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

LLM-as-an-Investigator: Evidence-First Reasoning for Robust Interactive Problem Diagnosis

arXiv:2606.13220v1 Announce Type: new Abstract: Large language models (LLMs) are increasingly used as interactive assistants for technical problem solving. However, when users provide incomplete descriptions or plausible but unverified explanations, LLMs may prematurely align with these assumptions and propose solutions before collecting sufficient evidence. We refer to this behavior as user-driven sycophancy: the tendency of an LLM to reinforce a user-provided hypothesis instead of testing alternative explanations. This paper introduces LLM-as-an-Investigator, an evidence-first agentic AI methodology for robust problem diagnosis. The approach is implemented through a Solution Investigator Agent, which estimates the ambiguity of an initial problem description, generates candidate hypotheses, asks targeted clarification questions, and updates hypothesis probabilities after each answer. Rather than producing an immediate response, the agent continues the investigation until the evidence makes one candidate explanation stronger than the alternatives. To evaluate the approach, we build a benchmark from solved technical forum threads in mechanical, electrical, and hydraulic domains. We use a three-agent evaluation pipeline in which a Problem-Solution Extractor Agent converts solved threads into structured cases, a Ground-Truth Evaluator Agent simulates the user while hiding the known solution, and the tested assistant attempts to recover the solution through dialogue. The experiments compare standard assistants, reasoning-oriented LLMs, and the proposed investigator-based model across LLM backbones. In addition to diagnostic accuracy, we analyze how standard assistants follow misleading user hypotheses in diagnostic cases. The results show that the proposed approach identifies the problem more accurately than direct prompting and reasoning-only baselines, while its evidence-first protocol helps reduce user-induced conversational bias.

03.
medRxiv (Medicine) 2026-06-15

Dysplasia-Stratified Management of Barrett's Esophagus: An Incidence-Based U.S. Cost-Effectiveness Analysis

Authors:

Background and Aims Barrett's esophagus (BE) is the principal precursor of esophageal adenocarcinoma (EAC), whose incidence has risen sharply in Western countries since the 1960s. Effective, dysplasia stratified surveillance strategies are needed to prevent progression. This study evaluated the cost effectiveness of dysplasia stratified surveillance intervals and endoscopic eradication therapy (EET) across the BE spectrum. Methods We developed an incidence-based Markov state transition model of BE progression calibrated to U.S. epidemiologic data from a healthcare sector perspective over a lifetime horizon. Four hypothetical cohorts of 50-year-old individuals with short segment BE (SSBE), nondysplastic BE (NDBE), low grade dysplasia (LGD), or high-grade dysplasia (HGD) were evaluated. Strategies included no surveillance; surveillance at 1-, 2-, 3-, 4-, 5-, or 10-year intervals; standard or AI assisted endoscopy; non endoscopic screening (sponge, breath, miRNA tests); and EET for LGD and HGD. Outcomes included costs, quality adjusted life years (QALYs), incremental cost effectiveness ratios (ICERs), net monetary benefits (NMBs), EAC cases, and EAC-related deaths. Sensitivity analyses used a willingness to pay threshold of US$100,000 per QALY. Results No surveillance was the most cost-effective strategy for SSBE and NDBE. For LGD, upfront EET was more cost effective than all surveillance strategies, with results sensitive to EAC incidence and recurrence. For HGD, EET was cost saving and yielded the greatest QALYs, with findings robust in 99.9% of simulations. EET prevented 12,614 and 44,295 EAC related deaths per 100,000 individuals with LGD and HGD, respectively. Conclusion Dysplasia-stratified management is essential for optimizing surveillance and treatment strategies in BE. Any degree of dysplasia should receive EET followed by targeted post-treatment monitoring, establishing EET as the central therapeutic pathway for dysplastic BE.

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

When Confidence Lacks Concepts: Interpretable OOD Detection via Representation Perturbations

Deep neural networks have achieved remarkable performance across medical imaging tasks, yet their tendency to overgeneralize under distributional shifts poses a major obstacle to safe clinical deployment. Out-of-Distribution (OOD) detection methods aim to mitigate this risk, but most existing approaches rely on opaque internal signals with poorly understood semantic meaning, limiting trust in safety-critical settings. In this work, we propose an interpretable OOD detection framework that probes the stability of model predictions under class-conditioned semantic perturbations. Leveraging sparse autoencoders (SAEs), we learn class-specific concept vectors from in-distribution data that disentangle dense intermediate representations into sparse, semantically meaningful components. At inference, we perturb deeper-layer representations using the concept vectors associated with the model's predicted class and measure the class logits stability. We hypothesize that in-distribution samples exhibit low sensitivity to such perturbations, as their representations align with class-specific semantic directions, whereas OOD samples show amplified deviations due to representational misalignment. By framing OOD detection as a concept conditioned stability analysis, our approach provides both a discriminative OOD signal and an interpretable lens into the internal mechanisms driving model uncertainty, making it particularly suitable for high stakes medical applications.

