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01.
arXiv (CS.LG) 2026-06-15

Attention-Based Estimation of the Individual Treatment Benefit Probability under Dose Variation

arXiv:2606.13821v1 Announce Type: new Abstract: Estimating the probability that a treatment outperforms a control for an individual patient, called the Individual Probability of Treatment Benefit (IPTB), offers a clinically intuitive alternative to population-average metrics. However, existing methods for IPTB estimation are largely confined to binary treatment settings, despite the prevalence of dose-varying interventions in clinical practice. We propose a general framework for IPTB estimation with ordinal outcomes under discrete dose assignments, called Dose-AIPTB (Dose Attention-based IPTB). Our approach recasts the problem as binary classification over the unobserved sign of the individual treatment effect, constructing pseudo-labels from covariate-similar pairwise comparisons and aggregating them via attention mechanisms or Nadaraya-Watson kernel regression. This formulation naturally accommodates multiple discrete dose levels, extending beyond the binary treatment paradigm. Through numerical experiments on real-world and synthetic data under covariate shift, varying sample sizes, and heterogeneous outcomes, we demonstrate that attention-based aggregation consistently outperforms kernel alternatives. The framework provides a foundation for personalized dose selection grounded in individual-level benefit probabilities. Codes implementing the model are publicly available at https://github.com/NTAILab/AIPTBDose.

02.
arXiv (CS.AI) 2026-06-18

Bounded Context Management for Tabular Foundation Models on Stream Learning

arXiv:2606.18677v1 Announce Type: cross Abstract: Tabular stream learning requires predictions on sequentially arriving examples under distribution shift. While standard methods adapt by updating model states, tabular foundation models (TFMs) make predictions conditioned on a labeled context in an in-context manner, making them a natural alternative for stream learning. This shifts the challenge from how to update the model to how to manage the context. We propose a future information view that yields three practical requirements for context management: preserve recent examples, retain uncertain examples, and remove redundant examples. We instantiate these requirements as CURE (Context management via Uncertainty-aware admission and Redundancy aware Eviction), a context-managing policy with entropy-gated admission and redundancy-aware eviction. Across seven streams, CURE shows up to 27.0% relative improvement over classical stream learners, remains robust across multiple TFM backbones, and ranks first among other policy variants. Code and datasets are available at https://github.com/morcellinus/CURE-ICML-FMSD.

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

A Conservation Law for Equilibrium Propagation and Coupled Learning

arXiv:2606.15444v1 Announce Type: cross Abstract: In this paper we show that the physical learning methods known as coupled learning (CL) and equilibrium propagation (EP) conserve a mass-like quantity in the trainable parameters in the continuous-time, small-nudging limit. We prove that this conservation holds in a broad range of physically relevant settings. We then show that the conservation law constrains the training dynamics in a way that makes convergence reliable in important settings for linear circuits. We conclude by discussing some practical implications of this conservation law.

04.
PLOS Computational Biology 2026-06-15

Fung-AI: An AI/ML-driven pipeline for antifungal peptide discovery

by Daniel S. Berman, Libby M. Lewis, Tom D. Curtis, Olivia N. Tiburzi, Daniel F. Q. Smith, Arturo Casadevall, Laura J. Dunphy Emerging fungal pathogens represent a concerning threat to both global health and food security. In this study, we aimed to address our rising vulnerability to fungal pathogens through the development of the Fung-AI pipeline: an AI/ML-driven approach for antifungal discovery. A generative adversarial network (GAN) was trained to generate novel candidate antifungal peptide sequences. Next, in silico antifungal and hemolytic classifiers were built to further prioritize AI-generated peptides for experimental validation. From a pool of ~10,000 candidates, thirteen peptides were selected for testing over two-stages of experimentation. Five peptides were found to display mild antifungal activity against the wheat pathogen, Fusarium graminearum, with minimal inhibitory concentrations (MICs) ranging from 250 µg/mL to 500 µg/mL. Four of the five peptides also showed activity against the human pathogen, Candida albicans (MIC: 500 µg/mL). Two of our AI-generated antifungal peptides additionally demonstrated low cytotoxicity in HepG2 human liver carcinoma cells (LC50 > 704.2 µg/mL) indicating that they may be useful as scaffolds for future optimization for therapeutic applications. None of our peptides were found to considerably inhibit the emerging pathogen C. auris, suggesting the need for pathogen-specific down-selection of candidate peptides. Overall, we present a proof-of-principle, generative-AI-based approach for the rapid design of de novo antifungal peptides.

