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

Contaminated Collaboration: Measuring Gender Bias Transfer in LLM-Assisted Student Writing

Gender bias in LLMs has been studied extensively in model outputs, with biased prompts shown to amplify stereotyped generations. Whether such bias propagates into text produced by humans who use these systems, however, remains underexplored. We investigate whether gender bias in an LLM writing assistant transfers into career plan essays written by students. We first verify that a gender-biased prompt induces gender-differentiated language in LLM-generated essays, while a neutral prompt does not. We then recruited participants (N = 123) in a controlled environment to write career plan essays for paired biographical profiles differing only in gender under three conditions: no AI assistance, neutral LLM assistance, or gender-biased LLM assistance. Students in the biased condition produced essays with a significantly larger agentic gap and more gender-stereotypic occupation suggestions than those in the control and neutral conditions. Our results also reveal that this bias transfer is asymmetric: agency is suppressed in female-target essays while male-target writing remains largely unaffected. Our findings highlight the risk of bias propagation in AI-assisted writing, calling for fairness-aware design in educational AI tools.

02.
arXiv (CS.AI) 2026-06-19

Thermodynamic Measure of Intelligence

arXiv:2606.20231v1 Announce Type: new Abstract: Can intelligence be measured? We propose that intelligence can be defined as the lawful amplification of rare but valid futures: a system increases the probability of outcomes that would be unlikely under passive dynamics but remain admissible under the constraints of the domain. We start with the premise that an intelligent system must model the world and its own place within it. Because the system is part of the world it models, this leads naturally to recursive self-simulation: the system represents futures in which its own actions are part of the trajectory. Our central results give a necessity statement and a conditional near-sufficiency statement connecting this architecture to a precise thermodynamic measure of lawful amplification of rare-valid futures: high rare-valid lift is impossible unless the internal simulation identifies rare-valid futures with high fidelity; conversely, when rare-valid fidelity is high and the simulation contains an effective policy, the achievable lift approaches the actuation-limited optimum. Thus recursive self-simulation is not merely a plausible feature of intelligence but, under the stated assumptions, is necessary and nearly sufficient for high thermodynamic intelligence. The resulting framework makes intelligence measurable on a universal scale, from passive matter and feedback controllers, large language models, and humans as text generators to Maxwell-demon-like information engines.

03.
arXiv (CS.CL) 2026-06-19

Reliability without Validity: A Systematic, Large-Scale Evaluation of LLM-as-a-Judge Models Across Agreement, Consistency, and Bias

LLM-as-a-Judge has become the dominant evaluation paradigm for language models, but judge validation in practice relies on exact-match agreement, a metric that does not correct for chance and systematically overstates discriminative ability. We present the largest systematic evaluation of LLM-as-a-Judge to date: 21 judges from nine providers across MT-Bench, JudgeBench, and RewardBench, evaluated under three protocols (agreement, consistency, bias audit) over 118 runs and approximately 541,000 individual judgments. Four findings emerge, consistent across the full cohort, including the April 2026 frontier: kappa deflation between exact match and Cohen's kappa is universal (33–41 pp on MT-Bench), judge rankings shift by up to 14 positions across benchmarks, high test–retest reliability (>0.95) coexists with severe position bias (>0.10) in two production-deployed judges (instantiating a consistency–bias paradox), and verbosity bias is small (

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

Optimal Spatio-Temporal Decoupling for Bayesian Conformal Prediction

arXiv:2605.00432v2 Announce Type: replace Abstract: Online conformal prediction must balance fast adaptation to distribution shift against stable coverage: feedback-driven methods react quickly but become volatile, while strongly discounted Bayesian methods lag and inflate intervals at tight coverage. We introduce State-Adaptive Bayesian Conformal Prediction (SA-BCP), which forms the predictive quantile as a gated convex combination of long-term temporal inertia and local spatial evidence from a kernel density estimate, controlled by a single interpretable evidence threshold $K$. We establish three results: (i) asymptotic marginal validity of the resulting intervals; (ii) a closed-form expression for the MSE-optimal threshold, $K^*_{\mathrm{MSE}}=\alpha(1-\alpha)/M^{\mathcal{T}}$, trading the coverage-indicator (Bernoulli) variance against the temporal structural bias $M^{\mathcal{T}}$; and (iii) a rolling-origin procedure for selecting $K$ online – consistent under stationarity, with $O(\sqrt{T\log N})$ regret against the best fixed $K$ and, for a segmented variant, a sublinear dynamic-regret bound under bounded drift. Across four financial-volatility and weather datasets, three target coverage levels, and eight baselines (including the strongest recent conditional-quantile methods, SPCI and KOWCPI), SA-BCP attains at-or-above-nominal coverage in most settings while producing substantially sharper intervals – up to roughly $3\times$ lower Winkler score than discounted Bayesian CP at the tightest coverage – and a coverage-matched audit confirms these efficiency gains are not an artifact of under-coverage. We disclose one principal limitation: a volatility-specialized conformal-GARCH competitor remains more efficient on its home volatility-base series, though it does not transfer across domains.

