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01.
arXiv (CS.AI) 2026-06-11

The Environmental Cost of LLMs in AIED: Reporting and Practices

arXiv:2606.11215v1 Announce Type: cross Abstract: Large Language Model (LLM) usage in recent years has become increasingly widespread in the Artificial Intelligence in Education (AIED) community. While LLMs offer unique avenues for learners and educators, using LLMs comes with computational and environmental costs. These costs are mostly hidden due to a lack of standardised procedures to measure and report these impacts. To address this gap, we first conducted a literature review of all papers published as part of the AIED 2025 conference proceedings, determining if and how computational or environmental costs of LLMs are reported. Most projects use LLMs, but few report computational resources used and almost none discuss environmental impacts of LLMs as an ethical concern. To address this lack of standardised reporting practices, we propose an open-source method for systematically measuring and reporting the computational expense of LLMs and environmental impact of running Machine Learning (ML) AIED systems. We provide software solutions to measure the carbon footprint for both local and cloud based hardware. We also provide an easy-to-use formula to calculate the computational expense of frontier LLMs even when the exact number of parameters is not known. Overall, we hope to motivate colleagues to use our method to strive for more transparent reporting of hidden costs of using LLMs in the AIED community.

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

Optimizing Lithium Production Decisions under Geological, Demand, and Pricing Uncertainties: A POMDP Framework for Multi-Objective Decision Making

arXiv:2606.18598v1 Announce Type: new Abstract: Decision making in lithium production is challenging, whether from an investor's perspective or a strategic production standpoint. Determining which mines to open and when to open them involves not only geological and price uncertainties, but also complexities around the choice of extraction method, from direct lithium extraction to hard rock mining. Prior work explored models of this problem and different methods to optimize mining decisions; these models did not account for uncertainty in pricing, uncertainty in demand, or different mining technologies to extract lithium. Incorporating different pricing models and extraction technology into these models enables more robust strategies for determining not only when and where to open a mine, but also which method of production to pursue. We frame the problem as a partially observable Markov decision process (POMDP) and solve using belief state planning methods to get optimal decision making. In our study, we show that POMDP solvers outperform human inspired heuristics by dynamically adapting to shifting lithium price regimes (static, linear, exponential, and stochastic) through belief state planning and explicit uncertainty management. By optimally sequencing exploration, production, and technology choice, the framework achieves higher demand fulfillment and more balanced economic environmental outcomes over the projects lifetime in all different pricing and deposit scenarios.

03.
medRxiv (Medicine) 2026-06-15

Poly-Social Risk for Hypertension Among Black and Latina Women

Background: Hypertension is a leading modifiable cardiovascular risk factor prominently influenced by health-related social needs (HRSN). Whether detailed information on HRSN can improve identification of hypertension among minoritized women is unknown. Methods: Black and Latina women aged 18-65 years completed the Centers for Medicare and Medicaid Services Accountable Health Communities Screening Tool, assessing 13 HRSN domains. Hypertension was ascertained by a validated EHR-based algorithm or self-report of hypertension. Logistic regression tested associations of HRSN with hypertension. LASSO regression with 10-fold cross-validation was used to derive a poly-social risk score in the training set (random 70%) and tested in the validation set (30%) against a sociodemographic model (age, race, income, education). Results: Among 1302 participants (mean [SD] age 40.1 [11.3] years, 70.4% Black, 44.3% Latina), higher cumulative burden of HRSN was associated with increased odds of hypertension (adjusted odds ratio [aOR] for each additional domain of HRSN: 1.07 [95% CI 1.01-1.14], P=0.02). Food insecurity (aOR 2.30 [1.37-3.87], P= 0.002), lapse in utilities (aOR 1.44 [1.04-1.96], P=0.02), poor concentration (aOR 1.57 [1.13-2.17], P=0.007), and social isolation (aOR 1.77 [1.14-2.73], P=0.01) were associated with hypertension. In the validation set, the poly-social risk score did not improve discrimination for hypertension vs. the sociodemographic model (AUC 0.76 [95% CI 0.71-0.81] vs. AUC 0.80 [0.75-0.85]). Conclusion: In this cross-sectional analysis of Black and Latina women, greater cumulative social disadvantage was associated with hypertension. While inclusion of HRSN did not improve hypertension prediction beyond conventional sociodemographic indices, findings may inform targeted interventions among minorities at cardiometabolic risk.