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

ATLAS: Active Theory Learning for Automated Science

arXiv:2606.12386v1 Announce Type: cross Abstract: Advancing scientific understanding through mechanistic modeling requires posing the right experimental questions to yield maximally informative data. To automate this pursuit within cognitive science, we introduce ATLAS (Active Theory Learning for Automated Science), an active learning framework for the data-driven discovery of interpretable behavioral models. ATLAS iterates between generating mechanistic hypotheses–instantiated as a diverse ensemble of sparse neural networks (Disentangled RNNs)–and designing experiments that optimally distinguish between them. We test this approach on the problem of recovering reinforcement learning agents from their behavior in bandit tasks. ATLAS designs varied sequences of qualitatively novel experiments with temporal structure tailored to underlying agent characteristics. The models trained on these experiments are evaluated against a comprehensive set of metrics for mechanistic modeling that capture behavioral, structural, and computational similarity. ATLAS achieves a 5-10x improvement in sample efficiency across all metrics compared to random experimentation, and its performance is further validated against expert-designed experiments derived from literature. These in silico results showcase ATLAS's potential to accelerate human-interpretable insights in cognitive science and other domains where scientific inquiry relies on discovering mechanistic models.

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

Landsat-Sentinel-2 Algal Bloom Mapping Using Vision Transformers: Model Description, Implementation, and Examples

Coastal algal bloom monitoring requires frequent, spatially detailed, and globally consistent observations, provided by Landsat-8/9 and Sentinel-2 A/B/C. Together, these missions offer over a decade of medium-resolution multispectral imagery with near-global coverage every 2-3 days, enabling the detection of fragmented bloom structures not resolvable by coarse ocean-color sensors. However, their use in aquatic environments remains challenging due to limited spectral coverage and a lack of harmonized reflectance products. As an alternative to traditional bio-optical methods, deep learning-based image classification offers a data-driven approach that can overcome many of these limitations. This study presents the first successful implementation of vision transformer-based coastal algal bloom mapping using 30-m Landsat-Sentinel-2 images. A globally distributed bloom patch dataset was generated across bloom-prone coastal hotspots worldwide. Four transformer-based architectures were compared against a standard convolutional baseline for fine-scale bloom detection, and assessed under different optical water types and atmospheric and surface conditions. All deep learning models showed strong capabilities in detecting floating bloom areas, with omission and commission errors of 8-65%. Under cloud and glint stress in a time series, the Swin Transformer outperformed traditional spectral-index approaches, which produced widespread false positives, effectively avoiding cloud- and glint-affected pixels. Comparisons with MODIS-derived products further highlighted the benefits of higher spatial resolution in detecting fragmented and irregularly affected blooms. Our findings support deep learning as a reliable tool for medium-resolution, consistent monitoring of floating algal blooms in dynamic coastal environments.

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

Market Design for AI: Beyond the Copyright Binary

arXiv:2606.12260v1 Announce Type: cross Abstract: How can we design a market of human-generated content for use in training AI models that both enables technological progress and preserves individual incentives for high-quality content creation? Existing approaches take polar positions: a "free-for-all" model based on fair use and a "strong intellectual property rights" model. We show that both fail: Free-for-all does not compensate creators, and – by modeling as a static Stackelberg game – strong intellectual property rights also underpower creative incentives. We find this especially true for more innovative creators, a phenomenon we term the "originality penalty." Extending this insight to a dynamic model, we find another market failure undermining AI model performance, even for an initially good model: Such a model induces greater reliance by humans on AI-assisted creation, resulting in homogenized content feeding back into training, which degrades the model performance – a "curse of precision." We further propose a market design with a data intermediary internalizing cross-creator externalities and subsidizing innovative contributions, thereby restoring efficiency.

