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01.
arXiv (CS.CV) 2026-06-16

CT-VDETR: Semi-supervised 3D Trauma Detection in Computed Tomography (CT) scans using Dense Vertex Relative Position Encoding

Accurate detection and localization of traumatic injuries in abdominal CT remain challenging because voxel-level annotations are limited and expensive to obtain. We present a label-efficient framework for 3D abdominal trauma detection that combines self-supervised pretraining with semi-supervised transformer-based detection. First, we use Masked Image Modeling (MIM) on 1098 CT volumes to pretrain a 3D U-Net encoder for anatomical representation learning. Next, we adapt V-DETR to dense volumetric CT through a feature adapter that converts the encoder feature grid into a compact token sequence for transformer decoding. The pretrained encoder is then integrated with V-DETR and 3D Vertex Relative Position Encoding (3D V-RPE) to improve the localization of irregularly shaped injuries. Finally, semi-supervised teacher-student consistency regularization leverages 2,000 additional unlabeled volumes during detector training. To the best of our knowledge, this is the first application of a 3D DETR-style detector to the RSNA abdominal trauma detection task. On this benchmark, the proposed method achieves 31.33% test mAP@0.50 using only 78 labeled training volumes, corresponding to a 1.53x improvement over supervised-only training. These results show that combining medical-domain pretraining with semi-supervised learning is an effective strategy for label-scarce 3D medical detection.

02.
arXiv (CS.AI) 2026-06-11

OmniBioTwin: A System-of-Twinned-Systems Framework for Health Digital Twins

arXiv:2606.11264v1 Announce Type: cross Abstract: Health digital twins (HDTs) promise patient-specific modeling and decision support but current approaches remain structurally fragmented: monolithic models that address a single organ or task lack cross-scale fidelity, while system-level twins lack generalizable architectural frameworks. We propose OmniBioTwin, a System-of-Twinned-Systems (SoTS) framework that organizes HDTs as modular computational entities coupled through explicit interaction operators within a multi-layer network architecture. The framework comprises seven coordinated layers - spanning data integration, autonomous twin modeling, cross-scale coupling, temporal synchronization, and human-in-the-loop decision support. We demonstrate OmniBioTwin by instantiating a multiscale twin for glucagon-like peptide-1 (GLP-1) signaling pathways in Alzheimer's disease, illustrating how molecular, cellular, and organ-level twins can be composed and coupled within a unified system.

03.
arXiv (CS.CL) 2026-06-12

Zero-source LLM Hallucination Detection with Human-like Criteria Probing

Large language models (LLMs) often hallucinate by generating factually incorrect or unfaithful content, posing significant risks to their safe use. Detecting such hallucinations is particularly challenging under the zero-source constraint, where no model internals or external references are available, and detection must rely solely on the textual query-answer pair. In this paper, we propose Human-like Criteria Probing for Hallucination Detection (HCPD), a paradigm that emulates the multi-faceted reasoning of human evaluators. Its core is a Human-like Criteria Probing (HCP) mechanism, in which a LLM agent adaptively decomposes its judgment into a weighted set of interpretable criteria and aggregates criterion-specific scores into a final truthfulness measure. To achieve this adaptive capability, we introduce a reward-based alignment scheme using only weak supervision from semantic consistency. At inference, we employ a multi-sampling aggregation strategy to ensure robust decisions while preserving full interpretability. We further provide theoretical analysis supporting the reliability of our approach. Extensive experiments show that HCPD consistently outperforms state-of-the-art baselines, offering an effective and explainable solution for zero-source hallucination detection. Code is available at https://github.com/TRISKEL10N/HCPD.