05.
arXiv (quant-ph) 2026-06-17

Emergent de Sitter Space and Non-Unitary Tensor Networks from Non-Hermitian Quantum Criticality

arXiv:2606.17983v1 Announce Type: new Abstract: Extending the holographic principle to de Sitter (dS) spacetimes remains one of the most vital open frontiers in quantum gravity, where a microscopic, bottom-up tensor-network framework that relates boundary quantum data to emergent de Sitter spacetime is still lacking. In this work, we first show the emergence of de Sitter spacetime from boundary entanglement by formulating a non-unitary continuous multi-scale entanglement renormalization ansatz (cMERA) for a concrete non-Hermitian critical fermion chain. Within this emergent spacetime, we analyze the associated geodesics and show that they act as extremal Ryu-Takayanagi (RT) surfaces undergoing a smooth timelike-to-null transition. Remarkably, we demonstrate that this continuum trajectory dictates a distinct tensor-network architecture in which the bond-counting contribution naturally truncates at the discrete timelike-to-null transition toward the deep infrared. In the resulting architecture, the null ray along the horizon is represented by zero-cost links, since the associated cut severs no tensor legs. This network structure successfully reproduces the logarithmic scaling of non-unitary critical entanglement entropy, offering a bond-counting picture for the de Sitter RT formula. Our results provide the long-sought dS/(c)MERA correspondence at the level of both emergent spacetime and discrete holographic entanglement.

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

Evaluation Sovereignty in Metadata-Driven Classification: A Multi-Track Framework for Weakly Supervised Information Systems

arXiv:2606.13436v1 Announce Type: new Abstract: Evaluation in machine learning is typically treated as a neutral measurement process. However, in operational information systems, evaluation outcomes are often conditioned by the processes used to generate labels. This paper does not seek to improve classification performance. Instead, it examines the validity of performance measurement under differing label-authority regimes. This issue is particularly relevant in large-scale metadata-driven systems, where labels are often incomplete, inconsistent, or weakly supervised. We introduce evaluation sovereignty, defined as the degree to which performance metrics are independent of label authority and supervision regime, and propose a multi-track evaluation framework that systematically varies training and evaluation label sources. Using hierarchical multi-label classification on large-scale scientific metadata, we demonstrate that models exhibiting strong performance under operational ("silver") evaluation degrade substantially under independent ("gold") evaluation, particularly for fine-grained classification. For example, Micro-F1 decreases from approximately 0.54 to 0.03. Notably, ranking-based metrics remain above baseline, revealing a divergence between latent model signal and classification validity. These findings suggest that commonly reported performance metrics may reflect alignment with labeling processes rather than true predictive capability. We therefore reconceptualize evaluation validity as a system-level property shaped by label governance and provide a practical methodology for auditing intelligent systems operating under weak supervision.

07.
arXiv (CS.CV) 2026-06-16

CycliST: A Video Language Model Benchmark for Reasoning on Cyclical State Transitions