09.
arXiv (CS.LG) 2026-06-17

A fairness-aware extension of Stochastic Multicriteria Acceptability Analysis for ranking

arXiv:2606.17756v1 Announce Type: new Abstract: Fairness has become a central concern in ranking problems involving individuals or social groups, particularly under the Responsible Artificial Intelligence agenda. In Multi-Criteria Decision Analysis, Stochastic Multicriteria Acceptability Analysis (SMAA) provides a robust framework for handling uncertainty and incomplete preference information, but it does not explicitly address fairness in the resulting rankings. This paper proposes SMAA-Fair, a fairness-aware extension of SMAA for ranking problems. The approach reweights the simulated rankings generated by SMAA according to their level of group fairness, so that fairer rankings contribute more strongly to the acceptability indices and central weights vector. The framework is independent of the aggregation model and can incorporate different fairness metrics. In this study, Statistical Parity, normalized discounted Kullback–Leibler divergence (rKL) and normalized discounted cumulative Kullback–Leibler divergence (nDKL) are adopted. Rankings are derived from the fairness-adjusted acceptability matrix using expected ranking and maximum acceptability ranking. We also derive the central weight according to the degree of fairness in the obtained rankings. Numerical experiments with synthetic and real data show that SMAA-Fair improves the representation of protected groups among favourable ranking positions, while preserving robustness to preference uncertainty.

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

A Pfaffian quantum Hall state of ultracold bosons

arXiv:2606.12409v1 Announce Type: cross Abstract: Fractional quantum Hall states are a cornerstone of topological physics, hosting fractionally charged quasiparticles with exotic statistics that promise to enable topologically protected quantum information processing. Among these, the Pfaffian state introduced by Moore and Read implements a p-wave pairing structure that supports excitations with non-Abelian exchange statistics. Despite extensive study in electronic systems, direct access to its pairing structure has remained limited. Here we realize a three-particle bosonic Pfaffian state of ultracold $^{87}\mathrm{Rb}$ atoms in an optical lattice subject to a Floquet-engineered synthetic magnetic field. Using a Bayesian-optimized adiabatic protocol, we prepare a state exhibiting Pfaffian pairing correlations. Site-resolved measurements of multi-point density correlations reveal a pronounced suppression of short-range three-body coincidences, reflecting the underlying pairing structure. We further probe the state's transport response through Hall drift measurements. Our results establish a bottom-up approach to engineering non-Abelian topological order and lay the groundwork for future explorations of anyonic braiding in synthetic matter.

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

Multi-fidelity aerodynamic data fusion by autoencoder transfer learning

arXiv:2512.13069v2 Announce Type: replace Abstract: Accurate aerodynamic prediction often relies on high-fidelity simulations; however, their prohibitive computational costs severely limit their applicability in data-driven modeling. This limitation motivates the development of multi-fidelity strategies that leverage inexpensive low-fidelity information without compromising accuracy. Addressing this challenge, this work presents a multi-fidelity deep learning framework that combines autoencoder-based transfer learning with a newly developed Multi-Split Conformal Prediction (MSCP) strategy to achieve uncertainty-aware aerodynamic data fusion under extreme data scarcity. The methodology leverages abundant Low-Fidelity (LF) data to learn a compact latent physics representation, which acts as a frozen knowledge base for a decoder that is subsequently fine-tuned using scarce HF samples. Tested on surface-pressure distributions for NACA airfoils (2D) and a transonic wing (3D) databases, the model successfully corrects LF deviations and achieves high-accuracy pressure predictions using minimal HF training data. Furthermore, the MSCP framework produces robust, actionable uncertainty bands with pointwise coverage exceeding 95%. By combining extreme data efficiency with uncertainty quantification, this work offers a scalable and reliable solution for aerodynamic regression in data-scarce environments.