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

Realistic noise synthesis reduces bias and improves tissue microstructure estimation with supervised machine learning

arXiv:2606.02044v2 Announce Type: replace Abstract: Diffusion MRI enables non-invasive probing of tissue microstructure, but accurate parameter estimation is challenged by noise-related effects. In supervised machine learning frameworks trained on simulated data, discrepancies between the noise characteristics of simulated and acquired signals introduce a form of covariate shift, whereby the input signal distribution differs between training and inference. We investigated the impact of this mismatch on microstructure parameter estimation and propose a realistic noise synthesis (RNS) framework to mitigate it. RNS incorporates both the Rician expectation and the effective post-processing noise variance into simulated training signals. The Rician expectation was modelled using a noise standard deviation estimated with MPPCA, while the effective standard deviation was derived from spherical harmonic residuals of preprocessed data. The method was evaluated using the cylinder-zeppelin and the SANDI models on simulated datasets across multiple SNR levels and on in vivo diffusion data with repeated acquisitions. Sensitivity to noise misestimation was also assessed. Ignoring magnitude-induced noise effects during training produced systematic, SNR-dependent parameter bias, particularly at low SNR. Incorporating the Rician expectation substantially reduced bias to the level of noise-aware nonlinear least-squares fitting. Modelling the effective standard deviation further improved precision. Performance was largely independent of regression architecture but sensitive to accurate noise estimation. These findings demonstrate that realistic noise modelling in simulated training data mitigates signal-domain covariate shift and is essential for unbiased supervised microstructure estimation, particularly in low-SNR regimes associated with high b-values or high spatial resolution.

05.
medRxiv (Medicine) 2026-06-18

Automated Airways Characterization and Assessment of Cystic Fibrosis from CT Imaging

Background Advancements in medical imaging have enabled non-invasive diagnosis and staging of cystic fibrosis (CF) using CT scans, revealing dilated airways, an increased number of visible airways, and airway generation splits in these patients. However, manual characterization of airways remains time-consuming and challenging due to the numerous structural changes, thereby limiting clinical feasibility. This study aims to develop an automated algorithm to characterize airways from segmented lung CT scans and apply this to a retrospective population. This approach reduces the time required to analyze images and obtain disease-staging results. Methods This framework consists of two stages. The first stage extracts and skeletonizes the airway tree from lung CTs, while the second stage measures lung features, including airway volumes, branch counts, generation splits, diameters, and cross-sectional areas. This permits comprehensive characterization for use in clinical assessment. Results The airways analysis was performed on 169 CT volumes ranging in age from 6 to 18 years of age, revealing substantial differences in detected airway branches, generation splits, and normalized airway volume between the control and CF groups. The framework also measures airway diameters and cross-sectional areas, revealing an increase in the number of small airways in cystic fibrosis patients, due to early bronchiectasis. These findings align with previous research and demonstrate the framework's ability to accurately quantify airway changes in patients with CF. Discussion The framework extracts entire airway trees, facilitating measurements of volume, branch count, diameters, and cross-sectional areas, which change with CF severity and/or treatment. However, partial lung atelectasis can limit the accuracy of airway detection in moderate-to-severe cases. Funding NIA U54 AG054345 and NIA R21 AG07857501

06.
arXiv (CS.LG) 2026-06-18

Bridging Data Gaps in Structural Fragility Modeling through Transfer Learning: Methodology and Case Studies

arXiv:2606.18567v1 Announce Type: cross Abstract: This paper presents a methodology-centered transfer learning framework for fragility adaptation under domain shift, class imbalance, and scarce target labels while preserving engineering interpretability and supporting decision-making under uncertainty. Four transfer learning strategies (instance-based, parameter-based, hierarchical Bayesian, and multi-source) are demonstrated through three complementary case studies: (i) instance-based transfer learning via importance weighting, demonstrated on coastal bridge fragility using Hurricane Katrina observations; (ii) parameter-based transfer learning together with hierarchical Bayesian transfer learning, enabling partial pooling across strata and posterior uncertainty quantification, demonstrated on residential building fragility using Hurricane Ian observations; and (iii) multi-source transfer learning that fuses multiple analytical fragility models with learned source weights and regularized target-domain adaptation, demonstrated on seismic bridge fragility using observations from the 2001 Nisqually earthquake. Across these case studies, direct transfer of source models (i.e. using existing state-of-the-art models) fails under domain shift and severe class imbalance, while targeted adaptation substantially improves failure detection and predictive stability in low-data regimes. These findings highlight the need for systematic guidance on diagnostics, strategy selection, and uncertainty reporting when developing and adapting fragility models.

