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01.
medRxiv (Medicine) 2026-06-15

Genome-wide colocalization of body fat distribution GWAS and subcutaneous adipose eQTLs identifies SNX10, DGKQ, and CBX3 as candidate causal genes for cardiometabolic disease

作者:

Background: Genome-wide association studies (GWAS) have identified hundreds of loci associated with body fat distribution, yet the causal genes and regulatory mechanisms through which these variants exert their effects remain largely unknown. Expression quantitative trait locus (eQTL) colocalization provides a powerful framework for identifying genes whose expression is genetically coregulated with complex traits. Methods: We performed a genome-wide colocalization analysis integrating waist-hip ratio adjusted for body mass index (WHRadjBMI) GWAS summary statistics from 694,649 individuals (Pulit et al., 2019) with subcutaneous adipose tissue eQTLs from the Genotype-Tissue Expression (GTEx) Project v8 (N = 581 donors). GWAS coordinates were lifted from GRCh37 to GRCh38 to enable direct alignment with GTEx data. We incorporated CAVIAR fine-mapping results to overcome the limitation of FDR-significant eQTL filtering. Colocalization was assessed using the approximate Bayes factor framework (coloc.abf) across 335 independent genome-wide significant loci. Results: Of 2,897 locus-gene pairs tested, 489 (16.9%) showed strong colocalization (PP.H4 > 0.8) and 618 (21.3%) showed moderate evidence (PP.H4 > 0.5). The strongest colocalization was observed for SNX10 (sorting nexin 10; PP.H4 = 1.000), a recently characterized regulator of adipocyte differentiation and female-specific diet-induced obesity. Other top hits included DGKQ (diacylglycerol kinase theta; PP.H4 = 0.9999999), an emerging pharmacological target for insulin resistance, and CBX3 (chromobox 3; PP.H4 = 0.9999974), an epigenetic regulator linked to cardiovascular disease. Established adiposity genes including GRB14 (PP.H4 = 0.681) and KLF14 (PP.H4 = 0.590) were recovered, validating our approach. Several loci exhibited extensive allelic heterogeneity, with 50 genes colocalizing at a single chromosome 3 locus. Conclusions: Our analysis provides a comprehensive map of adipose tissue gene regulatory mechanisms underlying genetic risk for body fat distribution. The identification of SNX10, DGKQ, and CBX3 as high-confidence candidate causal genes advances the translation of GWAS associations into mechanistic understanding and therapeutic targets for obesity-related cardiometabolic disease.

02.
arXiv (math.PR) 2026-06-18

Very large cliques in a scale-free random graph

arXiv:2606.18722v1 Announce Type: new Abstract: In this short article we consider a preferential attachment random graph model with edge steps, studied by Alves, Ribeiro and Sanchis. Starting with an initial graph $\mathbb{G}_1$ formed by a vertex with a self-loop attached to it, the model evolves as follows. At every subsequent (discrete) time step, either with probability $p$ we add a vertex to the graph and connect it to exactly one of the older vertices selected with probability proportional to its degree, or with probability $1-p$ we add one edge between two existing vertices, both selected (independently) with probability proportional to their degrees. Let $\omega(\mathbb{G})$ be the clique number of a graph $\mathbb{G}$, i.e.\ the number of vertices in a largest complete subgraph of $\mathbb{G}_{}$. Alves, Ribeiro and Sanchis showed that, for any given $\varepsilon>0$, we have $\omega(\mathbb{G}_{2t})\geq t^{\frac{1-p}{2-p}(1-\varepsilon)}$ with high probability (i.e.\ with probability tending to $1$ as $t\rightarrow \infty$). Here we strengthen this bound by showing that, for any function $f:\mathbb{N}\mapsto \mathbb{N}$ that satisfies $f(t)\rightarrow \infty$ as $t\rightarrow \infty$, with high probability \[\omega(\mathbb{G}_{2t}) = \Omega\left(t^{\frac{1-p}{2-p}}\Big(\log^{\frac{1}{2-p}}(t)f(t)\Big)^{-1}\right).\]