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

MARS: Efficient, Adaptive Co-Scheduling for Heterogeneous Agentic Systems

arXiv:2604.26963v2 Announce Type: replace-cross Abstract: Large language models (LLMs) are increasingly deployed as the execution core of autonomous agents rather than as standalone text generators. Agentic workloads induce a temporal shift from single-turn inference to multi-turn LLM-tool loops, and a spatial shift from chat-scale, GPU-only execution to repository-scale, GPU-CPU co-located execution. Consequently, coordinating heterogeneous resource demands of agentic execution has emerged as a critical system challenge. We design and implement MARS, an efficient and adaptive co-scheduling system that globally coordinates heterogeneous agentic workloads under coupled GPU-CPU resource pressure. By establishing holistic visibility across GPU inference and CPU tool execution via a unified information stream, an external control plane in MARS decouples admission from execution to prevent heterogeneous resource oversubscription. An internal agent-centric scheduler further minimizes the end-to-end critical path by prioritizing latency-sensitive continuations and adaptively retaining KV cache state only when warm resumption yields a latency benefit. Our evaluations show that MARS reduces end-to-end latency by up to 5.94x while maintaining nearly maximal system throughput. We further integrate MARS as the serving backend for the OpenHands coding agent framework, demonstrating its real-world effectiveness by accelerating end-to-end task completion time by up to 1.87x. Our source code is publicly available at https://github.com/Afterglow231/MARS_preview .

13.
arXiv (CS.LG) 2026-06-11

Energy Use of AI Inference, Efficiency Pathways, and Test-Time Scaling

arXiv:2509.20241v2 Announce Type: replace Abstract: As AI inference scales to billions of queries, estimates of per-query energy use are increasingly important for capacity planning, efficiency interventions, and policy. Yet many public estimates assume non-production settings, leading to systematic overestimation. We introduce a bottom-up framework estimating inference energy from token throughput, node power, and overhead under large-scale deployment assumptions. For frontier-scale models (>200B parameters) on H100 nodes, we estimate a median energy of 0.31 Wh/query (IQR 0.16-0.60), indicating widely cited estimates are overstated by 4-20x. In test-time scaling scenarios 15x longer than typical queries, the median energy rises 13x to 3.91 Wh (IQR 2.15-7.05). Across models, serving systems, and hardware, we estimate 8-20x line-of-sight energy reductions. At datacenter scale, serving 1 billion queries/day requires 0.7 GWh; if 10% are long queries, demand rises to 1.7 GWh/day. With efficiency interventions, it falls to 0.8 GWh/day, mitigating the energy impact of test-time scaling.

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

Improved Baselines with Representation Autoencoders

Representation Autoencoders (RAE) replace traditional VAE with pretrained vision encoders. In this paper, we systematically investigate several design choices and find three insights which simplify and improve RAE. First, we study a generalized formulation where the representation is defined as sum of the last k encoder layers rather than solely the final layer. This simple change greatly improves reconstruction without encoder finetuning or specialized data (e.g., text, faces). Second, we study the prevalent assumption that RAE (using pretrained representation as encoder) replaces representation alignment (REPA), which distills the same representation to intermediate layers instead. Through large-scale empirical analysis, we uncover a surprising finding: RAE and REPA exhibit complementary working mechanisms, allowing the same representation to be used as both encoder and target for intermediate diffusion layers. Finally, the original RAE struggles with classifier-free guidance (CFG) and requires training a second, weaker diffusion model for AutoGuidance (AG). We show that REPA itself can be viewed as x-prediction in RAE latent space. By simply re-parameterizing the output of the DiT model, it can provide guidance for "free". Overall, RAEv2 leads to more than 10x faster convergence over the original RAE, achieving a state-of-the-art gFID of 1.06 in just 80 epochs on ImageNet-256. On FDr6, RAEv2 achieves a state-of-the-art 2.17 at just 80 epochs compared to the previous best 3.26 (800 epochs) without any post-training. This motivates EPFID@k (epochs to reach unguided gFID < k) as a measure of training efficiency. RAEv2 attains an EPFID@2 of 35 epochs, versus 177 for the original RAE. We also validate our approach across diverse settings for text-to-image generation and navigation world models, showing consistent improvements. The code is available at https://raev2.github.io.

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

A PubMed-Scale Dataset of Structured Biomedical Abstracts

Structured abstracts are important for biomedical literature processing, by facilitating information retrieval, text mining, and knowledge synthesis. However, a vast portion of abstracts indexed in PubMed remain unstructured, presenting a significant bottleneck for downstream text-processing workflows and applications. To resolve this limitation, we introduce Structured PubMed, a comprehensive corpus of section-labeled biomedical abstracts compiled from the complete PubMed database, encompassing over 23.2 million research-article records. The corpus is divided into two distinct subsets: a collection of 5.9 million author-structured abstracts parsed from official XML files, and an automatically labeled collection of 17.2 million originally unstructured abstracts structured via a verbatim-extraction Large Language Model pipeline. Every record is harmonized under a unified five-section schema and mapped to its original PubMed identifier, publication type, and publication date. This dataset can be utilized to train sentence-classification models, benchmark text-segmentation architectures, and perform large-scale, section-specific information extraction at an unprecedented PubMed-wide scale.

