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01.
medRxiv (Medicine) 2026-06-22

Exploring the association of Obesity on Cold and Warm Autoimmune Hemolytic Anemia in San Joaquin Valley: A Retrospective Cross-Sectional Study

The relationship between obesity and specific autoimmune diseases haas been well-established, specifically due to obesity's role in promoting pro-inflammatory states. Although not much literature has been documented regarding obesity association with AIHA. As such, this study aims to assess any correlations in patients with elevated body mass index (BMI) and autoimmune hemolytic anemia (AIHA). Here we present a retrospective cross-sectional study conducted over a four-year period, across four medical centers during which a new electronic medical record was implemented. The study included 25 patients who had a previously documented history of AIHA from another facility, DAT positive with indicators of hemolysis, or DAT positive with monomer specific antisera. The patients BMI was recorded at the time of presentation to the hospital. However, for patients with a prior history of AIHA or those transferred from another facility, the BMI that was closest to the time period of when the patient was diagnosed with AIHA was used as an adjunct. Our results show that there is an association of patients with elevated BMI (>25) and AIHA; however, various other confounding variables should be taken into consideration, and further research should be done to establish a causal relationship.

02.
arXiv (CS.LG) 2026-06-24

Hardware-Oriented Inference Complexity of Kolmogorov-Arnold Networks

arXiv:2604.03345v2 Announce Type: replace Abstract: Kolmogorov-Arnold Networks (KANs) have recently emerged as a powerful architecture for various machine learning applications. However, their unique structure raises significant concerns regarding their computational overhead. Existing studies primarily evaluate KAN complexity in terms of Floating-Point Operations (FLOPs) required for GPU-based training and inference. However, in many latency-sensitive and power-constrained deployment scenarios, such as neural network-driven non-linearity mitigation in optical communications or channel state estimation in wireless communications, training is performed offline and dedicated hardware accelerators are preferred over GPUs for inference. Recent hardware implementation studies report KAN complexity using platform-specific resource consumption metrics, such as Look-Up Tables, Flip-Flops, and Block RAMs. However, these metrics require a full hardware design and synthesis stage that limits their utility for early-stage architectural decisions and cross-platform comparisons. To address this, we derive generalized, platform-independent formulae for evaluating the hardware inference complexity of KANs in terms of Real Multiplications (RM), Bit Operations (BOP), and Number of Additions and Bit-Shifts (NABS). We extend our analysis across multiple KAN variants, including B-spline, Gaussian Radial Basis Function (GRBF), Chebyshev, and Fourier KANs. The proposed metrics can be computed directly from the network structure and enable a fair and straightforward inference complexity comparison between KAN and other neural network architectures.

03.
arXiv (CS.AI) 2026-06-18

TLA-Prover: Verifiable TLA+ Specification Synthesis via Preference-Optimized Low-Rank Adaptation

arXiv:2606.06133v2 Announce Type: replace-cross Abstract: TLA+ is a formal specification language for verifying distributed systems and safety-critical protocols. Large language models (LLMs) frequently produce TLA+ specifications that fail the TLC model checker for semantic reasons. Across 25 LLMs, the best public baseline is 26.6% syntactic parse and 8.6% semantic model-check. We present TLA-Prover, a 20-billion-parameter model for TLA+ specification synthesis. Training combines supervised fine-tuning (SFT) on verified examples with repair-based group-relative policy optimization (GRPO). In the GRPO stage, the model learns to fix its own rejected specifications. We also train a direct preference optimization (DPO) variant from the same SFT checkpoint as an ablation. TLC provides the reward signal directly, with no learned reward model. Four tiers grade each output: Bronze (parses), Silver (no warnings), Gold (passes TLC), and Diamond. To reach Diamond, the model's correctness property is automatically altered in a small way; TLC must then detect a violation. If TLC still passes, the property was always-true and contributes nothing; the output fails Diamond. TLA-Prover reaches 9/30 (i.e. pass@1 = 30%) at both Gold and Diamond on a held-out 30-problem benchmark. This is roughly 3.5x the 8.6% untuned baseline. The DPO variant reaches 20% at Diamond. Gold and Diamond coincide at every checkpoint; this prevents the trivial-property failure mode.

