-to-Entity (E2E) generation used XML-annotated cases as RAG-supported input, whereas Text-to-Entity (T2E) generation required models to generate and annotate notes directly from plain text cases. Zero-shot and few-shot prompting were tested. Projection quality was measured using precision, recall and F1-score, and complemented by LLM-as-a-judge evaluation using Kimi K2.6. Results: E2E consistently outperformed T2E, indicating that explicit entity-enriched in- put substantially facilitates entity preservation and localisation. GLM5 achieved the best E2E zero-shot result (F1 = 0.915), followed by Claude Sonnet 4.6 (F1 = 0.896). In T2E, few-shot prompting improved performance, with Claude Sonnet 4.6 reaching the highest score (F1 =0.718). Age, Gleason, Disease, Procedure, Duration and negation-related entities were robustly projected, whereas PSA and Dose showed less stable behaviour. Conclusion: LLMs can generate clinically plausible synthetic prostate cancer evolution notes while preserving a substantial proportion of source entities, particularly when explicit semantic annotations are provided as input. However, the lower and more variable performance observed in T2E highlights the difficulty of jointly generating clinical narratives and projecting entities without source-side information, especially for numerical and measure-related entities.

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

TLA-Prover: Verifiable TLA+ Specification Synthesis via Preference-Optimized Low-Rank Adaptation

作者:
Eric Spencer↗Arslan Bisharat↗Brian Ortiz↗Khushboo Bhadauria↗TaiNing Wang↗George K. Thiruvathukal↗Konstantin Laufer↗Mohammed Abuhamad↗

arXiv:2606.06133v2 Announce Type: replace-cross Abstract: TLA+ is a formal specification language for verifying distributed systems and safety-critical protocols. Large language models (LLMs) frequently produce TLA+ specifications that fail the TLC model checker for semantic reasons. Across 25 LLMs, the best public baseline is 26.6% syntactic parse and 8.6% semantic model-check. We present TLA-Prover, a 20-billion-parameter model for TLA+ specification synthesis. Training combines supervised fine-tuning (SFT) on verified examples with repair-based group-relative policy optimization (GRPO). In the GRPO stage, the model learns to fix its own rejected specifications. We also train a direct preference optimization (DPO) variant from the same SFT checkpoint as an ablation. TLC provides the reward signal directly, with no learned reward model. Four tiers grade each output: Bronze (parses), Silver (no warnings), Gold (passes TLC), and Diamond. To reach Diamond, the model's correctness property is automatically altered in a small way; TLC must then detect a violation. If TLC still passes, the property was always-true and contributes nothing; the output fails Diamond. TLA-Prover reaches 9/30 (i.e. pass@1 = 30%) at both Gold and Diamond on a held-out 30-problem benchmark. This is roughly 3.5x the 8.6% untuned baseline. The DPO variant reaches 20% at Diamond. Gold and Diamond coincide at every checkpoint; this prevents the trivial-property failure mode.

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20.
medRxiv (Medicine) 2026-06-15

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

作者:
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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21.
arXiv (quant-ph) 2026-06-12

Experiment-compatible measurement–feedback quantum state preparation with reinforcement learning

作者:
Xiaotian Nie↗Tao Zhang↗Linghui Chen↗

arXiv:2606.13005v1 Announce Type: new Abstract: Ground-state preparation is a critical task in quantum simulation and quantum computing, as it enables the study of correlated phases and the generation of entangled resource states. While measurement–feedback control has emerged as a promising route to state preparation, existing schemes either rely on handcrafted, task-specific policies or are designed using full quantum-state information that is unavailable in real experiments and becomes impractical for large many-body systems. Here we develop an adaptive measurement–feedback protocol based on reinforcement learning under partial observability. The controller uses only the history of experimentally accessible measurement outcomes to choose both the measurement operator and the feedback action in real time. To make training compatible with experiments, we introduce a stochastic terminal reward built from one-shot measurements of randomly sampled Hamiltonian components, avoiding unphysical full-state reconstruction while remaining an unbiased estimator of the target energy. We demonstrate the method by preparing ground states of the Bose–Hubbard model and by generating GHZ states, establishing a scalable and hardware-compatible route to quantum state preparation.