05.
arXiv (CS.CV) 2026-06-19

Prediction of Alzheimer's Disease Risk Factors from Retinal Images via Deep Learning: Development and Validation of Biologically Relevant Morphological Associations in the UK Biobank

The systemic, metabolic, lifestyle factors have established associations with Alzheimer's Disease (AD) through epidemiologic and AD-specific biomarker studies. Whether colored fundus photography (CFP) contains retinal structural signatures corresponding to these AD-related risk domains remains unclear. To determine whether deep learning (DL) models can predict 12 AD-related risk factors from CFP and to characterize the retinal structures underlying these predictions, thereby assessing whether CFP reflects pathways to AD vulnerability. Using 62,876 CFPs from 44,501 unique participants from the UK Biobank, DL models were trained to predict 12 factors linked to AD incidence: 6 categorical (sex, smoking, sleeplessness, economic status, alcohol use, depression) and 6 continuous (age, age at completing education, BMI, systolic, diastolic blood pressure, HbA1c). Model performance, model saliency, and saliency-derived scores (CAM-Score) were evaluated and compared to retinal morphometry. The scores were also compared between incident-AD cases (average 8.55 years before onset) and matched controls. Performance of DL ranged from AUROC= 0.5654-0.9480 for categorical and R2=-0.0291-0.7620 for continuous factors, outperforming most of the morphometry-machine learning models. Saliency-based score consistently highlighted biologically meaningful regions, particularly the optic nerve head and retinal vasculature. It also aligned with present morphometric variations. Several saliency-based scores differed significantly between incident AD and matched controls, suggesting potential overlap between retinal correlates of risk factors and preclinical AD-associated changes. CFP encodes retinal signatures linked to AD risk factors. Although not diagnostic, DL-derived retinal representations may uncover biologically meaningful risk-related structural changes mirroring the potential AD vulnerability.

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

Creating squeezed and non-classical collective motional many-body states through stroboscopic Rydberg dressing

arXiv:2606.17849v1 Announce Type: cross Abstract: Realizing conditional quantum operations, e.g., quantum gates, for quantum computing and simulation requires controlled interactions between particles. Often, these interactions depend on the interparticle distance, and accordingly, an uncertainty of the relative particle position may translate into gate infidelities. We consider here a quantum computing platform based on an array of neutral atoms and present a method that allows to reduce the uncertainty of all interatomic distances. Our approach exploits the coupling between atomic motion and stroboscopically excited atomic Rydberg states. It allows to collectively squeeze the modes corresponding to interatomic displacements, thereby reducing distance fluctuations down to a fraction of the motional vacuum state. Furthermore, the method permits the creation of non-classical states with substantial Wigner negativity. These correlated states may allow reducing motional decoherence, increasing gate fidelity, and potentially yield a resource for quantum-enhanced metrology.

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

A Survey on Evaluating Quality and Trustworthiness in LLM-Generated Data

arXiv:2601.17717v3 Announce Type: replace Abstract: Large Language Models (LLMs) have emerged as powerful tools for generating data across various modalities. By transforming data from a scarce resource into a controllable asset, LLMs mitigate the bottlenecks imposed by the acquisition costs of real-world data for model training, evaluation, and system iteration. However, ensuring the high quality of LLM-generated synthetic data remains a critical challenge. Existing research primarily focuses on generation methodologies, with limited direct attention to the quality of the resulting data. Furthermore, most studies are restricted to single modalities, lacking a unified perspective across different data types. To bridge this gap, we propose the LLM Data Auditor framework. In this framework, we first describe how LLMs are utilized to generate data across six distinct modalities. More importantly, we systematically categorize intrinsic metrics for evaluating synthetic data from two dimensions: quality and trustworthiness. This approach shifts the focus from extrinsic evaluation, which relies on downstream task performance, to the inherent properties of the data itself. Using this evaluation system, we analyze the experimental evaluations of representative generation methods for each modality and identify substantial deficiencies in current evaluation practices. Based on these findings, we offer concrete recommendations for the community to improve the evaluation of data generation. Finally, the framework outlines methodologies for the practical application of synthetic data across different modalities.