04.
medRxiv (Medicine) 2026-06-17

LLM-Driven Extraction of NI-RADS and Imaging Tumor Characteristics to Enhance Oropharyngeal Cancer Survivorship Surveillance

Abstract Purpose Radiologic surveillance is essential for oropharyngeal cancer (OPC) survivors, guiding recurrence detection and follow-up strategies. The Neck Imaging Reporting and Data System provides a standardized framework for post-treatment risk reporting at both the primary tumor site (pNI-RADs) and cervical lymph nodes (nNI-RADS). Comprehensive surveillance additionally requires assessment of disease status, including the primary tumor, nodal involvement, and distant metastases. These clinical results are often embedded as unstructured data within free-text radiology reports. We hypothesized that a large language model (LLM) can reliably extract NI-RADS score criteria and summarize key imaging features from unstructured radiology text, achieving high concordance with expert review. Methods Previously untreated OPC patients who received definitive cancer therapy were identified. Eligible imaging reports included post-treatment head and neck CT, MRI, or FDG PET/CT scans containing narrative and impression text. Examinations lacking narrative or impression text, containing pre-existing NI-RADS annotations, or involving non-surveillance imaging modalities were excluded. A total of 200 reports were randomly selected from 7,076 eligible examinations for manual abstraction using a three-reviewer consensus framework to establish a reference dataset. Using the Palantir Foundry Pipeline Builder, a GPT-5-based LLM was deployed to extract pNI-RADS and nNI-RADS scores, and key imaging features of disease status from these reports. Performance was evaluated using exact agreement and F1-based metrics. Results Agreement for no evidence of disease (score of 1) was 93.3% (126/135; F1 = 0.94) and 90.3% (130/144; F1 = 0.93) for pNI-RADS and nNI-RADS, respectively. For NI-RADS [≥]2, exact category agreement was 73.1% (38/52; macro-F1 = 0.75) for pNI-RADS and 64.3% (27/42; macro-F1 = 0.56) for nNI-RADS. Quadratic weighted {kappa} was 0.81 and 0.59, respectively. For post-treatment disease surveillance variables, agreement was 94.9% (149/157; F1 = 0.87) for primary tumor presence, 89.1% (164/184; F1 = 0.87) for nodal disease presence, and 94.7% (126/133; F1 = 0.70) for distant metastasis detection. Specificity was high across disease-status variables (0.95-0.99), with negative predictive values of 0.95 for primary tumor, 0.87 for nodal disease, and 0.99 for distant metastasis. Conclusions Our LLM-based information retrieval and classification approach for radiographic treatment response from unstructured, multidimensional imaging reports achieved high performance for disease exclusion and moderate performance for detecting suspected residual and/or new disease. This pipeline supports scalable and standardized surveillance data capture for longitudinal monitoring, clinical analytics, and survivorship research in head and neck oncology.

05.
medRxiv (Medicine) 2026-06-17

Cardio Heart Connect: Protocol for a Randomized Trial of a Commercially Available mHealth Fitness Intervention for Cardiac Rehabilitation After Transcatheter Aortic Valve Replacement

Background: Despite ample evidence of the benefits of cardiac rehabilitation (CR), few transcatheter aortic valve replacement (TAVR) patients participate. Commercially available mobile health offers an opportunity to deliver activity-promotion content to populations that are challenged to participate in CR. This study aims to test the efficacy of clinically controlled, commercially available fitness programming for improving physical activity and cardiovascular health outcomes designed to be initiated while patients are on waitlists for traditional CR. Methods: The Cardio Heart Connect study is a hybrid type I effectiveness-implementation trial aiming to enroll N=200 patients who have been placed on a cardiac rehab waitlist following a TAVR procedure from the University of Colorado Hospital Heart and Vascular Center. Participants will be randomized 1:1 to the Cardio Heart Connect intervention with commercially available fitness or attention control, designed to control for technology access. At baseline, post-intervention (8 weeks), and follow-up (12 months), we will assess the primary outcome of participants? daily steps as measured by smartwatch accelerometer and secondary outcomes of interest including functional capacity (Duke Activity Status Index; VO2max), quality of life (Kansas City Cardiomyopathy Questionnaire), and cardiovascular health status (Life Essential 8). In addition, we will use mixed methodologies to evaluate the implementation of intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Conclusions: Commercially available fitness programs have the potential to provide more accessible opportunities for patients recovering from TAVR to engage in physical activity and may be preferred due to their customizability, convenience, and ease of scheduling. Overall, this study will provide insight into the use of commercial mHealth to promote activity following TAVR.