04.
medRxiv (Medicine) 2026-06-22

Regional Service-System Conditions Associated with Facility-Linked Home-Based Specialist Care in Japan: A Claims-Based Ecological Study of Home Dialysis

Authors:

Background Complex chronic care is increasingly delivered in patients' homes while remaining linked to specialist facilities for training, monitoring, and backup care. Home dialysis provides a useful case because peritoneal dialysis (PD) and home hemodialysis (HHD) share a home-facility delivery structure but differ in technical and operational requirements. This study examined regional service-system conditions associated with the presence and scale of PD and HHD in Japan. Methods This ecological study used publicly available claims, administrative, census, and geospatial data harmonized to 334 Secondary Medical Areas. Regional indicators were organized into four domains: dialysis service delivery, implementation support for home-based care, hospital backup capacity, and living and sociodemographic context. Diffusion was examined using claims-based indicators of regional presence and post-presence scale, analyzed separately for PD and HHD with Firth penalized logistic regression and zero-truncated negative binomial regression, respectively. Results PD was observed in 271 regions and HHD in 109. Patterns of associated regional conditions differed by modality and stage. PD was associated mainly with existing dialysis-service organization, whereas HHD was associated with broader regional supports, including home-care delivery, living infrastructure, transition support, and hospital-system indicators. Conditions associated with presence differed from those associated with scale. Cross-modality associations suggested that shared regional factors may shape the distribution of both modalities. Conclusions Regional conditions for home dialysis diffusion in Japan differed by modality and stage. PD was linked mainly to existing dialysis-service organization, whereas HHD was linked to multi-domain regional support for technically demanding home treatment. Under standardized reimbursement, local service-system capacity may remain important for modality- and stage-specific diffusion of home dialysis.

05.
medRxiv (Medicine) 2026-06-16

Reliability and construct validity of the Technology Device Interference Scale in a sample of children and parents

There is increasing interest in parent-child technoference: the interference with personal interactions caused by technology devices. This study examined the reliability and construct validity of the Technology Device Interference Scale (TDIS) to measure technoference in a sample of Canadian parents and children. Parents (n=883) and children (n=376) were recruited from clinical and community settings and completed the TDIS for their own and family member technoference over three timepoints (T1=2023, T2=2024, T3=2025). TDIS internal consistency, test-retest reliability, and construct validity were assessed using Cronbachs alpha, intraclass correlation coefficient, and confirmatory factor analysis, respectively. The TDIS showed good internal consistency and adequate to good construct validity when used by children to report on their own technoference (all >.70; CFI>.95, TLI>.95, RMSEA.70; CFI>.95, TLI>.90, RMSEA[≤].11). The TDIS had low to acceptable internal consistency and poor model fit for parent report of their own technoference ( range: .63 - .66; CFI

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

Variational Learning for Insertion-based Generation

arXiv:2606.02133v3 Announce Type: replace-cross Abstract: Non-monotonic sequence generation methods, such as masked diffusion models, provide a flexible alternative to left-to-right autoregressive modeling by allowing tokens to be generated in non-fixed and prescribed orders. Despite their practical advantages, most existing non-monotonic models are order-agnostic and rely on a fixed-length grid, limiting their ability to support variable-length generation and adaptive insertion order. In this work, we introduce a probabilistic framework for learning insertion order in variable-length insertion models. We formalize a bijective correspondence between insertion trajectories and permutations, which enables an exact reparameterization of the data likelihood as a sum over permutations. Building on this result, we propose the Insertion Process (IP), a stochastic generative model that jointly learns where to insert, what to insert, and when to terminate, trained via permutation-based variational inference. Unlike prior fixed-canvas approaches, IP natively supports variable-length generation and learns data-driven preferences over insertion orders. Experiments on goal-conditioned planning and molecular string generation demonstrate that learning insertion order improves both modeling quality and generalization in domains without a canonical left-to-right structure.

07.
medRxiv (Medicine) 2026-06-16

Reporting patterns of adverse drug withdrawal events using individual case safety reports in United States and European databases

Introduction: Adverse drug withdrawal events (ADWEs) are a key safety concern with deprescribing but are infrequently reported in trials. Although pharmacovigilance systems have advanced our understanding of medication-related harms, it is unclear how extensively these systems have been used for ADWEs. Objectives: To examine the reporting patterns of ADWEs for all drugs recorded in United States and European pharmacovigilance databases between 2004 and 2023. Methods: A retrospective study was conducted using two pharmacovigilance databases, the publicly available FDA-FAERS dataset and EMA-EV Level 2A (individual-level) dataset. ADWE cases were identified using relevant MedDRA preferred terms. Data on patient characteristics, reporter type, drugs, indication, ADWE outcomes, dechallenge/rechallenge, seriousness criteria, time to onset, duration, and causality were summarised. Results: A total of 158,505 ADWE reports were analysed (FDA-FAERS: 145,514; EMA-EV: 12,987), with mean ages of 46.1 (FDA; 55.3% female) and 45.5 years (EMA; 57.1% female). The frequently reported drug classes were opioids (FDA: oxycodone, 29.8%; EMA: buprenorphine, 19%), antidepressants (FDA: duloxetine, 32%; EMA: venlafaxine, 25.9%) and gabapentinoids (FDA: pregabalin, 6.7%; EMA: pregabalin, 6.0%). The most common adverse outcomes were other serious medical conditions (FDA=63.9%; EMA=46.0%), hospitalisation (FDA=15.9%; EMA=28.3%), and disability (FDA=13.3%; EMA=6.2%) and these outcomes varied significantly based on sex and age group (p