03.
arXiv (CS.LG) 2026-06-15

Muon$^p$: Muon with Fractional Spectral Powers

arXiv:2606.13867v1 Announce Type: new Abstract: Muon is an increasingly widely used optimizer that replaces a gradient $G=USV^\top$ with its polar factor $UV^\top$, thereby flattening the singular spectrum. However, full flattening discards singular-value information that may matter for adaptation. We introduce Muon$^p$, a Muon-style optimizer that instead uses fractional spectral-power updates $US^pV^\top$ for rational $p\in(0,1)$, interpolating between Muon and gradient descent. To make it practical, we prove that fractional spectral powers cannot be computed by any fixed univariate polynomial iteration, and furthermore derive low-degree odd bivariate recurrences that approximate $US^pV^\top$ using only matrix multiplications, preserving Muon's matrix-multiplication-only structure and compute complexity. We show that Muon$^p$ maximizes the linear improvement in loss under the Schatten $q$-norm for $q=1+\frac{1}{p}$. Empirically, Muon$^p$ is especially effective for finetuning: on billion-scale models, Muon$^p$ improves validation perplexity and downstream task performance. We further analyze when Muon$^p$ is less suitable, through the lens of spectral geometry. Our results reveal important insights on when preserving the singular spectrum can bring significant gains, and introduce a principled way to achieve them.

04.
arXiv (CS.CL) 2026-06-17

ProvenanceGuard: Source-Aware Factuality Verification for MCP-Based LLM Agents

Tool-using LLM agents increasingly use the Model Context Protocol (MCP) to answer from heterogeneous evidence sources, including search, APIs, databases, clinical records, and formulary tools. Standard factuality metrics usually test whether an answer is supported by pooled evidence, missing a provenance-sensitive failure mode: a claim may be supported somewhere while being attributed to the wrong source. We call this cross-source conflation. We introduce ProvenanceGuard, a source-aware verifier for MCP-grounded answers. It consumes captured MCP traces with stable tool IDs, source IDs, and raw outputs; decomposes answers into atomic claims; routes claims to source-specific evidence; checks support with NLI and a token-alignment proxy; compares stated attribution with the routed source; and returns per-claim verdicts plus an answer-level allow/block decision. Blocked answers can be repaired with retrieval-augmented answer revision and re-verified. We evaluate on 281 medical-domain MCP-agent traces. A 266-trace adjudicated subset yields 2,325 LLM-assisted claim labels split by trace; 361 held-out labels are human-verified. On the 40-trace held-out split, ProvenanceGuard achieves block F1 0.802 and source accuracy 0.858 over 260 source-eligible claims, outperforming source-blind baselines that do not emit claim-to-source IDs. On a harder multi-source benchmark it reaches block F1 0.846, while source-plus-relation accuracy drops to 0.229, showing that exact source ownership remains difficult with semantically close sources. Repair-and-reverify resolves all blocked answers in the full trace set, often via conservative fallback. In 50 controlled clinical conflation probes, ProvenanceGuard detects all injected attribution swaps with no retained wrong attribution. These results show that source attribution is an independent axis for factuality verification in MCP-based agents.

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

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

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

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

ZipSplat: Fewer Gaussians, Better Splats

Feed-forward 3D Gaussian Splatting methods reconstruct a scene from posed or pose-free images in a single forward pass, yet current approaches predict one Gaussian per input pixel, tying the representation budget to camera resolution rather than scene complexity. A flat wall and a richly textured object thus produce equally many Gaussians despite very different geometric needs. We propose ZipSplat, a token-based feed-forward model that decouples Gaussian placement from the pixel grid. A multi-view backbone extracts dense visual tokens, and k-means clustering compresses them into a compact set of scene tokens. Cross- and self-attention refine these tokens, and a lightweight MLP decodes each into a group of Gaussians with unconstrained 3D positions. Because clustering is applied at inference, a single trained model spans the quality-efficiency curve without retraining. ZipSplat operates without ground-truth poses or intrinsics, yet sets a new state of the art on DL3DV and RealEstate10K with ${\sim}6{\times}$ fewer Gaussians than pixel-aligned methods, surpassing the best pose-free baseline by 2.1dB and 1.2dB PSNR, respectively. It further generalizes zero-shot to Mip-NeRF360 and ScanNet++, outperforming all comparable baselines. Our project page is at https://veichta.com/zipsplat.