07.
medRxiv (Medicine) 2026-06-19

Within-host pathogen population diversity predicts treatment response in tuberculosis

Background: Tuberculosis (TB) treatment outcomes remain suboptimal, and standard clinical diagnostics cannot reliably identify patients at high risk of treatment failure or relapse at the time of diagnosis. While within-host Mycobacterium tuberculosis genetic diversity is hypothesized to reflect the viable bacterial burden and adaptive capacity of the infection, its clinical prognostic value remains unknown. Methods: We conducted a prospective cohort study of 364 patients with newly diagnosed, rifampicin-susceptible pulmonary TB in South Africa. Patients received standard 6-month therapy and were monitored for up to two years to ascertain composite unfavorable outcomes (treatment failure, death, or relapse). To accurately detect low-frequency (unfixed) genetic variants and eliminate reference bias artifacts, we mapped medium to high depth short-read sequences against matched, patient-specific long-read assemblies. The association between baseline pathogen genetic diversity and clinical outcomes was evaluated using multivariable Cox proportional-hazards models. Results: After bioinformatic filtering, true unfixed variants were relatively rare but significantly enriched in genes mediating pathogen adaptation and drug tolerance, including transporter proteins and two-component regulatory systems. Within-host bacterial genetic diversity (i.e., the total number of unfixed variants) ranged from 0-20, with a median of 1 per patient. In survival analysis adjusting for known clinical risk factors–including HIV status, prior TB, baseline smear positivity, and radiographic lung involvement–baseline within-host genetic diversity emerged as a strong, independent predictor of unfavorable treatment outcomes. For patients with greater than 3 unfixed variants at diagnosis, each increase of 5 unfixed variants was associated with more than double the risk of a composite unfavorable outcome (adjusted Hazard Ratio, 2.36; 95% CI, 1.27 to 4.39; p=0.007). Conclusions: Baseline within-host pathogen genetic diversity is an independent predictor of unfavorable TB treatment outcomes. As sequencing becomes increasingly integrated into routine diagnostics, quantifying unfixed variants is an accessible approach that promises to risk-stratify patients and guide the duration of individualized regimens.

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

Benchmarking Large Language Models for Safety Data Extraction

Accurate extraction of structured information from Safety Data Sheets (SDS) remains challenging in industrial safety due to heterogeneous document formats and the limitations of traditional rule-based methods. This study benchmarks state-of-the-art Large Language Models (LLMs) for automated SDS data extraction, comparing text-based and multimodal processing pipelines. We systematically evaluate four models: Gemini 1.5 Pro, GPT-4o, Claude 3.7 Sonnet, and Llama 3.1-70B, across three prompting strategies: zero-shot, few-shot, and chain-of-thought. The evaluation framework assessed accuracy, latency, and cost across more than 50,000 extracted data fields. Results show that text-based extraction consistently outperforms multimodal processing across all metrics. Gemini 1.5 Pro combined with a Chain-of-Thought prompt achieved the highest accuracy (84%), outperforming GPT-4o (81%) and Claude 3.7 Sonnet (79%). However, no model surpassed the 90% accuracy threshold commonly required for reliable real-world deployment. These findings indicate that general-purpose LLMs are not yet robust enough for unsupervised industrial use, though performance suggests strong potential with task-specific fine-tuning. Future research should focus on domain-adapted training, model calibration, and the integration of Human-in-the-Loop verification to ensure safety-critical reliability.

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

When Does Delegation Beat Majority? A Delegation-Based Aggregator for Multi-Sample LLM Inference

arXiv:2606.08098v2 Announce Type: replace Abstract: Majority voting over sampled answers is the dominant unsupervised aggregator for multi-sample LLM inference. In this paper, we show a delegation-based aggregator (Propagational Proxy Voting, PPV; Sakai et al., 2025) yields an unsupervised consensus rule that beats majority on MMLU-Pro by +1.5 pp overall and +2.24 pp on the non-trivial subset (paired McNemar p ~ 1.0e-14, n = 8,099). Majority discards two signals that every sample carries: within-group letter entropy and between-group reasoning geometry. PPV exposes per-voter levers that consume exactly these two signals: When (how much weight a voter keeps on its own pick) and Whom (how it splits the remainder across peers). We drive When with letter entropy and Whom with per-question-centered embedding cosine. Our method needs no gold labels and no auxiliary training: per-question, we partition 128 sampled generations into 16 groups, compute each group's letter-level semantic entropy and reasoning embedding centroid, and feed both into a stochastic delegation matrix whose stationary distribution selects the consensus answer. We walk through an example in which PPV overturns a clear 10-6 majority for the wrong letter: the 10-voter majority cluster is geometrically incoherent (mean within-cluster cosine -0.02) while the 6-voter minority is tight (+0.26), so propagated delegation mass concentrates on the minority's answer even though entropy alone would keep the majority ahead. We further report delegation strategies with negative results that constrain the design space for unsupervised LLM aggregation. No within-question ensemble of confidence modes closes the oracle gap.