08.
arXiv (CS.CL) 2026-06-11

I Understand How You Feel: Enhancing Deeper Emotional Support Through Multilingual Emotional Validation in Dialogue System

Emotional validation - explicitly acknowledging that a user's feelings make sense - has proven therapeutic value but has received little computational attention. Emotional validation in dialogue systems can be decomposed into (i) validating response identification, (ii) validation timing detection, and (iii) validating response generation. To support research on all three subtasks, we release M-EDESConv, a 120k English-Japanese multilingual corpus created through hybrid manual and automatic annotation, and M-TESC, a multilingual spoken-dialogue test set. For timing detection, we propose MEGUMI, a Multilingual Emotion-aware Gated Unit for Mutual Integration, that fuses frozen XLM-RoBERTa semantics with language-specific emotion encoders via cross-modal attention and gated fusion. MEGUMI shows superior performance on both the M-EDESConv and M-TESC datasets, both objectively and subjectively. Finally, our EmoValidBench benchmarks of GPT-4.1 Nano and Llama-3.1 8B indicate that current LLMs generate contextually similar and diverse validating responses, but emotional understanding remains a major area for improvement. Project page: https://github.com/zihaurpang/Multilingual-Emotional-Validation

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

Loss Landscape Diagnosis for Gradient-Based Gray-Scott System Inversion: Disentangling the Roles of PINN Components

Authors:

arXiv:2606.11258v1 Announce Type: new Abstract: Gradient-based inversion of reaction-diffusion systems is typically approached via surrogate models or physics-informed neural networks (PINNs), while the most direct route, backpropagation through the PDE's structure itself, has largely been avoided. We pursue this direct route as a diagnostic probe, backpropagating a steady-state loss through unrolled Gray-Scott simulation to recover its parameters, with no surrogate or neural-network augmentation. Optimization fails to converge, and plotting the landscape directly locates the failure in its geometry – flat plateaus with no gradient signal, bounded by sharp cliffs that align with bifurcation boundaries – a structure that recurs across loss functions and is inherited however the gradients are routed to parameters. Reading this minimal setup as an ablation of PINN, we disentangle each component's role: with the neural network fixed, the residual loss is quadratic in the PDE parameters and yields a smooth landscape, so it alone already avoids the pathology, by implicitly encoding the full PDE dynamics across all initial conditions. The neural network, for its part, cannot repair an ill-posed parameter subspace, and so serves only to complete the observed data – a division of labor not previously made explicit. These findings carry concrete design implications for PINN-type methods and a broader heuristic on when added dimensions actually help.

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

Prism: Cost-Efficient Multi-LLM Serving via GPU Memory Ballooning

arXiv:2505.04021v3 Announce Type: replace-cross Abstract: Inference providers must maintain availability for many LLMs, including low-volume but essential models, making resource efficiency increasingly important as token prices fall. Analysis of production traces reveals a dynamic bursty-group pattern in which sets of models become active together and shift over time; existing space- and time-sharing approaches lack principled mechanisms to adapt to this variability, forcing trade-offs between SLO adherence and efficiency. We observe that elastic memory allocation can unify spatial and temporal sharing. Based on this insight, we have developed Prism, a memory-centric LLM co-serving framework that applies memory ballooning to reclaim memory across models and support both forms of sharing under a single scheme. Prism's balloon driver, referred to as kvcached, has been open-sourced at https://github.com/ovg-project/kvcached, and deployed in production environments across 10K+ GPUs.

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

Towards Unified Song Generation and Singing Voice Conversion with Accompaniment Co-Generation

arXiv:2606.07015v2 Announce Type: replace-cross Abstract: While song generation and singing voice conversion (SVC) have evolved significantly, they have long been developed isolated: the former lacks zero-shot speaker cloning, while the latter overlooks vocal-accompaniment synergy. To bridge this gap, we propose UniSinger, the first end-to-end framework unifying speaker cloning song generation and accompaniment co-generation SVC. Building on the multimodal diffusion transformer, we construct a unified speaker embedding space transferring speaker representation from SVC to song generation, endowing fine-grained cross-task timbre control. To mitigate multi-task optimization conflicts, we design a curriculum learning strategy using task-specific modality masking to guide the model to gradually master the generative mechanisms among semantic content, vocal timbre, and accompaniment. Experiments show state-of-the-art performance on both tasks and realizes complementary benefits, offering new possibilities for intelligent music production.