We present CycliST, a novel benchmark dataset designed to evaluate Video Language Models (VLM) on their ability for textual reasoning over cyclical state transitions. CycliST captures fundamental aspects of real-world processes by generating synthetic, richly structured video sequences featuring periodic patterns in object motion and visual attributes. CycliST employs a tiered evaluation system that progressively increases difficulty through variations in the number of cyclic objects, scene clutter, and lighting conditions, challenging state-of-the-art models on their spatio-temporal cognition. We conduct extensive experiments with current state-of-the-art VLMs, both open-source and proprietary, and reveal their limitations in generalizing to cyclical dynamics such as linear and orbital motion, as well as time-dependent changes in visual attributes like color and scale. Our results demonstrate that present-day VLMs struggle to reliably detect and exploit cyclic patterns, lack a notion of temporal understanding, and are unable to extract quantitative insights from scenes, such as the number of objects in motion, highlighting a significant technical gap that needs to be addressed. More specifically, we find no single model consistently leads in performance: neither size nor architecture correlates strongly with outcomes, and no model succeeds equally well across all tasks. By providing a targeted challenge and a comprehensive evaluation framework, CycliST paves the way for visual reasoning models that surpass the state-of-the-art in understanding periodic patterns.

08.
arXiv (quant-ph) 2026-06-19

Optimized Quantum States for Sensing in the Presence of Loss and Phase Noise

arXiv:2606.19649v1 Announce Type: new Abstract: Squeezed vacuum lets gravitational-wave detectors and other quantum sensors surpass the standard quantum limit, and is optimal in the loss-limited regime; phase noise breaks this optimality. Numerically optimizing the quantum Fisher information across the loss and phase-noise landscape, we identify non-Gaussian states that outperform any Gaussian state. These fall into three classes: Fock-like, cubic-phase-like, and states with discrete rotational symmetry. Limiting the average number of photons in the input state to $\bar{n}=5$, with $1-\eta = 5\%$ photon loss and 200 mrad phase noise, the non-Gaussian advantage reaches up to 2.2 dB. Furthermore, we observe that the non-Gaussian advantage can persist even when the measurement strategy is homodyne detection.

09.
arXiv (CS.LG) 2026-06-15

Compressed Computation is (probably) not Computation in Superposition

arXiv:2606.14673v1 Announce Type: new Abstract: We study whether the Compressed Computation (CC) toy model (Braun et al., 2025) is an instance of computation in superposition. The CC model appears to compute 100 ReLU functions with just 50 neurons, achieving a better loss than expected from only representing 50 ReLU functions. We show that the model mixes inputs via its noisy residual stream, corresponding to an unintended mixing matrix in the labels. Splitting the training objective into the ReLU term and the mixing term, we find that performance gains scale with the magnitude of the mixing matrix and vanish when the matrix is removed. The learned neuron directions concentrate in the subspace associated with the top 50 eigenvalues of the mixing matrix, suggesting that the mixing term governs the solution. Finally, a semi-non-negative matrix factorization (SNMF) baseline derived solely from the mixing matrix reproduces the qualitative loss profile and improves on prior baselines, though it does not match the trained model. These results suggest CC is not a suitable toy model of computation in superposition.

10.
arXiv (CS.LG) 2026-06-18

When Does Trajectory-Level Supervision Permit Efficient Offline Reinforcement Learning?

arXiv:2606.18531v1 Announce Type: cross Abstract: Offline reinforcement learning is typically analyzed under process-level reward supervision, yet many sequential decision datasets record only trajectory-level outcomes. We develop a statistical theory for offline policy optimization from such outcome-level supervision. We first study the canonical setting where the target remains the expected cumulative reward, but each offline trajectory provides only a scalar label whose conditional mean is the cumulative return. We propose OPAC, a pessimistic actor-critic algorithm that learns a latent reward model and optimizes a policy from trajectory-level labels. We prove a high-probability guarantee of order $\widetilde O(H^2\sqrt{C_{sa}(\pi^\star)/n})$ and a matching lower bound, characterizing the sharp statistical cost of replacing process-level rewards with one trajectory-level label. We then extend the principle to preference-based feedback, preserving the leading horizon and concentrability dependence up to preference-model constants. Finally, we study generalized outcome-based offline RL, where both the supervision and the objective are trajectory-level quantities induced by a nonlinear aggregation of latent per-step rewards. This problem is not learnable in general: for all-success objectives, any offline learner may require $\Omega(2^H)$ trajectories even with deterministic transitions and constant concentrability. We then identify a tractable regime through two structural coefficients, $\kappa_\mu(\sigma)$ and $\chi_\mu(\sigma)$, capturing information loss in outcome aggregation and generalized Bellman updates, under which generalized OPAC achieves polynomial sample complexity. Together, our results delineate when outcome-level supervision enables sample-efficient offline control and when missing process-level rewards create fundamental statistical barriers.