07.
arXiv (CS.CV) 2026-06-18

Optimizing Incomplete, Large-Scale and Sparse Multi-Graph Matching in Bioimaging

Multi-graph matching is a fundamental problem in computer vision. Our work is motivated by a challenging application in bioimaging, where dozens or even hundreds of 3D microscopy images of worms must be brought into correspondence. Existing datasets do not cover this large-scale regime, and virtually all existing methods are inapplicable because they assume a complete or dense problem setting. To support further research, our first contribution is a new large-scale dataset based on problem instances from bioimaging. Our second contribution is a comprehensive analysis of the two main multi-graph matching paradigms: direct and permutation synchronization-based formulations. We argue, in part by proof, that practical large-scale methods must explicitly address problem sparsity and incompleteness. Since standard permutation synchronization approaches fail in this setting, we further introduce a sparse permutation synchronization paradigm. Our final contribution is GREEDA, a general method for sparse and incomplete problems that can be instantiated across cost orders and paradigms. While our paper focuses on objective functions up to quadratic order, GREEDA is inherently generalizable to arbitrary orders. On larger, sparse instances, GREEDA outperforms competing methods in both objective value and runtime. For example, for moderately-sized problems based on 30 worm images GREEDA produces a high-quality solution within 2 minutes, whereas competitors require at least half an hour and yield far worse results. On smaller dense problems, GREEDA remains on par with leading methods while being an order of magnitude faster.

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

Knowledge Manifold: A Riemannian Geometric Framework for Semantic Mapping and Geodesic Analysis of Scientific Literature

arXiv:2606.05907v2 Announce Type: replace-cross Abstract: We present the knowledge manifold: a Riemannian geometric space in which a corpus of documents is arranged according to semantic positional relationships derived from character n-gram TF-IDF representations. The framework proceeds in five tightly coupled stages. First, each document is converted to a character-level n-gram TF-IDF vector (4-7 grams, up to 250,000 features, L2-normalized) and embedded in a two-dimensional knowledge map via constrained stress minimization with repulsion, variance, and centering regularizers. Second, knowledge at an arbitrary query point is estimated through Smoothed Particle Hydrodynamics (SPH) interpolation using a cubic-spline kernel, yielding an interpolated TF-IDF feature vector that can be linguistically characterized. Third, directional knowledge gradients at 0, 45, and 90 degrees are computed from the SPH interpolation map, and pairwise directional similarity is quantified via inner product and cosine similarity. Fourth, a Gaussian Process Regression (GPR) model, with a Constant x RBF + White kernel fitted on a 10-dimensional SVD projection, provides a Bayesian posterior mean, uncertainty estimate, and per-document contribution rate at the query point. Fifth, geodesics in the knowledge space are obtained by minimizing a discrete Riemannian path energy derived from the SPH-induced metric tensor, using L-BFGS-B with seven deterministic initial-path candidates. We apply the formulation to a corpus of 20 papers in fiber-reinforced composite materials and aerospace structural mechanics, showing that the semantic map recovers meaningful research clusters, geodesic paths reveal natural conceptual bridges between distant topics, and SPH/GPR interpolation enables the generation of virtual knowledge: hypothetical paper abstracts describing unstudied but geometrically predicted research directions.

09.
arXiv (CS.AI) 2026-06-12

SMSR: Certified Defence Against Runtime Memory Poisoning in Persistent LLM Agent Systems

作者:

arXiv:2606.12703v1 Announce Type: cross Abstract: Retrieval-augmented generation (RAG) agents increasingly run with persistent memory that accumulates across user sessions. This creates a new attack surface: an adversary interacting only through normal channels can inject crafted memories that, once retrieved, steer the agent's responses for future users, without touching model weights or code. We call this Multi-Session Memory Poisoning (MSMP) and show that no existing defence certifies against it; static-corpus defences (RobustRAG, ReliabilityRAG) assume a fixed knowledge base, and heuristic filters are bypassed by fluent enterprise-style text. We present Signed Memory with Smoothed Retrieval (SMSR), the first defence with a certified robustness bound for this setting. Component 1 adds HMAC-SHA256 provenance at write time, blocking unsigned injection. Component 2 applies randomised memory ablation with verdict-based majority voting at query time, bounding the influence of authenticated adversaries. We prove that no provenance-free retrieval-time filter can certify against adaptive injection, derive a hypergeometric certificate for Component 2, and formalise the Consistent Minority Effect, whereby a consistent adversarial answer wins string-based voting as a numerical minority while verdict-based voting removes it. Across 15 enterprise scenarios (3,150 repeated trials), Component 1 cuts attack success from 93-100% to 0% for all unsigned variants. For an authenticated adversary with a single injection, Component 2 holds success to 8.0% (95% CI [5.8, 10.9], n=450), below the certified worst case. In an end-to-end query-only attack where the agent itself writes the poison rather than it being pre-seeded, SMSR reduces success from 65.3% to 5.3% (n=150, non-overlapping CIs) on a live agent stack. Clean-query utility is 90% (Component 1) and 85% (combined).