08.
arXiv (CS.AI) 2026-06-16

An Empirical Investigation of Pre-Trained Deep Learning Model Reuse in the Scientific Process

arXiv:2603.13584v2 Announce Type: replace-cross Abstract: Deep learning has achieved recognition for its impact within natural sciences, yet the prohibitive financial and technical cost of training models from scratch inhibit adoption. Following software engineering community guidance, natural scientists are reusing pre-trained deep learning models (PTMs) to amortize these costs. While prior works recommend PTM reuse patterns, we present the first empirical study of PTM reuse patterns in the natural sciences, quantifying the utilization and impact of PTM reuse within the scientific process across 17,718 peer reviewed, open access papers. Our results show that "Biochemistry, Genetics and Molecular Biology" has outpaced other natural scientific fields in PTM reuse, "adaptation" reuse is the most prevalent PTM reuse pattern identified across all natural science fields, and the "testing" stage of the scientific process has been most impacted by PTM integration.

09.
bioRxiv (Bioinfo) 2026-06-16

Expanding gene regulatory networks from transcriptome data through graphical modeling with heterogeneous priors

Gene regulatory network inference is widely used to reconstruct large-scale networks and identify functional genes from transcriptome data. Meanwhile, in many biological fields, core regulatory genes have been extensively studied, leading to the establishment of small-scale gene regulatory networks, and novel genes connected to these networks remain to be identified. However, methods for expanding existing gene networks by identifying novel regulatory interactions, rather than reconstructing the entire network, are not well established. Here, we propose a method for gene network expansion that incorporates known regulatory relationships and evaluates each candidate gene individually to infer its regulatory connections to the existing network. Using simulated datasets from the DREAM4 benchmark and the PRECISE-1K experimental dataset, our method outperformed conventional methods by incorporating prior knowledge. In particular, it improved the ability to distinguish true regulatory interactions from indirect associations arising from strong correlations among genes in the existing network. The method also showed strong performance for interactions involving genes with high outdegree or centrality. Furthermore, it maintained stable performance as the size of the existing network increased and was robust to noise in prior information. These results demonstrate that our method provides an effective framework for expanding existing gene regulatory networks by leveraging prior knowledge.

10.
medRxiv (Medicine) 2026-06-22

Midlife Measures of General Cognitive Performance in the National Longitudinal Study of Adolescent to Adult Health (Add Health)

Objective: The Add Health Cognitive Assessment, Physical, and Sensory Function Protocol (Add CAPS) was developed to assess cognitive, physical, and sensory function in early midlife in a nationally representative sample in the United States. Using Add CAPS, we developed two general cognitive performance measures. Methods: The sample included 2,525 participants from Add Health Wave VI who completed an in- home assessment of cognitive performance. Confirmatory factor analysis (CFA) was used to derive two general cognitive performance (GCP) scores: (1) a five-domain score based on originally designed cognitive domains (Add CAPS GCP), and (2) a modified score aligned with the Harmonized Cognitive Assessment Protocol (HCAP) framework (Add CAPS GCP-H). We evaluated model fit using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), and Comparative Fit Index (CFI) and tested factor scores for criterion validity. Results: Both models showed good fit (Add CAPS GCP: RMSEA = 0.025, SRMR = 0.031, CFI = 0.968; Add CAPS GCP-H: RMSEA = 0.027, SRMR = 0.033, CFI = 0.962), indicating that they adequately represent the underlying GCP construct. Discussion: The Add CAPS cognitive battery captures a robust, hierarchical structure of GCP across alternative domain specifications. The derived factor scores provide a valuable method for characterizing a person's cognitive baseline during midlife. Importantly, the Add CAPS GCP-H enhances comparability with the HCAP network, supporting cross-cohort analyses of cognitive aging.

11.
arXiv (quant-ph) 2026-06-24

Quantum Metric Bound State of Light

arXiv:2606.22479v2 Announce Type: replace-cross Abstract: The spatial confinement of defect-induced bound states is conventionally governed by the effective mass in dispersive bands. More recently, Compact Localized States (CLSs) arising from exact destructive interference have been utilized to achieve confinement in flat bands. However, CLSs rely on pristine lattice symmetries and fine-tuned defect profiles. The introduction of a generic local impurity inevitably breaks these strict phase-matching conditions, resulting in extensive bound states whose fundamental length scale has remained an open question. Here, we establish a third regime of confinement: the quantum metric bound state. We provide a rigorous mathematical proof demonstrating that in the absence of kinetic energy and CLS protection, the exponential decay length of these states is lower-bounded by the quantum metric of the unperturbed flat band. We demonstrate the tightness of this geometric limit by constructing a family of highly tunable flat-band generators, and we verify its universality across diverse realistic architectures. Ultimately, this classification establishes the independently measurable quantum metric as a predictive design principle for engineering confined modes in synthetic wave platforms.