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

Controlled Quantum Metrology with Anisotropic Heisenberg Spin Interactions under Intrinsic Decoherence

arXiv:2606.16918v1 Announce Type: new Abstract: We theoretically investigate quantum parameter estimation in a two-qubit anisotropic Heisenberg spin system with Dzyaloshinskii-Moriya (DM) interaction in the presence of intrinsic decoherence described by the Milburn model. Using the Quantum Fisher Information (QFI), we study the estimation of both the uniform magnetic field and the DM interaction strength. Analytical expressions for the time-evolved density matrix are obtained and used to explore the effects of exchange anisotropy, intrinsic decoherence, and probe-state preparation on the achievable estimation precision. Our results show that suitable tuning of the anisotropic exchange coupling and the initial entangled state can considerably enhance the estimation performance, with different optimal parameter regimes emerging for magnetic-field and DM-interaction sensing. To better understand the role of quantum resources in metrology, we also examine the behaviour of concurrence, quantum coherence, and von Neumann entropy. Overall, our findings demonstrate that anisotropic Heisenberg spin systems with DM interaction provide a promising and flexible platform for high-precision quantum metrology even in the presence of intrinsic decoherence.

12.
medRxiv (Medicine) 2026-06-18

Hard to Halt: Automation Bias in Agent-Driven Sequencing Prior Authorization Workflows

Purpose: Prior authorization (PA) for exome or genome sequencing is a time-consuming process that impedes timely rare disease diagnosis. Large language model-based browser agents offer potential for automating these workflows, but their clinical reliability remain uncharacterized. Methods: We developed a sandbox compromising a simulated ES/GS PA submission payer portal and a synthetic EHR containing 836 patient records spanning compliant profiles and deficient profiles with different types of issues. Gemini 3 Pro, Gemini 3 Flash, and Claude Opus 4.5 were evaluated on task completion rate, form completion accuracy, and appropriate withholding for deficient profiles. Results: Larger models achieved much higher task completion rates (Gemini 3 Pro 95.45%, Claude Opus 4.5 93.67%) compared to Gemini 3 Flash (56.05%), but nearly universally failed to withhold submission for deficient profiles whereas Gemini 3 Flash ironically demonstrated superior withholding performance (17.33%). In a non-agentic setting, Gemini 3 Pro correctly identified 91% of the issues in deficient profiles, indicating that withholding failure is attributable to the browser interaction rather than the model's reasoning limitations. Conclusion: Current LLM-based browser agents exhibit a systematic bias towards form submission that poses risks in PA workflows. A modular, multi-agent architecture with human supervision is necessary for a safe clinical deployment.

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

Evaluating LLM Personalization via Semantic Constraint Verification

Current evaluation paradigms for Large Language Model (LLM) personalization rely heavily on brittle surface-matching metrics or computationally expensive LLM-as-a-judge protocols, both of which lack interpretability. To address these limitations, we introduce Natural Language Inference Constraint Verification (NLICV), a scalable, semantically invariant framework that maps sentence meanings to truth-condition sets to verify personalization constraints via a Natural Language Inference (NLI) model. Moving beyond binary scoring, NLICV categorizes LLM behaviors into four distinct modes: personalization, generalization, sycophancy, and failure. Extensive experiments demonstrate that NLICV aligns closely with human annotations while drastically reducing the latency and token costs associated with LLM judges (up to 2100 inference speedup). Finally, through an ablation-based procedure, NLICV pinpoints the exact sentences driving the constraint verification, yielding faithful, understandable evidence for its evaluations.

14.
arXiv (CS.CV) 2026-06-17

Looped World Models

Current world models face a fundamental tension: faithful long-horizon simulation demands deep computation, but deeper models are expensive to deploy and prone to compounding errors. We resolve this by introducing Looped World Models (LoopWM), which are the first looped architectures for world modelling. Our method iteratively refines latent environment states through a parameter-shared transformer block. This yield up to 100x parameter efficiency over conventional approaches with adaptive computation that automatically scales depth to match the complexity of each prediction step. Orthogonal to scaling model size and training data, LoopWM establishes iterative latent depth as a new scaling axis for world simulation, which might significantly push the community forward.