16.
arXiv (quant-ph) 2026-06-11

Controlled ion-ion interactions and cavity-enhanced emission of a coherent dinuclear Eu$^{3+}$ complex

arXiv:2606.11947v1 Announce Type: new Abstract: Molecular rare-earth-ion complexes offer unique opportunities for quantum technologies by combining the intrinsic coherence properties of rare-earth ions with chemically tunable molecular environments. A crucial capability is the realization of multi-qubit architectures with defined qubit couplings to enable two-qubit quantum gates. Here, we investigate the optical coherence properties and excitation-induced interactions of two Eu$^{3+}$-based molecular complexes, comparing a mononuclear reference system with a dinuclear analogue in which two Eu$^{3+}$ ions are positioned at a well-defined intramolecular distance of about 7 Angstrom. Using cryogenic ensemble spectroscopy, including spectral hole burning, free-induction decay, and photon echo measurements at temperatures down to 100 mK, we demonstrate long optical coherence times $T_{2,o}$ of up to 9 $\mu$s. As a key step toward scalable multi-qubit architectures, a control-target sequence was implemented to probe conditional ion-ion interactions, revealing a stronger interaction-induced dephasing in the dinuclear complex. Finally, we show the integration of the dinuclear complex into a fiber-based optical microcavity, and observe an 380-fold emission enhancement of the $\mathrm{}^5\mathrm{D}_0\rightarrow\mathrm{}^7\mathrm{F}_0$ transition. Together, these results position molecular rare-earth complexes as versatile and chemically tunable building blocks for scalable quantum technologies.

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

DeepRHP: A Hybrid Variational Autoencoder for Designing Random Heteropolymers as Protein Mimics

arXiv:2606.11651v1 Announce Type: new Abstract: Synthetic random heteropolymers (RHPs), consisting of a predefined set of monomers, offer an approach toward the design of protein-like materials. These RHPs, if designed appropriately, can mimic protein behavior and function. As such, there is a need for computational tools to efficiently guide RHP design. We bridge this gap by developing DeepRHP, a modified variational autoencoder (VAE) model under a semi-supervised framework. By equipping a classical VAE with an additional feature-based VAE, DeepRHP forces the latent space to capture structures of critical chemical features as well as individual RHP sequence patterns. In this sense, our method is versatile by allowing any relevant features to be incorporated in a hybrid manner. We demonstrate the effectiveness of DeepRHP by suggesting potential monomer compositions that stabilize membrane proteins (e.g. Aquaporin Z) in non-native environments and cross-validating our prediction with published results. The concordance between our model and true RHP function suggests strong potential in utilizing hybrid autoencoder architectures to guide RHP design for proteins and other biological compounds.

18.
arXiv (CS.AI) 2026-06-16

Synthetic Counteradaptation: A Principle of Human-AI Co-evolution

arXiv:2606.15503v1 Announce Type: new Abstract: In this paper, we introduce the concept of synthetic counteradaptation, a process where human and AI systems co-evolve by adapting to each other's strategies and behaviors. Synthetic counteradaptation occurs when AI systems develop novel strategies or social protocols, prompting humans to extract insights and adapt their own behaviors in response, leading to the emergence of new agent interaction dynamics. To illustrate these dynamics, we analyze examples from various contexts, including the game of Go, mixed-motive social interactions, and geopolitical simulations. By exploring these cases, we demonstrate how synthetic counteradaptation provides a framework for understanding the recursive and co-evolutionary nature of human-AI interactions in multi-agent environments.