10.
arXiv (CS.LG) 2026-06-11

Few-Shot Resampling for Scalable Statistically-Sound Data Mining

arXiv:2606.11235v1 Announce Type: new Abstract: A key step in knowledge discovery is the evaluation of data mining results. In several applications, including pattern mining, graph analysis, and others, this step includes the evaluation of the statistical significance of the results, to avoid spurious discoveries due only to noise or random fluctuations in the data. While specialized procedures have been developed for some specific applications, resampling-based approaches are widely used, in particular for complex analyses where analytical results cannot be derived. However, current resampling-based approaches require the generation and analysis of thousands of resampled datasets, and are therefore impractical for large datasets or computationally intensive analyses. In this paper, we introduce FewRS, a simple and effective resampling-based approach to assess the statistical significance of data mining results with rigorous guarantees on the probability of false discoveries. Our approach can be used in every situation where resampling-based approaches are applied. FewRS builds on our derivation of a novel bound to the supremum deviation of test statistics representing the quality of data mining results. We prove that FewRS needs to generate and analyze an extremely small number of resampled datasets, leading to a highly scalable approach with wide applicability. We test our approach on common tasks such as pattern mining and network analysis. In all cases, our approach results in a reduction of up to two orders of magnitude in running time compared to the state of the art, while preserving high statistical power, enabling the statistical validation of data mining results on large-scale real-world datasets.

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

Heterogeneous SAR-optical fusion for near-real-time land use and land cover mapping under cloud contamination: A novel framework and global benchmark dataset

Optical remote sensing imagery is frequently degraded by cloud and cloud-shadow contamination, which limits its reliability for near-real-time land use and land cover (LULC) mapping. Although synthetic aperture radar (SAR) can provide cloud-penetrating structural information, existing SAR-optical fusion methods often assume reliable optical observations and insufficiently address the semantic uncertainty introduced by cloud contamination. To address this issue, we propose CloudLULC-Net, an end-to-end heterogeneous SAR-optical fusion framework that directly predicts LULC maps from cloud-contaminated Sentinel-2 imagery and temporally adjacent Sentinel-1 SAR observations. The proposed network incorporates optical reliability modulation to suppress unreliable optical responses, heterogeneous information adaptive aggregation to model high-order spatial-channel interactions between optical and SAR representations, and a unified semantic mapping transformer to organize fused features in a LULC-oriented latent space. A semantic anchor-guided optimization strategy is further introduced to improve the consistency of intermediate semantic representations. To support this task, we construct CloudLULC-Set, a large-scale benchmark dataset containing 40,223 curated SAR-optical-label triplets with pixel-level LULC annotations across diverse geographic regions and cloud conditions. Experimental results show that CloudLULC-Net achieves an OA of 86.60%, an F1-score of 83.29%, and an mIoU of 73.51%, outperforming representative heterogeneous reconstruction-first and end-to-end SAR-optical mapping methods. Comparisons with existing global LULC products and analyses under different cloud-cover levels further demonstrate the robustness and practical value of CloudLULC-Net for target-date LULC mapping in cloud-prone regions.The project is publicly available at: https://github.com/RSIIPAC/CloudLULC

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

Beyond Third-Person Audits: Situated Interaction Auditing for User-Centered LLM Bias Research

Research on bias in large language models (LLMs) has predominantly focused on third-person audits, which study how models represent or evaluate demographic groups as external subjects. However, this paradigm overlooks a structural blind spot because the user is absent from the audit. In practice, LLMs are used in open-ended, personal interactions, during which the model implicitly represents the user and adjusts its responses accordingly. When identical requests yield different responses depending on who is asking, bias manifests not in how the model describes others but in how it treats its interlocutor. We propose Situated Interaction Auditing (SIA), a user-centered framework for studying how user profile signals – implicit sociodemographic markers, writing style, and stated identity – systematically shape LLM response quality, content, and tone. We demonstrate the framework through a case study that intersects gender and socioeconomic status signals across multiple task domains and outline a research agenda for SIA as a new mission for natural language processing.