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

Generative Molecular Design with Steerable and Granular Synthesizability Control

arXiv:2505.08774v2 Announce Type: replace-cross Abstract: Designing molecules that are both property-optimal and readily synthesizable is a central challenge in drug discovery. Existing works that do consider synthesizability can jointly output predicted synthesis routes for generated molecules. However, there has been minimal attention in addressing the ease of synthesis and with flexibility to incorporate desired reaction constraints. On the other hand, virtual screening searches for commercially available compounds, but imposes challenges when scaling to ultra-large (billion-size and beyond) chemical spaces. Here, we propose a generative design framework that unifies synthesis-constrained molecular design and ultra-large-scale virtual screening through steerable and granular synthesizability control. Generated molecules satisfy arbitrary multi-parameter optimization objectives with predicted synthesis routes satisfying mix-and-match constraints: including or avoiding certain reactions, incorporating specific building blocks, and minimizing synthesis route length. In an end-to-end in-house campaign targeting BRD4, we designed molecules synthesizable with specific selected reactions and building blocks, synthesized all six selected compounds, and identified two micromolar binders. We further demonstrate that reaction control enables efficient navigation of ultra-large make-on-demand chemical spaces to identify property-optimal candidates. By applying our framework to Chemspace's Freedom 4.0 make-on-demand space (142 billion molecules), we generated ~320k molecules (0.00023% of the library) on a single consumer-grade GPU (with only 8 GB GPU memory) and identified a micromolar Wee1 binder amongst 60 synthesized candidates. The single unified framework thus enables generating novel synthesizable molecules and retrieving catalogue-ready candidates, offering a flexible solution to mitigating the synthesizability bottleneck.

16.
arXiv (CS.AI) 2026-06-19

On the Limitations of Ray-Tracing for Learning-Based RF Tasks in Urban Environments

arXiv:2507.19653v2 Announce Type: replace-cross Abstract: We study the realism of Sionna v1.0.2 ray-tracing for outdoor cellular links in central Rome. We use a real measurement set of 1,664 user-equipments (UEs) and six nominal base-station (BS) sites. Using these fixed positions we systematically vary the main simulation parameters, including path depth, diffuse/specular/refraction flags, carrier frequency, as well as antenna's properties like its altitude, radiation pattern, and orientation. Simulator fidelity is scored for each base station via Spearman correlation between measured and simulated powers, and by a fingerprint-based k-nearest-neighbor localization algorithm using RSSI-based fingerprints. Across all experiments, solver hyper-parameters are having immaterial effect on the chosen metrics. On the contrary, antenna locations and orientations prove decisive. By simple greedy optimization we improve the Spearman correlation by 5% to 130% for various base stations, while kNN-based localization error using only simulated data as reference points is decreased by one-third on real-world samples, while staying twice higher than the error with purely real data. Precise geometry and credible antenna models are therefore necessary but not sufficient; faithfully capturing the residual urban noise remains an open challenge for transferable, high-fidelity outdoor RF simulation.

17.
arXiv (CS.LG) 2026-06-16

SSNAPS: Audio-Visual Separation of Speech and Background Noise with Diffusion Inverse Sampling

arXiv:2602.01394v2 Announce Type: replace-cross Abstract: This paper addresses the challenge of audio-visual single-microphone speech separation and enhancement in the presence of real-world environmental noise. Our approach is based on generative inverse sampling, where we model clean speech and ambient noise with dedicated diffusion priors and jointly leverage them to recover all underlying sources. To achieve this, reformulate a recent inverse sampler to match our setting. We evaluate on mixtures of 1, 2, and 3 speakers with noise and show that, despite being entirely unsupervised, our method consistently outperforms leading supervised baselines in WER across all conditions. We further extend our framework to handle off-screen speaker separation. Moreover, the high fidelity of the separated noise component makes it suitable for downstream detection of the acoustic scene. Code and pretrained models will become available upon acceptance. Demo page: https://ssnaps2026.github.io/ssnaps2026/

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

Parallelizing Tool Execution and LLM Generation for Low-Latency Agent Serving

arXiv:2603.18897v2 Announce Type: replace-cross Abstract: LLM-powered agents execute tasks through a sequential loop of model generation and tool execution. Today's serving systems serialize this loop, leaving tool latency exposed on the task critical path. This paper presents PASTE, a tool-aware agent-serving system that predicts concrete future tool invocations from recurring agent patterns and executes them speculatively while the LLM is still generating. PASTE isolates speculative results until confirmed by the LLM and jointly schedules tool execution and returning LLM sessions to avoid shifting bottlenecks to the GPU. Across deep research, coding, and scientific-agent workloads, PASTE reduces average task completion time by 43.5% and lowers observed tool latency by 1.8x.