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22.
Nature (Science) 2026-06-10

Efficient and accurate neural-field reconstruction using resistive memory

作者:
Yifei Yu↗

Applications such as medical imaging, augmented and virtual reality, and embodied artificial intelligence (AI) depend on the ability to reconstruct complex signals from sparse observations. These applications are characterized by incomplete measurements and limited computational resources. Traditional approaches to digital hardware face the following challenges: explicit signal representations require heavy sampling and storage, data movement across the von Neumann bottleneck dominates energy and latency, and CMOS (complementary metal–oxide–semiconductor)-based circuits offer limited parallel efficiency. Here we present a software–hardware co-optimization framework for sparse-input signal reconstruction. At the software level, we use neural fields1 to implicitly represent signals using neural networks, which are further compressed by low-rank decomposition and structured pruning. At the hardware level, we design a resistive-memory-based computing-in-memory platform, featuring a Gaussian encoder and a multi-layer perceptron processing engine. The Gaussian encoder leverages the intrinsic stochasticity of resistive memory for efficient encoding, whereas the processing engine enables precise weight mapping through a hardware-aware quantization circuit. On a 40-nm 256 Kb resistive-memory macro, the system delivers 23.5×, 21.0× and 32.3× gains in projected energy efficiency, together with 10.8×, 38.8× and 6.2× gains in projected parallelism, for three-dimensional computed tomography sparse reconstruction, novel view synthesis and dynamic-scene novel view synthesis, without compromising on reconstruction quality. This work advances AI-driven signal reconstruction technology and paves the way for future efficient and robust medical AI and three-dimensional vision applications. A co-optimized AI hardware–software system using resistive-memory computing improves energy efficiency and parallelism for sparse signal reconstruction in imaging and three-dimensional vision applications.

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23.
Nature Medicine 2026-06-22

<b>PROTEUS trial heralds perioperative therapy for prostate cancer</b>

作者:
Karen O’Leary↗

Perioperative androgen-deprivation therapy plus apalutamide could represent a new treatment option for patients with high-risk, localized prostate cancer. Perioperative androgen-deprivation therapy plus apalutamide could represent a new treatment option for patients with high-risk, localized prostate cancer.

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

LakeFM: Toward a Foundation Model for Aquatic Ecosystems Using Irregular Multivariate Multi-depth Time Series Data

作者:
Abhilash Neog↗Sepideh Fatemi↗Medha Sawhney↗Kazi Sajeed Mehrab↗Aanish Pradhan↗Bennett J. McAfee↗Emma Marchisin↗Arka Daw↗Robert Ladwig↗Cayelan C. Carey↗Paul Hanson↗Anuj Karpatne↗…

arXiv:2606.11268v1 Announce Type: new Abstract: Understanding and forecasting lake dynamics is critical for monitoring water quality and ecosystem health across lakes and reservoirs. While machine learning methods have been recently applied to ecological time-series data, existing works assume regular sampling in time and depth, and struggle to generalize across lakes with heterogeneous variables, depths, and observation patterns. To address these limitations, we introduce \textsc{LakeFM}, a foundation model for aquatic systems, pre-trained on large-scale ecological datasets comprising both simulated and observed lakes. Through extensive empirical evaluation, we show that \textsc{LakeFM} learns meaningful representations spanning broader lake-level characteristics, and achieves competitive or often superior-forecasting performance compared to existing time-series foundation and non-foundation models, while producing physically plausible predictions consistent with real-world lake dynamics.

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25.
arXiv (math.PR) 2026-06-17

Order statistics for edge eigenvectors of Wigner matrices

作者:
Zhigang Bao↗Teodor Bucht↗Kevin Schnelli↗

arXiv:2606.17425v1 Announce Type: new Abstract: In this paper, we establish a general comparison theorem for the order statistics of the edge eigenvectors for generalized Wigner matrices. Consequently, we derive the Gumbel law for the maximal edge eigenvector component and prove the universality of the Gaussian fluctuations of the order statistics in an intermediate regime close to the maximum. In addition, our comparison result also implies a quantitative first order estimate for moderately small order statistics.

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