12.
Nature (Science) 2026-06-19

Daily briefing: Human detritus remakes geology

Authors:

What, exactly, is a rock? Plus, a stem-cell success for a severe autoimmune disease and evidence that ‘AI deskilling’ is real. Researchers have tracked the electrical activity of individual brain cells during conversation in real time. Plus, the history of GPS and a cross-species transplant that could reveal clues about the origin of animals.

13.
arXiv (CS.CL) 2026-06-19

A Layered Security Framework Against Prompt Injection in RAG-Based Chatbots

Prompt injection is ranked as the most critical vulnerability in large language model (LLM) deployments by the OWASP Top 10 for LLM Applications, yet existing defenses operate at isolated pipeline stages and remain incomplete. Input filters cannot inspect retrieved documents, while output monitors cannot prevent malicious payloads from reaching the model. Consequently, retrieval-augmented generation (RAG) chatbots remain vulnerable to indirect injection, where a poisoned knowledge-base document compromises every user whose query retrieves it. We present a three-layer framework that intercepts both direct and indirect prompt injection throughout the inference pipeline. Layer 1 screens user input using a rule-based pattern library and a fine-tuned semantic anomaly classifier. Layer 2 enforces a provenance-based instruction hierarchy during context assembly, preventing retrieved content from overriding operator policy. Layer 3 audits model output using a policy rule engine and semantic drift detector before delivery. A continuous audit loop aggregates structured logs and supports retraining to adapt the classifier to emerging attack patterns. The framework is model-agnostic and deploys as middleware without modifying the underlying LLM. Evaluation on 5,080 samples across GPT-4o, Llama 3, and Mistral 7B shows that the framework reduces Attack Success Rate (ASR) from 71.4\% to 11.3\%, outperforming the best single-layer baseline by 27.3 percentage points and a published guardrail system by 23.8 percentage points, while maintaining a 4.8\% false positive rate and a median latency overhead of 61.2 ms. Ablation studies confirm that all three layers provide complementary protection and that their combined effect exceeds the sum of individual contributions.

14.
medRxiv (Medicine) 2026-06-17

Hormonal Contraceptives Drive Genital Lipid Metabolism Reprogramming and Susceptibility to HIV Infection

Heterosexual genital HIV transmission is a major driver of new infections, particularly in women, making them disproportionately vulnerable to HIV acquisition. Previous studies have associated injectable hormonal contraceptives (HC) with increasing susceptibility to HIV. Yet, the underlying molecular mechanism remains incompletely understood. Given the structural and signaling role of lipids in the female genital tract, cervicovaginal lipidomic profiling has the potential to reveal the mechanistic interplay among HC, lipidome, and HIV susceptibility in the female genital tract. We conducted untargeted cervicovaginal lipidomics study in a cohort of high-risk, HIV-negative, Kenyan sex workers who were using injectable depot medroxyprogesterone acetate (DMPA), oral contraceptive pill (OCP), or no hormonal contraception (NH). Genital lipids were quantitatively analyzed using liquid chromatography-mass spectrometry (LC-MS) and bioinformatics platforms. A total of 1045 lipid species were identified in the cervicovaginal lavage samples. Injectable DMPA significantly downregulated major structural and signaling membrane lipids, including phospholipids, ceramides, sphingomyelins, and glycosphingolipids (p

15.
arXiv (CS.AI) 2026-06-19

Creativity Reconsidered: Generative AI and the Problem of Intentional Agency

arXiv:2601.15797v2 Announce Type: replace Abstract: Many theorists maintain that conscious intentional agency is a necessary condition of creativity. We argue that this requirement, which we call the Intentional Agency Condition (IAC), should be abandoned. We motivate this by highlighting the problems this criterion encounters in the face of recent advances in generative AI, which is ostensibly creative despite being incapable of intentional agency. We present two corpus analyses to illustrate the rapidly increasing tendency of people to predicate creativity to generative AI. In response to this predicament, theorists of creativity have proposed a range of conflicting solutions, which we critically evaluate. We find that none of these satisfyingly resolves the initial predicament, and we therefore propose a novel approach. Our claim is that ascriptions of creativity are dependent on what we call creative ability. This solution explains why intentional agency is important for judgements of creativity, without being a necessary condition. Our approach thereby accommodates AI creativity without dismissing the intuition that perceived intentions are of key importance for ascriptions of creativity.