06.
arXiv (quant-ph) 2026-06-25

Software compensation of trigger-synchronous control-frame errors in qubits and qudits

arXiv:2606.00358v2 Announce Type: replace Abstract: Quantum control experiments are often subject to coherent, time-dependent disturbances that vary over timescales comparable to the experiment duration. We show that when such disturbances are reproducible with respect to a trigger signal, their effect can be measured and compensated through software-defined updates to the control frequency and phase. We experimentally verify the performance of our protocol using a trapped $^{137}$Ba$^+$ ion experiencing magnetic-field-induced energy shifts synchronous with the laboratory AC mains power. Using this compensation technique, the calibrated AC line contribution to the instantaneous oscillator detuning is reduced by $21(9)\times$, and the fitted AC-induced phase amplitude is reduced below the measurement uncertainty. We use randomized benchmarking to validate the compensation performance in quantum gate sequences, recovering an average single-qubit gate fidelity of 99.93(1)\% with a magnetic-field-sensitive qubit. Finally, we extend the compensation framework to multi-level qudit control. Using the Bernstein-Vazirani algorithm as a benchmark, we increase the algorithm's success probability from 10(7)\% to 70(9)\% in a 16 level system when compensation is enabled. Our results demonstrate that trigger-synchronized coherent errors can be reframed as deterministic control-frame errors and corrected in software.

07.
medRxiv (Medicine) 2026-06-22

Reliable quantification of renal function from frozen blood samples

BACKGROUND: Differences in renal function may affect Alzheimer disease (AD) blood biomarker levels independent of AD pathology. Although renal function was unaccounted for in foundational AD blood biomarker studies, there is potential to address this through quantification of estimated glomerular filtration rate (eGFR) from frozen serum and plasma samples. However, the validity of eGFR evaluation from long-term frozen blood samples is unknown. METHODS: Adults aged 50-85 with at least 2 vascular risk factors were recruited from vascular surgery or cardiology clinics in Tucson, Arizona from 2022-2025. Individuals with creatinine assessments in point-of-care whole blood (POC-WB) and frozen serum and plasma samples using the iSTAT (Abbott) were included. eGFR was calculated using the 2021 CKD-EPI creatinine equation without race. Agreement between POC-WB and frozen blood samples was assessed using Cohen's kappa with linear weights. RESULTS: 134 participants (mean [SD] age: 72.6 [7.5] years, 39.6% female, 23.1% chronic kidney disease) had POC-WB eGFR available. Frozen serum and plasma samples had strong agreement with POC-WB for eGFR (Kw= 0.90-0.95, P

08.
arXiv (CS.AI) 2026-06-17

Belief-Space Control for Personalized Cancer Treatment via Active Inference

arXiv:2606.10376v2 Announce Type: replace Abstract: Cancer treatment is at the core a sequential decision-making problem with partial observability, latent patient heterogeneity, and explicit constraints on the budget for medical measurements. Unlike standard Reinforcement Learning (RL) approaches that control state trajectories, cancer treatments permanently modify patients' transition dynamics, changing how states evolve over time. We model cancer treatment as a belief-space planning problem using active inference, deriving an expected free-energy objective that unifies goal-directed control and information acquisition under measurement budgets without. We implement this framework using real clinical cancer data from the AACR Project GENIE Biopharma Collaborative dataset. Results on clinical data demonstrate a simultaneous patient categorization and high treatment efficacy, under real measurement and treatment constraints.

09.
medRxiv (Medicine) 2026-06-16

The Target48 Neurodegeneration Panel: A Novel Tool for Profiling Protein Signatures in Neurodegenerative Disorders

Introduction: Novel tools for absolute quantification of established and emerging fluid neuro-biomarkers are required to advance diagnostic studies and improve biological insights. Methods: We conducted an extensive analytical and clinical validation of the Olink Target 48 Neurodegeneration panel (T48 Neuropanel) in 352 paired CSF and plasma samples from cognitively unimpaired controls (CU), Alzheimer dementia (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB), n=44 per group. Comparisons with benchmark assays were performed. Results: Good detectability (CSF: 31 out of 42 assays; plasma: 38 out of 42 assays) and technical performance was observed. Benchmark assays showed good correlations, supporting method transformation formulas. Next to emerging biomarkers (MMP10, ITGB2), discriminative performance was excellent in AD: CSF pTau217: AUC=1; FTD: plasma NfL: AUC=0.952; and DLB: CSF DDC: AUC=0.901. Discussion: This analytical and clinical validation of the T48 Neuropanel highlights initial cut-offs and emerging biomarkers to aid clinical studies for the diagnosis, prognosis, and monitoring of neurodegenerative diseases. Highlights: The T48 Neuropanel shows robust analytical performance, with high detectability across both plasma and CSF matrices. The T48 Neuropanel validates established (i.e., pTau217, Abeta42, NfL, and GFAP) and emerging biomarkers (i.e., DDC, MMP10, ITGB2, ITGAM, NPTX2, NPTXR, SMOC1, sTREM1, and sTREM2) in CSF and plasma. CSF NfL, GFAP, ITGB2, and ITGAM and plasma GFAP were dysregulated across AD, FTD, and DLB dementias. -The multiplex design of the T48 Neuropanel enables rich biological interpretation by simultaneously quantifying established and emerging neurodegeneration biomarkers. Importantly, the inclusion of absolute quantification facilitates the establishment of cut-offs, supporting its potential for clinical translation.