10.
arXiv (CS.AI) 2026-06-19

Reward as An Agent for Embodied World Models

arXiv:2606.19990v1 Announce Type: new Abstract: While RL has become a promising tool for refining world models, existing methods largely rely on conservative rollouts near the training distribution, limiting exploration, behavioral diversity, and richer dynamic discovery. In this work, we challenge this conservative paradigm. We argue that the core limitation is not exploration itself, but the lack of reliable verification strategies to support broader exploration. Without reliable verification, expanded exploration becomes highly susceptible to reward hacking, where policies exploit imperfect rewards without achieving genuine improvement. To evaluate this motivation, we instantiate our method in embodied world models, where physical plausibility, and task completion provide a rigorous testbed for scalable RL under complex dynamics. On the verification side, we introduce Reward as an Agent, an agentic reward framework that actively evaluates generated behaviors to provide robust reward signals and mitigate reward hacking under distribution shifts. On the exploration side, we introduce Dynamic-Aware Rollout Diversification through DynDiff-GRPO, which explicitly expands action-space exploration to diversify trajectories, broaden state-action coverage, and encourage richer embodied behaviors beyond conservative rollout regimes. By unifying Reward as an Agent with DynDiff-GRPO, we enable RL on a more reliable reward foundation with substantially diversified sampling, effectively mitigating reward hacking while yielding significant accuracy gains across multiple open-source world models, thereby demonstrating that broader exploration can scale successfully when grounded in robust verification.

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

MuVAP: Multimodal Multiparty Voice Activity Projection for Turn-taking Prediction in the Wild

arXiv:2606.16731v1 Announce Type: cross Abstract: Current multiparty turn-taking models often rely on complex microphone arrays or multi-camera setups, limiting their applicability in human-robot interaction scenarios. We introduce MuVAP, a causal multimodal framework that extends Voice Activity Projection by grounding acoustic predictions in face tracks, enabling speaker-aware turn-taking predictions from a monaural audio stream and a single camera view. To address the combinatorial complexity of modeling multiple speakers, we propose Role-Relative Projection, which maps any N-speaker interaction onto a fixed current versus next floor-holder state. Because existing audiovisual datasets contain disruptive editing cuts that break causal tracking, we introduce the Audio-Visual Conversation Corpus, a 31-hour dataset of unedited, single-camera multiparty conversations. Evaluations demonstrate that MuVAP outperforms strong baselines on Shift-Hold and next-speaker prediction tasks across two- and three-speaker settings.

12.
medRxiv (Medicine) 2026-06-22

Associations of Chemical Exposures with Psychological Distress and Depression Diagnosis among Waste Pickers in Brasilia, Brazil: A Cross-Sectional Study

Introduction: Waste pickers face chemical exposures. We evaluated whether chemical exposure is associated with psychological distress and depression. Methods: A 2017 cross-sectional survey included 1,141 waste pickers working in the Estrutural open dump in Brasilia, Brazil. Participants self-reported occupational exposure to 11 chemical categories, 17 psychological distress symptoms, and depression diagnoses. Associations of chemical exposure with mean psychological distress scores and depression prevalence were assessed, adjusted for age, sex, marital status, and income. Results: Mean psychological distress score was higher among those exposed to any chemical (mean of 8.1 vs 6.1; adjusted mean difference [aMD]: 1.8 [0.9, 2.7]) and higher among those exposed to each of 11 chemical categories, for example, smoke (aMD: 1.2 [0.6, 1.7]), batteries (aMD: 1.5 [1.0, 1.9], and oils (aMD: 1.3 [0.9, 1.8]). Depression was more prevalent among those exposed to oils (16.6% vs 10.6%; adjusted prevalence difference [aPD]: 6.3% [95% CI: 2.3, 10.2]), cleaning products (aPD: 5.4% [1.2, 9.5]), medications (aPD: 4.7% [0.6, 8.8]), and aerosols (aPD: 5.3% [1.3, 9.3]) but, not smoke, batteries, greases, insecticides, solvents, paints, chemical containers, or any chemical. Conclusion: These associations highlight the need to consider policy level protections for waste pickers to reduce chemical exposure and guard against psychological distress. Further research is necessary to explore which specific chemicals, within broad chemical categories, are associated with psychological distress and depression.