13.
arXiv (CS.LG) 2026-06-16

Scalar-pathway fidelity improves physical accuracy in short-range equivariant interatomic potentials

arXiv:2606.15892v1 Announce Type: new Abstract: Accurate interatomic potentials enable molecular dynamics of materials, molecules, and interfaces beyond density-functional-theory length and time scales. Equivariant neural network potentials have improved the representation of local geometry. However, their deployable energy surfaces ultimately manifest through invariant scalar channels, whose aggregation and spectral resolution remain comparatively underexamined. Here we use Physics-Aware Neighborhood (PAN) pooling and Physics-Guided Spectral (PGS) mixers as controlled scalar-pathway probes: lightweight, symmetry-preserving modifications that act only on \(\ell=0\) channels while leaving the equivariant tensor backbone unchanged. Using MACE as a high-body-order mechanistic scaffold, PAN adds coordination-sensitive amplitude modulation, whereas PGS augments edge and readout scalar features with radial and tapered spectral bases. Across metallic Ag, covalent Si, a short-range ionic LiF/Li–F subset, and MD17/rMD17 molecules, this scalar-pathway correction reduces MACE force errors by 22–27\% and energy errors by 19–22\%; on systems with stress labels, stress errors decrease by 27–28\%, at approximately 5\% additional inference-FLOPs cost. Directionally consistent gains in Allegro and NequIP further indicate that the correction is portable across distinct short-range equivariant backbones, although effect sizes remain architecture-dependent. These results identify scalar-pathway fidelity as a practical design dimension for short-range equivariant interatomic potentials.

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

Localized Kernel Projection Outlyingness: A Two-Stage Approach for Multi-Modal Outlier Detection

arXiv:2510.24043v4 Announce Type: replace Abstract: This paper presents Two-Stage LKPLO, a novel multi-stage outlier detection framework that overcomes the coexisting limitations of conventional projection-based methods: their reliance on a fixed statistical metric and their assumption of a single data structure. Our framework uniquely synthesizes three key concepts: (1) a generalized loss-based outlyingness measure (PLO) that replaces the fixed metric with flexible, adaptive loss functions like our proposed SVM-like loss; (2) a global kernel PCA stage to linearize non-linear data structures; and (3) a subsequent local clustering stage to handle multi-modal distributions. Comprehensive 5-fold cross-validation experiments on 10 benchmark datasets, with automated hyperparameter optimization, demonstrate that Two-Stage LKPLO achieves state-of-the-art performance. It significantly outperforms strong baselines on datasets with challenging structures where existing methods fail, most notably on multi-cluster data (Optdigits) and complex, high-dimensional data (Arrhythmia). Furthermore, an ablation study empirically confirms that the synergistic combination of both the kernelization and localization stages is indispensable for its superior performance. This work contributes a powerful new tool for a significant class of outlier detection problems and underscores the importance of hybrid, multi-stage architectures.

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

Interpretable Neural Marked Statistics for Cosmological Inference

arXiv:2606.11295v1 Announce Type: cross Abstract: Recovering cosmological information beyond the power spectrum is a central goal for upcoming cosmological surveys, since late-time non-Gaussian signal in the matter density cannot be accessed through two-point statistics alone. Marked statistics fold part of this information back into the two-point level by reweighting the field with non-linear functions. We propose a neural marking scheme to generalize this process through a set of interpretable, physically motivated transformations that directly allow to interpret the gain in cosmological information at the morphological level. We employ a contrastive learning objective to align learnable marked summaries with the underlying cosmological parameters. At $k_{\max}=0.2\,h\mathrm{Mpc}^{-1}$, our neural mark tightens the marginalized constraint on $\sigma_8$ by $2.9\times$ and on $\Omega_m$ by $1.8\times$ compared to classical marks, breaking the $\Omega_m-\sigma_8$ degeneracy at the Fisher information level. It further reduces the parameter MSE across our cosmological parameter prior by $1.45\times$ over the best classical mark. The learned latent geometry aligns with the $\Omega_m$ and $\sigma_8$ directions in parameter space, indicating that the contrastive objective recovers the dominant axes of cosmological information. Our approach opens the door to more powerful, interpretable summary statistics for cosmological inference.