10.
arXiv (CS.LG) 2026-06-25

The Inference-Compute Frontier and a Latency-Efficient Architecture for Limit Order Book Prediction

arXiv:2606.25986v1 Announce Type: new Abstract: We study whether a scaling-law-style inference-compute frontier appears in limit order book prediction. Using FI-2010 and a suite of models ranging from small decision trees to neural LOB architectures, we find that the realized empirical frontier of predictive loss versus structural forward work is well summarized by a power law. In particular, with MLPLOB held out as an architecture family, a power-law fit to the low- and mid-compute non-MLPLOB frontier extrapolates across multiple orders of magnitude and attains $R^2=0.941$ on the excluded high-compute MLPLOB target frontier. A similar exercise in latency space gives substantially weaker results, showing that latency is not merely noisy compute. We use this gap to motivate FastBiNLOB, a dense axis-separable LOB mixer built from hardware-friendly temporal and feature mixing operations. In a five-seed experiment, FastBiNLOB exceeds the published $y_{10}$ and $y_{100}$ macro-F1 targets at notably lower latency than existing published SOTA architectures.

11.
medRxiv (Medicine) 2026-06-22

Panel-level multilocus methylation quantification in native cell-free DNA by PCR-compatible sequential enzymatic processing

DNA methylation is informative for liquid biopsy, but low template abundance, distributed methylation signals and workflow complexity limit implementation. Here we present Delta-HLD, a PCR-compatible methylation assay platform that quantifies methylation directly in native DNA through sequential hybridization, ligation and methylation-sensitive digestion. The assay co-reports methylation-dependent signals from multiple loci through a shared amplification architecture, generating a single panel-level PCR readout. We established the chemistry, optimized panel size and composition through model-guided experiments, and implemented the assay as a triplex qPCR workflow with per-sample internal process controls. Plasma proof-of-concept analyses showed discriminatory signal in CRC and proof-of-concept transferability to hepatocellular carcinoma. Additional platelet-retaining experiments identified a strategy to increase recovery of analyzable circulating templates while reducing genomic DNA recognition. Delta-HLD provides a compact PCR-compatible framework for low-input methylation analysis without base conversion.

12.
medRxiv (Medicine) 2026-06-18

Maternal and fetal HLA heterozygosity in preeclampsia: Insights from a large multi-ancestry pregnancy cohort

Preeclampsia (PE) is a leading cause of maternal and neonatal morbidity, with immune dysregulation at the maternal-fetal interface central to its pathogenesis. The highly polymorphic human leukocyte antigen (HLA) region mediates maternal immune tolerance of the semi-allogeneic fetus, yet the contribution of HLA diversity to PE risk remains poorly defined. Whether the HLA heterozygote advantage observed in other immune disorders is relevant to PE has not been systematically evaluated. Using data from the multi-ancestry TOPMed Boston-Colombia Collaborative for Adverse Pregnancy Outcomes (n = 12,790; 4,770 PE, 8,020 controls; 10,808 maternal, 1,982 fetal, including 1,848 pairs), we evaluated associations between heterozygosity across eight classical HLA loci and PE and four sub-phenotypes, adjusting for genetic ancestry. HLA heterozygosity was common across most loci (>80%). No individual maternal HLA locus was associated with overall PE; however, heterozygosity across class I loci showed a protective effect in preterm PE (OR=0.82, 95%CI:0.69-0.97), with a similar pattern for HLA-A heterozygosity (OR=0.78, 95%CI:0.64-0.96). In contrast, fetal heterozygosity at HLA-DQB1 was nominally associated with increased risk of PE (OR=1.36, 95%CI:1.03-1.79) and preterm PE (OR=1.73, 95%CI:1.13-2.73). No individual maternal or fetal HLA alleles were associated with PE. Maternal-fetal mismatch analysis demonstrated locus-specific associations with preterm PE, including increased risk with HLA-DQA1 mismatch and reduced risk with HLA-C mismatch. These findings highlight distinct maternal and fetal immunogenetic contributions to PE risk and underscore the importance of considering HLA diversity-rather than individual alleles alone-in studies of PE etiology.