19.
arXiv (math.PR) 2026-06-11

Additive Noise, Shift Recovery, and Signed Signals in the Cumulative Distribution Transform

arXiv:2606.11432v1 Announce Type: cross Abstract: The cumulative distribution transform (CDT) is a quantile-based transport representation that exactly linearizes one-dimensional translations of positive densities. We study how this structure behaves under additive perturbations and how it can be exploited for shift recovery. Under a local nondegeneracy condition, we derive a first-order expansion showing that additive noise in physical space induces a nonlocal perturbation in CDT space through the primitive of the noise, weighted by the reciprocal density. This yields an explicit description of transform-domain sensitivity and shows, in particular, that perturbations are amplified in low-density regions. When the physical-space perturbation is modeled as a centered Gaussian random field, the induced first-order CDT perturbation is again Gaussian, with an explicit covariance kernel. We then use this structure to study recovery in CDT coordinates. In the known-template setting, the transport shift is obtained by projection onto the constant mode, giving an explicit estimator together with exactness in the noiseless case and a stability bound under perturbations. In the unknown-template setting, multiple observations permit joint recovery of the shifts and a common template up to the natural constant-mode gauge, leading to a simple de-shift–and–average procedure. We also consider a signed-signal analogue based on the signed cumulative distribution transform (SCDT), where shifts are estimated numerically by feature matching and unknown templates are recovered by alternating alignment and averaging. Numerical experiments validate the perturbation analysis and illustrate effective recovery for both density-valued and signed signals.

20.
arXiv (CS.CV) 2026-06-11

How Seemingly Inconsequential Design Choices Dictate Performance of LLMs in Pathology

General-purpose large language models (LLMs) are routinely used as baselines when evaluating specialized pathology models on whole-slide images (WSIs). Because WSIs exceed contemporary model context limits, LLM baselines routinely use small, high-magnification patches processed independently via majority voting, without systematic evaluation of seemingly inconsequential design choices such as patch size, patch count, and magnification. Generalist LLMs have consistently underperformed specialized systems, reinforcing the perception that domain-specific training or architectural adaptation is necessary for pathology tasks involving WSIs. Here, we conduct a systematic factorial analysis of four input design factors: inference mode, patch size, magnification, and patch count. We demonstrate that prior studies have overstated the gap between specialized models and general-purpose LLMs by choosing non-optimized input configurations. On the MultiPathQA benchmark, switching to a single balanced configuration (large patches at lower magnification, processed jointly) raises GPT-5 from 15.1% to 39.5% on cancer-type classification (TCGA) and from 38.1% to 62.9% on organ classification (GTEx). Per-task optimization yields further gains up to 43.9% (TCGA) and 71.6% (GTEx). The same configuration generalizes to two other models and to a fully held-out CPTAC cohort, where it improves Gemini 3 Flash by 23.4 percentage points without any task-specific tuning.

21.
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.

22.
medRxiv (Medicine) 2026-06-11

PCRAgent: A Multi-Agent Framework for Transforming Noisy clinical conversations into Structured Pre-Consultation Medical Records and Reusable Clinical Data Resources

In primary care and outpatient settings, clinically important patient information is often embedded in fragmented, ambiguous, repetitive, and noisy communication between physicians and patients. This limits physicians ability to obtain a clear preconsultation overview of symptoms, history of present illness, and visit intent, while also preventing real world clinical dialogues from being reused in hospital information systems and medical artificial intelligence applications. To address this challenge, we developed PCRAgent, a centrally coordinated multi agent framework for preconsultation clinical information organization. Guided by physician inquiry logic, PCRAgent identifies, extracts, corrects, and standardizes patient-reported information from noisy consultations. Its coordinated modules including error detection, semantic editing, output control, contextual memory, and intent recognition enable robust parallel handling of spelling errors, repetitions, grammatical inconsistencies, medical ambiguities, and non-medical interference. A traceable edit list records intermediate corrections and context, allowing iterative refinement without redundant modifications. PCRAgent generates two complementary outputs. One is a PreConsultation Clinical Report for rapid physician review. The other is a Structured Clinical Conversation Dataset for hospital data construction and downstream AI applications. In evaluations using 220000 strongly perturbed consultations, PCRAgent maintained high robustness, achieving a clinical information accuracy of 4.99 out of 5 and key element completeness of 5 out of 5, outperforming GPT4o. Expert review of Chinese and English dialogues confirmed high clinical accuracy of 4.85 out of 5 and high safety of 4.79 out of 5. Multicenter validation in real-world outpatient workflows further demonstrated practical utility. These findings indicate that PCRAgent can efficiently transform noisy and unstructured consultations into physician ready reports and AI ready structured data, improving outpatient efficiency, reducing cognitive burden, ensuring information completeness, supporting precise decision-making, and enabling high-quality reuse of clinical data.