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

SEVRA-BENCH: Social Engineering of Vulnerabilities in Review Agents

arXiv:2606.13757v1 Announce Type: cross Abstract: Large language model (LLM) reviewers are increasingly used in pull-request (PR) workflows, where their approvals help decide which code is merged into a repository. This raises a question that benchmarks for static vulnerability detection or code generation do not address: can an automated reviewer reject a malicious contribution when the attacker controls both the code change and the accompanying PR text? We introduce SEVRA-BENCH (Social Engineering of Vulnerabilities in Review Agents), a benchmark that measures how often an automated reviewer approves such adversarial pull requests. Each malicious PR in SEVRA-BENCH is built from a real project commit that previously fixed a vulnerability listed in the Common Vulnerabilities and Exposures (CVE) database. We automatically invert that fix to restore the original vulnerable code and submit it as a pull request wrapped in one of 15 social-engineering framings, which vary the claims made, the supporting evidence, the urgency conveyed, signals of prior approval, and appeals to authority. SEVRA-BENCH contains 1,062 malicious PRs drawn from Common Vulnerabilities and Exposures (CVE)-linked fixes across the top 10 entries of the 2025 Common Weakness Enumeration (CWE) Top 25. In a realistic setting, we evaluate 8 current LLMs as code review agents on PRs that introduce vulnerabilities previously reported in public disclosures. Our results reveal a sharp gap in security capabilities between closed- and open-source models. We hope SEVRA-BENCH will serve as a valuable resource for advancing open-source models and narrowing this gap.

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

Effects of interaction range on the mean-field dynamics of Bose polarons

arXiv:2606.20020v1 Announce Type: cross Abstract: We consider the three-dimensional Bose polaron problem in the regime of finite range interactions and competing length scales. Working in the reference frame of the impurity, we study both static and out of equilibrium properties of the system, in particular the transfer of momentum between the impurity and the host gas. We find that relaxation dynamics can occur via damped oscillations of the impurity velocity with simple dependence on the interaction strength. Furthermore, the equilibration process is sensitive to the type of the impurity-bath interaction. Specifically, interatomic forces describing ion-atom systems lead to much longer timescales and more pronounced oscillations in the strong coupling regime with respect to local interaction potentials. We also find that the effective masses can differ by a large amount between the two scenarios, even if the number of atoms in the polaron cloud remains similar for both cases.

18.
arXiv (CS.LG) 2026-06-15

Lower Complexity Bounds for Nonconvex-Strongly-Convex Bilevel Optimization with First-Order Oracles

作者:

arXiv:2511.19656v3 Announce Type: replace Abstract: Although upper bound guarantees for bilevel optimization have been widely studied, progress on lower bounds has been limited due to the complexity of the bilevel structure. In this work, we focus on the smooth nonconvex-strongly-convex setting and develop new hard instances that yield nontrivial lower bounds under deterministic and stochastic first-order oracle models. In the deterministic case, we prove that any first-order zero-respecting algorithm requires at least $\Omega(\kappa^{3/2}\epsilon^{-2})$ oracle calls to find an $\epsilon$-accurate stationary point, improving the optimal lower bounds known for single-level nonconvex optimization and for nonconvex-strongly-convex min-max problems. In the stochastic case, we show that at least $\Omega(\kappa^{5/2}\epsilon^{-4})$ stochastic oracle calls are necessary, again strengthening the best known bounds in related settings. Our results expose substantial gaps between current upper and lower bounds for bilevel optimization and suggest that even simplified regimes, such as those with quadratic lower-level objectives, warrant further investigation toward understanding the optimal complexity of bilevel optimization under standard first-order oracles.