16.
arXiv (CS.LG) 2026-06-15

Anytime-Valid Confirmation of Label-Shift Corrections

Authors:

arXiv:2606.14028v1 Announce Type: cross Abstract: In small-batch scientific deployments, labeled target outcomes may be too scarce for reliable shift estimation even when unlabeled target inputs are available. We address the complementary setting where the practitioner has a pre-specified label-shift correction from domain knowledge and asks whether incoming labeled outcomes support it. We show that the per-observation likelihood ratio between a label-shift-corrected predictive and the source predictive is a conditional e-value, so its running product is a nonnegative martingale and Ville's inequality yields an anytime-valid confirmation rule. The log martingale equals the cumulative negative log-predictive density (NLPD) gap between the source and the corrected predictive, converting routine model monitoring into a formal sequential test. Rejection means the incoming data support the posited correction relative to the source predictive, but it is not a precise estimate of the degree of shift. Closed forms are available for GP sources with Gaussian label-shift ratios. GP regression simulations validate Type I control, finite-sample power, miscalibration sensitivity, and the small-batch advantage of a reliable prior over label-based re-estimation.

17.
arXiv (quant-ph) 2026-06-19

Impossibility of superluminal signalling rules out causal loops in conical spacetimes

arXiv:2606.20476v1 Announce Type: cross Abstract: In PRL 129, 110401 it was shown that it is theoretically possible to have operationally detectable causal loops without violating the principle of no superluminal signalling (NSS) in (1+1)-Minkowski spacetime. Whether or not such causal loops are also possible in $d > 1$ spatial dimensions, has remained a key open question. We resolve this question by showing that in a wide class of "conical" spacetimes, including Minkowski with d > 1, NSS does rule out all operationally detectable causal loops, in classical, quantum and post-quantum theories. This establishes that the relationship between the relativistic principles of NSS and no causal loops depends inherently on the geometry of spacetime.

18.
Science (Express) 2026-05-21

Nodeless superconducting gap and electron-boson coupling in (La,Pr,Sm)3Ni2O7 films | Science

Authors: Unknown Author

The discovery of superconductivity in Ruddlesden-Popper (RP) bilayer nickelate films under ambient pressure provides an opportunity to directly investigate electronic energy scales of the superconducting state and the pairing mechanism. We report angle-resolved photoemission spectroscopy measurements of superconducting (La,Pr,Sm) 3 Ni 2 O 7 thin films by developing an ultra-high vacuum cryogenic sample quenching and transfer technique. A superconducting gap of ~18 meV with coherence peaks is observed along the Brillouin zone diagonal. The finite gap persists across the entire Brillouin zone, revealing the absence of gap nodes. A kink is observed in the energy-momentum dispersion at ~70 meV below Fermi level, indicating an electron-boson coupling. The simultaneous observation of a nodeless superconducting gap and electron-boson coupling provides insight into the pairing symmetry and gluing mechanism in RP bilayer nickelates.

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

Mixed-State Topological Order under Coherent Noise

arXiv:2411.03441v2 Announce Type: replace Abstract: Mixed-state phases of matter under local decoherence have recently garnered significant attention due to the ubiquitous presence of noise in current quantum processors. One of the key issues is understanding how topological quantum memory is affected by realistic coherent noise, such as random rotation noise and amplitude-damping noise. In this work, we investigate the intrinsic error threshold of the two-dimensional toric code (TC), a paradigmatic topological quantum memory, under these types of coherent noise by employing both analytical and numerical methods based on the doubled-Hilbert-space formalism. A connection between the mixed-state phase of the decohered TC and a non-Hermitian Ashkin-Teller-type statistical-mechanics model is established, and the mixed-state phase diagrams under the coherent noise are obtained. We find remarkable stability of mixed-state topological order under random rotation noise with axes near the $Y$-axis of qubits. We also identify intriguing extended critical regions at the phase boundaries, highlighting a connection with non-Hermitian physics. We argue that these phase boundaries provide upper bounds for the intrinsic error threshold, beyond which quantum error correction becomes impossible. We complement these findings by estimating the error thresholds for random rotation noise under standard quantum error correction, thereby providing lower bounds on the intrinsic error threshold.