13.
arXiv (CS.LG) 2026-06-15

A Composite Activation Function for Learning Stable Binary Representations

arXiv:2605.11558v2 Announce Type: replace Abstract: Activation functions play a central role in neural networks by shaping internal representations. Recently, learning binary activation representations has attracted significant attention due to their advantages in computational and memory efficiency, as well as interpretability. However, training neural networks with Heaviside activations remains challenging, as their non-differentiability obstructs standard gradient-based optimization. In this paper, we propose Heavy Tailed Activation Function (HTAF), a smooth approximation to the Heaviside function that enables stable training with gradient-based optimization. We construct HTAF as a sigmoid hyperbolic tangent composite function and theoretically show that it maintains a large gradient mass around zero inputs while exhibiting slower gradient decay in the tail regions. We show that Spiking Neural Networks, Binary Neural Networks and Deep Heaviside neural Networks can be trained stably using HTAF with gradient-based optimization. Finally, we introduce Implicit Concept Bottleneck Models (ICBMs), an interpretable image model that leverages HTAF to induce discrete feature representations. Extensive experiments across various architectures and image datasets demonstrate that ICBM enables stable discretization while achieving prediction performance comparable to or better than standard models.

14.
medRxiv (Medicine) 2026-06-22

Between Patterns and Predictions: Interpretable Latent EEG Representations for Clinical Insights

Electroencephalography (EEG) captures rich brain dynamics, yet in clinical practice this complexity is often reduced to simplified summaries or categorical labels, limiting its interpretability for decision-making. We tested the hypothesis that a pretrained latent embedding framework, the Universal Map of EEG (UM-EEG), can preserve clinically meaningful structure across heterogeneous datasets and provide a generalizable representation of brain states. We applied UM-EEG, without retraining, to three independent cohorts spanning distinct clinical contexts: long-term EEG recordings from cardiac arrest patients (n = 576), subarachnoid hemorrhage (n = 100), and routine clinical EEG recordings containing physiological and pathological patterns (n = 141). EEG segments were projected into a shared 128-dimensional space anchored by expert-derived reference states, including wakefulness, sleep stages, ictal-interictal continuum activity, and burst suppression. Across datasets, favorable outcome or physiological recordings were consistently located closer to healthy reference states, whereas poor outcome and pathological recordings shifted toward pathological regions of the embedding space. Trajectory-derived geometric and temporal features discriminated outcome in cardiac arrest (ROC-AUC 0.83) and subarachnoid hemorrhage (ROC-AUC 0.76), and distinguished physiological from pathological routine EEGs (ROC-AUC 0.93). In routine EEG, similarity relationships derived from embedding trajectories correlated with those derived from structured clinical reports, indicating that the latent space recapitulates clinically relevant organization. These findings show that a fixed, semantically structured EEG embedding generalizes across etiologies and recording settings, enabling prognostic stratification and contextual interpretation while preserving the relational structure of brain states.

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

Precision-Aware Illumination-Disentangled Vision Transformer for Spacecraft 6D Pose Estimation

Vision sensors provide a lightweight solution for spacecraft proximity operations, but monocular spacecraft 6D pose estimation remains difficult under illumination variation, specular reflection, shadowing, weak texture, and background interference. These factors make local visual evidence spatially unreliable and can destabilize pose regression. This article proposes a Precision-Aware Illumination-Disentangled Vision Transformer (PAID-ViT) for robust spacecraft pose estimation.The proposed model separates pose-relevant structure tokens from illumination-sensitive appearance tokens, estimates patch reliability before pose aggregation, and uses foreground mask supervision to preserve silhouette cues. A parameter-free geometric recovery module converts normalized crop coordinates, log-depth, and a continuous 6D rotation representation into camera-frame rotation and translation. Experiments on SPEED+ V2, the SPEED+ validation/lightbox/sunlamp evaluation configuration used in this study, suggest that PAID-ViT reduces translation error and improves robustness in the challenging sunlamp domain, while ablation studies support the complementary roles of illumination disentanglement, reliability-aware token aggregation, mask supervision, and training-side regularization.