23.
arXiv (quant-ph) 2026-06-16

Experimental Observation of Dynamical Phase Transitions in a Dephased Photonic Quantum Walk

arXiv:2606.15935v1 Announce Type: new Abstract: Dynamical phase transitions in open quantum systems govern how non-equilibrium states relax toward a stationary state. We study these transitions experimentally using a discrete-time photonic quantum walk on a three-node graph. A tunable synthetic gauge flux and calibrated dephasing allow us to control time-reversal symmetry and the detailed balance properties of the effective Markovian dynamics. With detailed balance, we observe a first-order dynamical phase transition marked by a crossing of real Liouvillian eigenvalues. When detailed balance is broken, we observe a second-order dynamical phase transition at an exceptional point where eigenvalues and eigenvectors coalesce. By progressively reducing the dephasing strength, we track the crossover toward the quantum-coherent regime and determine that the transitions persist down to a finite threshold. Our results link Liouvillian spectral topology to relaxation criticality and demonstrate a controllable platform for engineered dissipative dynamics.

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

sebis at CRF Filling 2026: A Two-Stage Local LLM Pipeline for Medical CRF Filling

The extraction of structured clinical information from unstructured EHR notes is a persistent bottleneck in healthcare informatics. While large language models (LLMs) offer high performance, their deployment in clinical settings is hindered by privacy risks, inference costs, and the tendency to hallucinate beyond textual evidence. We address these challenges for the CL4Health 2026 Case Report Form (CRF) filling task by proposing a fully local, domain-adapted pipeline using the MedGemma-27B model. Our two-stage architecture, which separates binary presence classification from value extraction, enforces strict adherence to textual evidence and ensures deterministic outputs for negated, uncertain, or unknown states. By leveraging item-specific, few-shot in-context learning without external API calls or fine-tuning, our approach achieves a macro-F1 score of 0.55 on the official English test track. This result secures second place among all locally-hosted, open-source submissions. Our work demonstrates that privacy-preserving, on-premise LLM pipelines can achieve near-competitive performance with proprietary frontier models, providing a practical, data-sovereign framework for clinical NLP.

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

Depth-Attention: Cross-Layer Value Mixing for Language Models

Self-attention selects information freely across the sequence, but across depth, Transformers merely add each layer's output to the residual stream, so later layers cannot selectively reuse earlier-layer representations. Recent cross-layer methods improve this flow but operate on hidden states outside attention, adding state beyond the key-value cache at inference–a cost that becomes increasingly salient as modern LLMs compress the cache with grouped-query and multi-head latent attention. We introduce Depth-Attention, which performs this selection inside the attention module itself: before a layer attends over the sequence, its query attends over the keys of earlier layers at the same token position and mixes their values into the value that self-attention then reads. Because Depth-Attention reuses the standard attention queries, keys, and value-cache slots, storing depth-mixed values in place of the original values, it adds no parameters and introduces no persistent inference state beyond the standard key-value cache–the same cache size as a vanilla decoder and less than hidden-state-based cross-layer methods. On Qwen3-style decoders at 1.5B and 3B parameters, Depth-Attention attains the lowest perplexity and the highest average downstream accuracy, improving over the vanilla Transformer by up to 2.3 accuracy points and surpassing strong cross-layer baselines in perplexity and average accuracy, while adding under 0.01% extra arithmetic FLOPs and no additional persistent inference state. The gains hold from 360M to 3B parameters and extend to looped Transformers.