20.
arXiv (CS.CL) 2026-06-12

Beyond the Commitment Boundary: Probing Epiphenomenal Chain-of-Thought in Large Reasoning Models

Chain-of-thought (CoT) reasoning is the dominant paradigm for inference-time scaling in language models, yet the causal influence of individual steps on the final answer poorly understood. We estimate each step's causal importance via early exit and use this measure to study how answers form across the reasoning traces of several model families. Across diverse tasks, we find that reasoning typically crosses a commitment boundary – a sharp transition from transient intermediate guesses to a stable, high-confidence answer. This transition often happens in a single step, well before the model's reasoning block ends, and is followed by epiphenomenal CoT steps that leave the final answer probability unaltered. Using attention probes, we show that answer-formation stages can be linearly decoded from intermediate reasoning steps with high accuracy and generalize robustly to unseen reasoning tasks. We exploit this signal to early-exit reasoning blocks at the commitment boundary, reducing the length of CoTs up to 55\% on average with negligible impact on model performance.

22.
arXiv (CS.CL) 2026-06-17

Do Large Language Models Always Tell The Same Stories?

Recent advances in large language models (LLMs) have enabled the generation of high-quality prose, yet the question of whether these models are capable of generating diverse outputs remains contested. In this work, we investigate the diversity of LLM-generated stories through the framework of narrative similarity. Using a contrastive framework and a dataset of human-written stories and prompts from r/WritingPrompts, we collect narrative similarity judgments across 10 representative LLMs, utilizing both human evaluations and three different automatic annotation methods. Our findings reveal a consistent trend: LLM-generated narratives are consistently more similar to each other than human-written stories are. We demonstrate that frontier models in particular converge on a ``mean'' generic narrative that approximates individual human stories but lacks the collective diversity of human authors. Finally, we show that common mitigation strategies, including negative prompting and temperature scaling, fail to meaningfully address this homogeneity.

23.
arXiv (CS.LG) 2026-06-15

Decoupled Latent Optimization of Diffusion Models for Full Waveform Inversion

arXiv:2606.14139v1 Announce Type: new Abstract: Full waveform inversion (FWI) recovers subsurface velocity from seismic recordings by solving a severely ill-posed, nonconvex PDE-constrained optimization. Classical regularizers stabilize the inversion but fail to reproduce realistic geological structures; recent diffusion-prior methods improve realism at the cost of a fragile trade-off between data fidelity and prior consistency. We propose Decoupled Latent Optimization (DLO), which relaxes the standard latent-optimization formulation into a quadratic-penalty objective over an auxiliary physical variable and a latent variable. The data-fidelity gradient acts in physical space, the diffusion sampler contributes only through a decoded prior sample, and the standard smoothed-velocity initialization of classical FWI is preserved. On the OpenFWI benchmark, DLO outperforms classical regularizers and existing diffusion-based methods under clean, noisy, and missing-trace acquisitions. The prior, trained on 70*70 OpenFWI models, transfers directly to the Marmousi and Overthrust benchmarks, where DLO recovers intricate fault structures and remains robust to initialization smoothing and measurement noise.

24.
arXiv (CS.AI) 2026-06-12

An Embodied Simulation Platform, Benchmark, and Data-Efficient Augmentation Framework for Wet-Lab Robotics

arXiv:2606.12936v1 Announce Type: cross Abstract: Wet-lab robots can improve the reproducibility, throughput, and safety of biomedical experiments, but scaling their learning requires customizable simulators for safe and reproducible task generation, open editable laboratory assets, and efficient pipelines that turn limited demonstrations into usable training data. We present Pipette, an embodied simulation platform, benchmark, and data-efficient augmentation framework for wet-lab robot learning. Pipette releases over 43 open-source and re-editable wet-lab assets, together with an extensible asset-building pipeline. A key component of Pipette is its simulation-based data augmentation pipeline, replaying human demonstrations in simulation, applies lighting, camera, speed, and action perturbations, and filters generated episodes with automatic task success checks, rapidly expanding usable training data from limited manual demonstrations. We further introduce an 11-task wet-lab embodied benchmark covering sample handling, culture-ware manipulation, device operation, and precision placement. With only 30 demonstrations per task, ACT achieves 65.5% average success rate, while simulation augmentation improves SmolVLA from 44.1% to 74.7% and {\pi}0 from 40.4% to 46.5%, validating the effectiveness of Pipette for data-efficient VLA training and evaluation. Pipette also supports natural-language-driven scene construction and task registration, lowering the barrier for non-expert users to define new wet-lab robotic tasks.

25.
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.