16.
PLOS Medicine 2026-05-22

Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993–2025: A systematic review and meta-analysis

by Nicole A. Swartwood, Nanki Singh, Seyed Alireza Mortazavi, Melike Hazal Can, Hening Cui, Do Kyung Ryuk, Peter MacPherson, Katherine C. Horton, Nicolas A. Menzies Background Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a systematic review of sex-stratified TB prevalence survey data published over 1993–2025, to provide updated estimates of male-to-female (M:F) TB prevalence ratios and determine whether sex-related disparities in TB burden have closed over time. Methods and findings We identified surveys reporting community-representative, sex-stratified estimates of pulmonary TB prevalence in low- and middle-income countries (LMICs), including surveys from an earlier review (covering January 1993–March 2016) and a new systematic review (covering 1st December 2015–13th October 2025). This review was prospectively registered with PROSPERO (CRD42024503853) and included searches of PubMed, Embase, Global Health, the Cochrane Library, Africa Index Medicus, LILACS, and SciELO. We extracted data on bacteriologically confirmed and smear-positive TB prevalence among adults (aged ≥ 15 years), stratified by sex. Risk of bias was evaluated using eight criteria specific to prevalence surveys. We fit multi-level Bayesian regression models with study- and country-level random effects to estimate the M:F ratio of TB prevalence (male prevalence divided by female prevalence), overall and for key subgroups. In meta-regression analyses, we estimated how prevalence ratios varied over time and according to known TB risk factors and TB case definitions.We identified 10,124 publications and extracted data from 100 eligible studies representing 102 unique prevalence surveys and 4,658,310 participants (45.6% male) in 33 LMICs. TB prevalence was higher in men than women in 90/102 of the included surveys, with a pooled M:F prevalence ratio of 2.02 (95% credible interval (CrI): 1.71, 2.34) for bacteriologically confirmed TB and 2.38 (95% CrI: 1.91, 2.90) for smear-positive TB. Time trend analyses showed a 2.0% (95% CrI: −0.2, 4.5%) average annual change in the M:F ratio of bacteriologically confirmed TB over the study period. The M:F prevalence ratio was estimated to be higher for countries with greater excess HIV prevalence among men, and countries with greater gender equity (as measured by the United Nation’s Gender Development Index). The estimated M:F prevalence ratio was also higher for surveys that did not restrict testing to individuals reporting TB symptoms. Study limitations include heterogeneity in survey methods and definitions, as well as limited data from the Americas, Eastern Mediterranean, and Europe WHO world regions and post-COVID-19 period. Conclusions Men in LMICs consistently experience TB at a higher prevalence than women. Time trend estimates are uncertain, but consistent with widening sex differences in TB prevalence over the last three decades, despite efforts to address the risk factors underlying this excess TB burden.

17.
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.

18.
arXiv (quant-ph) 2026-06-15

Universal Crossovers of Stabilizer Entropy Beyond Criticality

arXiv:2606.13810v1 Announce Type: new Abstract: Stabilizer Rényi entropy has emerged as a probe of nonstabilizerness in quantum many-body systems, but its scaling structure beyond critical points remains poorly understood compared with entanglement entropy. Recent field-theory approaches indicate that stabilizer entropy contains universal critical data and boundary-sensitive terms, raising the question of how these structures extend into massive and crossover regimes. We address this problem for a broad class of finite-range spin chains at Rényi index one-half. We derive exact finite-size formulas for both full periodic chains and finite intervals of the infinite chain, making the universal crossover from critical to noncritical behavior analytically accessible. In periodic geometry, the entropy obeys a volume law away from criticality and exhibits a universal finite-size crossover controlled by the competition between system size and correlation length. We also show that the large-scale SRE density develops a cusp across the field-tuned critical line, while the XX endpoint is governed by a distinct scaling regime associated with the saturation point. In the subsystem geometry, the interval entropy separates bulk critical behavior from boundary contributions generated by the way the finite region cuts the infinite chain. The crossover from critical to massive behavior is then encoded in boundary constants and universal functions controlled by the correlation length. Through exact stabilizer-entropy correspondences, the scaling theory extends to internal XY reductions, Finite-range spin chains, and Cluster–Ising representatives. Our results provide an exact lattice benchmark for the emerging QFT description of stabilizer entropy beyond isolated conformal points.