19.
medRxiv (Medicine) 2026-06-10

Developing a Unified Criminal Justice Pathway into Drug and Alcohol Treatment from Police Custody: A Public Health Service Evaluation and Pathway-Design Project in Blackpool, United Kingdom

Introduction: Blackpool, England's most deprived local authority, has the highest drug-related death rate in the country. People in police custody with problem substance use are a key Core20PLUS5 inclusion-health group, yet referral from the police into structured drug and alcohol treatment is fragmented and relies heavily on self-report. We evaluated the current police-to-treatment route in Blackpool and designed an evidence-informed unified pathway. Materials and Methods: A mixed-methods service evaluation and pathway-design project was conducted during a six-month General Practice / Public Health rotation. Routinely collected referral data from Horizon (the local specialist drug and alcohol service) covering the 47-month period from December 2019 to October 2023 were analysed. Findings were triangulated with national policy, the Project ADDER and Liaison and Diversion evaluations, and the international evidence on police-led pre-arrest diversion. Results: Of 5,900 total referrals into Horizon over 47 months, only 269 (4.56%) originated from the police. Police referrals accounted for fewer than 5% of monthly referrals in 30 of 47 months, for 5 to 9.9% in 16 months, and for >/= 10% in only one month (10.8%, December 2022). Blackpool recorded 76 drug-misuse deaths in 2019-21 (19.4 per 100,000, approximately four times the England rate). A six-step unified pathway is proposed: Initiate Referral (opt-out, from ADDER Police and Liaison and Diversion); Initial Assessment; Tailored Treatment Plan; Continuous Support; Collaboration and Monitoring; and Evaluation and Adjustment. Conclusions: Police contact is markedly under-used as a gateway to treatment despite Blackpool having the highest drug-related mortality in England. An opt-out, multi-agency pathway anchored in Core20PLUS5 has the potential to narrow the treatment gap, reduce re-offending, and address the structural health inequalities that drive premature mortality.

20.
medRxiv (Medicine) 2026-06-22

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

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.

21.
arXiv (CS.AI) 2026-06-19

Learning Geometric Representations from Videos for Spatial Intelligent Multimodal Large Language Models

arXiv:2606.05833v2 Announce Type: replace-cross Abstract: Multimodal Large Language Models (MLLMs) excel at 2D semantic understanding but lack intrinsic 3D awareness, resulting in representations that fail to maintain geometric and spatial consistency across video frames. Given the scarcity of large-scale 3D data, we present GeoVR, a novel framework that learns geometric representations using purely 2D video sequences. This approach effectively restructures the semantic latent space within MLLMs to unlock spatial intelligence. Rather than employing superficial feature mixing, GeoVR reshapes the internal representations of the MLLM by distilling geometry knowledge from pre-trained 3D foundation models. This is accomplished through a multi-objective learning strategy driven by four complementary geometric targets: (1) estimating inter-frame camera poses to embed varying viewpoint dynamics, (2) regressing dense depth maps to anchor physical distances, (3) predicting a metric scale factor for real-world calibration, and (4) distilling multi-scale 3D features to align the intermediate feature space. Guided by these explicit physical and geometric constraints, the model's internal representations naturally develop strong 3D awareness. Extensive experiments on spatial reasoning benchmarks demonstrate that GeoVR achieves state-of-the-art performance, establishing a new paradigm for endowing foundation models with spatial intelligence.

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

Cognitive Debt: AI as Intellectual Leverage and the Dynamics of Systemic Fragility

作者:

arXiv:2606.15078v1 Announce Type: new Abstract: We develop a formal theory of cognitive debt: the stock of unverified reasoning obligations that accumulates when individuals use AI as a substitute rather than a complement for first-principles cognition. The model features two state variables per agent, cognitive capital and cognitive debt, and a multiplicative production technology in which cognitive capital functions as collateral that determines the return to AI adoption. We establish six propositions. Rational agents incur positive cognitive debt because the costs are deferred, partially external, and masked by short-run productivity gains. Tranquil periods lower subjective risk assessments, raise AI substitution intensity, and compound leverage, generating a cognitive Minsky moment in which subjective risk falls while true systemic fragility rises. Expected crisis losses are convex in aggregate leverage. Post-crisis, output-target pressure can produce a false-correction loop in which agents patch AI failures with more AI. The decentralised equilibrium over-adopts substitutive AI relative to the social optimum because of systemic risk, cognitive public goods, and arms-race externalities. In a two-type heterogeneous-agent economy, high-cognitive-capital agents adopt AI more intensively and may eventually erode their unaided cognitive capital below that of initially lower-skilled agents.