19.
PLOS Medicine 2026-05-26

Requiring code sharing to strengthen transparency and trust in research

by Helen Lumbard, Lauren Cadwallader, Devin Soper, on behalf of the PLOS Medicine Staff Editors PLOS Medicine has always championed open science and data transparency. Now, recognizing that code is as essential a research artifact as the data it analyzes, we are strengthening our code sharing policy to further ensure reproducibility and trust in the scientific record. Recognizing that code is as essential a research artifact as the data it analyzes, this Editorial outlines how PLOS Medicine is strengthening its code sharing policy to further ensure reproducibility and trust in the scientific record.

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

Edit3DGS: Unified Framework for Dynamic Head Editing via 2D Instruction-Guided Diffusion and 3D Gaussian Splatting

We present Edit3DGS, a unified framework for dynamic 3D head editing that integrates 2D instruction-guided diffusion with 3D Gaussian splatting. Unlike prior approaches that separately address frame-based edits or static 3D reconstruction, our method couples semantic controllability in the image domain with photorealistic, temporally consistent 3D representations. Given an input video, editable facial regions are masked and modified using a text-conditioned diffusion model to support fine-grained operations such as expression transformation, attribute modification, and appearance refinement. The edited frames are then aggregated through 3D Gaussian splatting to produce a coherent, high-fidelity avatar that preserves both identity and motion dynamics. To enforce consistency, Edit3DGS incorporates multi-view batch editing and lightweight inpainting strategies that recover lost expressions across timesteps. Experimental results demonstrate that our framework enables controllable, artifact-free head editing with smooth temporal transitions, offering practical applications in virtual avatars, immersive communication, film production, and interactive media.

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

The Containment Gap: How Deployed Agentic AI Frameworks Fail Public-Facing Safety Requirements

arXiv:2606.12797v1 Announce Type: new Abstract: Agentic large language model systems that autonomously invoke tools, maintain persistent memory, and execute multi-step plans are increasingly deployed in public-facing domains, including government services, healthcare triage, and financial advising. We ask whether the frameworks used to build these systems provide architectural-level structural safety guarantees. Applying six containment principles derived from a compositional model of agentic architectures, we audit three dominant frameworks (LangChain, AutoGPT, and OpenAI Agents SDK) and find no native compliance in any of them. Memory integrity, a defense against one of the most prevalent vulnerability classes, is not observed in any of the three evaluated frameworks. We validate these findings empirically: in a simulated government benefits agent built on LangChain, a single memory-poisoning write induces persistent targeted corruption across all tested seeds and backends, increasing the wrongful denial rate for targeted applicants to 88.9%. Under a complex five-factor policy, the same attack preserves aggregate accuracy while increasing targeted wrongful denials by 3.5x, rendering the corruption difficult to detect through standard monitoring. We then introduce two lightweight containment mechanisms: a memory integrity validator and a policy gate, which eliminate both attack vectors with sub-millisecond overhead (

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

Graph Neural Networks for Semi-Supervised Image Classification with Multi-Feature Aggregation

Feature extraction involves the identification and extraction of salient characteristics or patterns, including edges, textures, shapes, and color attributes. Contemporary feature extractors predominantly leverage deep learning architectures, such as Convolutional Neural Networks (CNNs) and Vision Transformers (VITs). The availability of diverse feature extractors in the literature provides a wide range of feature representations. Features extracted from an image depend on the specific application, the chosen extractor, and its configuration. Therefore, integrating complementary information by combining distinct extractors offers a promising way to enhance performance. Graph Neural Networks (GNNs), particularly Graph Convolutional Networks (GCNs), have emerged as powerful and widely adopted approaches for semi-supervised image classification, as they effectively leverage both labeled and unlabeled data while exploiting the underlying graph structures that capture relationships among samples. This study proposes a novel approach for GNNs in scenarios where labeled data is scarce, by integrating diverse sets of feature and graph representations derived from various extractors in classification scenarios. Experimental investigations were conducted, encompassing combinations of distinct feature and graph extractors, as well as rank aggregation strategies. The primary contributions of this work are underscored by the experimental findings, which demonstrate that the strategic combination of feature and graph representations, coupled with the application of manifold learning for graph processing, leads to significant improvements in classification accuracy across the majority of experimental conditions. Furthermore, the utilization of rank aggregation techniques to integrate features from different extractors was shown to enhance classification accuracy.

24.
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.

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

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

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