19.
arXiv (quant-ph) 2026-06-15

OQMD: Single-Qubit Rotation Control Improves Low-CNOT Multiclass Quantum Classification

arXiv:2606.14088v1 Announce Type: new Abstract: Near-term variational classifiers incur substantial error and latency from two-qubit gates, yet practitioners often assume that additional entangling depth is the default route to higher accuracy. This work studies Optimal Quantum Measurement Decoding (OQMD): optimizing how quantum outcomes are mapped to classical labels by training a readout layer before measurement, jointly with the variational circuit, without adding CNOTs. Experiments use trainable triple single-qubit rotations as one concrete, hardware-native realization of OQMD; other single-qubit parametrizations fit the same classical outer loop. On the Iris benchmark with a 30-point stratified test split, the best observed 0-CNOT configuration with OQMD reaches 83.33\% accuracy, with a 96\% at 9 CNOTs, exceeding the best 18-CNOT controls (56.67\%) and the best 18-CNOT configuration with OQMD (66.67\%) under a common protocol. A six-point CNOT-depth series from 0 to 18 (fixed optimizer, iteration budget, random-seed count, and ZXZ readout) shows that the highest raw scores need not occur at the largest template, so aggregate complexity is not summarized by CNOT count alone. Because run-level accuracies are discrete and non-Gaussian, we emphasize best-observed scores and, where a global comparison of pooled runs is required, Mann–Whitney $U$ tests rather than parametric tests on means. Across architectures, OQMD shows statistically consistent but magnitude-dependent gains: large peak lifts on minimal circuits coexist with a small pooled mean shift on complex 18-CNOT runs ($p\approx 0.03$) that is not ``universal'' in the sense of uniformly large practical effects.%

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

BrainWorld: A Structural-Prior-Conditioned Generative Model for Whole-Brain 4D fMRI Dynamics

Whole-brain 4D fMRI generation is valuable for modeling functional brain dynamics, yet existing fMRI foundation models mainly target representation learning and downstream prediction rather than conditional predictive generation. We introduce BrainWorld, a structural-prior-conditioned generative model for whole-brain 4D fMRI dynamics. BrainWorld uses sMRI as subject-level anatomical context to guide future fMRI generation, integrating structural information into the denoising process rather than treating it as a parallel modality. Evaluated on 22 datasets spanning diverse cohorts and brain states, BrainWorld generates stable 4D fMRI trajectories up to 400 frames, improves downstream performance through generated-example augmentation, and learns transferable multimodal representations that outperform baselines. Together, these results establish BrainWorld as a condition-aware generative framework for long-horizon brain dynamics modeling and multimodal representation learning.

21.
arXiv (CS.CL) 2026-06-16

Think-at-Hard: Selective Latent Iterations to Improve Reasoning Language Models

Improving the reasoning abilities of Large Language Models (LLMs), especially under parameter constraints, is crucial for real-world applications. Looped transformers address this by performing multiple latent iterations to refine each token beyond a single forward pass. However, we identify a latent overthinking phenomenon: most token predictions are already correct after the first pass, but are sometimes revised into errors in later iterations. We ask whether selectively skipping latent iterations can improve accuracy, and reveal significant potential with an oracle iteration policy that boosts performance by up to 7.3%. Motivated by this, we propose Think-at-Hard (TaH), a looped transformer optimized for selective iteration. TaH employs a lightweight neural decider to trigger latent iteration, only at tokens likely to be incorrect after the standard forward pass. During latent iterations, depth-aware Low-Rank Adaptation (LoRA) modules shift the objective from general next-token prediction to focused hard-token refinement. A duo-causal attention mechanism extends attention from the token sequence dimension to an additional iteration depth dimension, enabling cross-iteration information flow with full sequential parallelism. Experiments on nine benchmarks show consistent gains across math, QA, and coding tasks. With identical parameter counts, TaH outperforms always-iterate baselines by 3.8-4.4% while skipping iterations on 93% of tokens, and exceeds single-iteration Qwen3 baselines by 3.0-3.8%. When allowing

22.
arXiv (CS.LG) 2026-06-16

Escaping the Cognitive Well: Efficient Competition Math with Off-the-Shelf Models

arXiv:2602.16793v2 Announce Type: replace Abstract: In the past year, custom and unreleased math reasoning models reached gold medal performance on the International Mathematical Olympiad (IMO). Similar performance was then reported using large-scale inference on publicly available models but at prohibitive costs (e.g., 3000 USD per problem). In this work, we present an inference pipeline that attains best-in-class performance on IMO-style math problems at an average inference cost orders of magnitude below competing methods while using only general-purpose off-the-shelf models. Our method relies on insights about grader failure in solver-grader pipelines, which we call the Cognitive Well (iterative refinement converging to a wrong solution that the solver as well as the pipeline's internal grader consider to be basically correct). Our pipeline addresses these failure modes through conjecture extraction, wherein candidate lemmas are isolated from generated solutions and independently verified alongside their negations in a fresh environment (context detachment). On IMO-ProofBench Advanced (PB-Adv), our pipeline achieves 67.1 percent performance using Gemini 3.0 Pro with an average cost per question of approximately 31 USD. At the time of evaluation, this represented the state-of-the-art on PB-Adv among both public and unreleased models, and more than doubles the success rate of the next best publicly accessible pipeline, all at a fraction of the cost.