23.
arXiv (quant-ph) 2026-06-12

To Cool, or Not to Cool? Displacement Sensing with Hot Quantum States

arXiv:2606.13650v1 Announce Type: new Abstract: Quantum-enhanced displacement sensing with bosonic systems is typically formulated assuming that the oscillator is cooled close to its ground state before nonclassical probe preparation. We investigate whether such near-ground-state initialization is necessary, or whether sensitive probes can instead be generated directly from thermal states. We analyze hot quantum probes produced by squeezing, number-raising, and Schrödinger-cat-state generation applied to thermal inputs. We identify two distinct mechanisms by which thermal mixedness can remain compatible with enhanced displacement sensitivity. First, projecting a mixed probe onto a definite parity sector removes the usual thermal suppression of the displacement quantum Fisher information, which can then increase with initial thermal occupation. Second, coherent superpositions of opposite displacements can retain sensitivity through coherence between their displaced components, even when the underlying state is mixed. We use these two mechanisms to classify hot-state protocols according to whether their sensitivity comes from parity selection, coherence between displaced components, or both. Finally, we formulate an experimentally relevant optimization problem comparing initial cooling with direct hot-state preparation under realistic decoherence and show that complete cooling is not universally optimal. Our results establish hot-state engineering as a route to quantum-enhanced bosonic displacement sensing without mandatory ground-state initialization.

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

SkillJuror: Measuring How Agent Skill Organization Changes Runtime Behavior

arXiv:2606.11543v1 Announce Type: new Abstract: Agent Skills augment large language model (LLM) agents with procedural knowledge at inference time, but current benchmarks rarely distinguish what a Skill says from how it is organized. We study this distinction through Progressive Disclosure, where a concise root file points agents to supporting resources on demand, and compare it with a normalized flat baseline. We present SkillJuror, a framework for evaluating Skill writing paradigms through semantically controlled variants, matched multi-trial evaluations, and trajectory evidence while holding task knowledge fixed. In an 82-task SkillsBench study, Progressive Disclosure changes runtime behavior before aggregate outcomes: distinct Skill resources touched per trajectory rise from 1.18 to 3.85, and effective uptake events rise from 1.33 to 3.92. It also yields 17 additional verifier-passing trials out of 410 matched trials (+4.1%) over the normalized flat baseline. The benefit is task-dependent. Progressive Disclosure helps when supporting resources guide implementation, checking, or repair, but is weaker when success hinges on exact output conventions, numerical thresholds, or long artifact-generation pipelines. These results show that Skill organization is not mere presentation: it can change how agents search and apply procedural knowledge, while outcome gains depend on whether the exposed resources are actionable for the task. Code is available at https://github.com/zhiyuchen-ai/skill-juror.

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arXiv (CS.AI) 2026-06-15

HarnessX: A Composable, Adaptive, and Evolvable Agent Harness Foundry

arXiv:2606.14249v1 Announce Type: new Abstract: AI agent performance depends critically on the runtime harness, comprising the prompts, tools, memory, and control flow that mediate how a model observes, reasons, and acts. Yet today's harnesses remain largely hand-crafted and static: each new model or task still demands bespoke scaffolding, and the rich traces produced during execution are rarely distilled back into systematic improvement. We introduce HarnessX, a foundry for composable, adaptive, and evolvable agent harnesses. HarnessX assembles typed harness primitives via a substitution algebra, adapts them through AEGIS, a trace-driven multi-agent evolution engine grounded in an operational mirror between symbolic adaptation and reinforcement learning, and closes the harness-model loop by turning trajectories into both harness updates and model training signal. Across five benchmarks (ALFWorld, GAIA, WebShop, tau^3-Bench, and SWE-bench Verified), HarnessX yields an average gain of +14.5% (up to +44.0%), with gains largest where baselines are lowest. These results suggest that agent progress need not come from model scaling alone: composing and evolving runtime interfaces from execution feedback is an actionable and complementary lever. The complete codebase will be open-sourced in a future release.