23.
arXiv (CS.CV) 2026-06-17

m2sv: A Scalable Benchmark for Map-to-Street-View Spatial Reasoning

Vision–language models (VLMs) achieve strong performance on many multimodal benchmarks but remain brittle on spatial reasoning tasks that require aligning abstract overhead representations with egocentric views. We introduce m2sv, a scalable benchmark for map-to-street-view spatial reasoning that asks models to infer camera viewing direction by aligning a north-up overhead map with a Street View image captured at the same real-world intersection. We release m2sv-20k, a geographically diverse benchmark with controlled ambiguity, along with m2sv-sft-11k, a curated set of structured reasoning traces for supervised fine-tuning. Despite strong performance on existing multimodal benchmarks, the best evaluated VLM achieves only 65.2% accuracy on m2sv, below human annotators who reach 72.0% on average (and 95% for an expert) with strong inter-annotator agreement ($\kappa$ up to 0.76). While supervised fine-tuning and reinforcement learning yield consistent gains, cross-benchmark evaluations reveal limited transfer. Beyond aggregate accuracy, we systematically analyze difficulty in map-to-street-view reasoning using both structural signals and human effort, and conduct an extensive failure analysis of adapted open models. Our findings highlight persistent gaps in geometric alignment, evidence aggregation, and reasoning consistency, motivating future work on grounded spatial reasoning across viewpoints.

24.
arXiv (math.PR) 2026-06-16

Interplay of insurance and financial risks in a non Levy-Renewal environment

arXiv:2606.15596v1 Announce Type: new Abstract: In this paper we consider a multivariate risk model, with common counting process and common process of logarithmic returns for the investment portfolio. We assume that the claim-vectors, the counting process and the logarithmic returns of the investment portfolio satisfy a weak dependence structure. Further, we consider that the counting process represents an inhomogeneous renewal process, and the logarithmic returns represent a cadlag process with independent but not necessarily stationary increments. Under these conditions we provide an asymptotic expression for the infinite-time entrance probability of the discounted aggregate claims into some rare set xA, where A denotes a set from a general set family, crucial for the actuarial practice, when the common distribution of the claim vectors belong to a multivariate heavy-tailed distribution class. This result, is derived under a moment condition for the financial risks, and underlines the multivariate linear single big jump principle. When we restrict the distribution class of the claim-vectors to multivariate regular variation, we find more explicit asymptotic expressions, weakening the moment conditions on the financial risks. The asymptotic formulas, derived through double dependence solution, become more direct and practical in applications. With respect to the technical part, due to non Levy-Renewal framework, the classical Kesten-Goldie theorems are not applicable, nor their extensions. The way we make the discretization of the process of the discounted aggregate claims permits to derive uniform asymptotics with respect to the number of summands, that facilitate the approximation of the infinite sums of the main results.

25.
arXiv (CS.AI) 2026-06-19

Multi-Head Attention-Based Feature Extractor Integration with Soft Actor-Critic for Porosity Prediction and Process Parameter Optimization in Additive Manufacturing

arXiv:2606.20087v1 Announce Type: new Abstract: Additive manufacturing process optimization requires precise parameter control to minimize defects such as porosity. Traditional reinforcement learning (RL) approaches using discrete action spaces suffer from slow convergence and susceptibility to local optima, limiting their effectiveness for high-precision manufacturing tasks. This study addresses these limitations by employing a continuous action space combined with a novel architecture that integrates a multi-head attention mechanism with the Soft Actor-Critic (SAC) algorithm. The attention-based feature extractor enhances the agent's ability to capture subtle variations in low-dimensional input features, enabling more effective exploration-exploitation balance for navigating value spaces with local minima. We validate our approach on porosity prediction and process parameter optimization in laser powder bed fusion, demonstrating faster convergence and higher final reward values compared to standard RL methods including DQN, PPO, TD3, and vanilla SAC. The proposed methodology achieves a convergence value of 322.79 within 14 episodes, outperforming existing approaches while maintaining stability throughout training.