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01.
arXiv (CS.CV) 2026-06-19

HY-WU (Part I): An Extensible Functional Neural Memory Framework and An Instantiation in Text-Guided Image Editing

Foundation models are transitioning from offline predictors to deployed systems expected to operate over long time horizons. In real deployments, objectives are not fixed: domains drift, user preferences evolve, and new tasks appear after the model has shipped. This elevates continual learning and instant personalization from optional features to core architectural requirements. Yet most adaptation pipelines still follow a static weight paradigm: after training (or after any adaptation step), inference executes a single parameter vector regardless of user intent, domain, or instance-specific constraints. This treats the trained or adapted model as a single point in parameter space. In heterogeneous and continually evolving regimes, distinct objectives can induce separated feasible regions over parameters, forcing any single shared update into compromise, interference, or overspecialization. As a result, continual learning and personalization are often implemented as repeated overwriting of shared weights, risking degradation of previously learned behaviors. We propose HY-WU (Weight Unleashing), a memory-first adaptation framework that shifts adaptation pressure away from overwriting a single shared parameter point. HY-WU implements functional (operator-level) memory as a neural module: a generator that synthesizes weight updates on-the-fly from the instance condition, yielding instance-specific operators without test-time optimization.

02.
bioRxiv (Bioinfo) 2026-06-16

cuBayes: GPU accelerated FreeBayes that achieves 1-minute whole-genome SNV calling while maintaining algorithmic semantics

Next-generation sequencing now produces whole-genome data in hours, but downstream variant calling remains a multi-hour to multi-day bottleneck that excludes genomic analysis from time-critical clinical settings. GPU acceleration offers a natural path forward – variant calling is inherently parallelizable across genomic positions – yet open-source infrastructure for porting existing algorithms to GPU hardware remains limited, leaving many widely-used tools without accelerated implementations. FreeBayes, a haplotype-based variant caller central to the 1000 Genomes Project and to multi-sample tumor evolution analyses, exemplifies this gap: it is natively single-threaded despite its algorithmic suitability for parallelization. We present cuBayes, a CUDA implementation of FreeBayes germline SNV calling that completes HG002 and HG004 2x250bp Illumina 60x whole-genome analysis in one minute (as opposed to hours if not days with manual region-based CPU parallelization) on a single NVIDIA RTX 6000 Ada GPU, while producing variant calls with >99.9% concordance to the CPU reference. cuBayes is structured around an atom/molecule architecture in which reusable functional units (BAM decompression, position-wise pileup, batch coordination) are cleanly separated from algorithm-specific logic, providing a foundation intended to support acceleration of additional sequence analysis algorithms without redundant low-level engineering.

03.
arXiv (CS.LG) 2026-06-11

FlexiBrain: Resolution-Agnostic Voxel-Level Encoding for Native fMRI

arXiv:2606.11500v1 Announce Type: cross Abstract: The success of large-scale deep learning models in neuroscience is fundamentally constrained by severe data heterogeneity. Native fMRI data aggregated from diverse sources exhibit substantial variation in both spatial and temporal resolutions. Consequently, most existing frameworks rely on lengthy, rigid preprocessing pipelines that enforce uniformity across datasets. This practice introduces two critical limitations: (1) potential degradation of subject-specific anatomical information; (2) significant computational overhead, often requiring hours of processing per subject. Here, we propose FlexiBrain, a resolution-agnostic voxel-level encoding framework for native fMRI based on Mamba-JEPA. FlexiBrain defines patch sizes in real-world physical units and employs a dynamic patch resizing, thereby bypassing destructive spatial standardization while enabling direct ingestion of data in native space. We instantiate the framework using an efficient Mamba-JEPA backbone to model high-dimensional 4D fMRI signals. Across five diverse downstream neuroscience tasks, FlexiBrain consistently outperforms recent state-of-the-art methods, achieving gains of up to 12 percentage points without external data augmentation. Importantly, FlexiBrain functions as a seamless plug-in module, substantially reducing preprocessing costs and accelerating the development of robust voxel-level fMRI foundation models. Code is available at https://github.com/OneMore1/FlexiBrain.

04.
arXiv (CS.LG) 2026-06-17

Monotonic Kolmogorov-Arnold Networks: A Theoretical and Empirical Study of Monotonicity as an Inductive Bias

arXiv:2606.17886v1 Announce Type: new Abstract: Monotonicity has been a long-running architectural inductive bias for neural networks, motivated by tabular, scientific, and economic settings where outputs are known to respond monotonically to certain inputs. Existing approaches are MLP- or flow-based and lack per-edge functional transparency; the only Kolmogorov–Arnold Network (KAN) variant with monotonicity, MonoKAN, enforces the constraint only on a restricted parameter subset and requires a projection-style training procedure. We close this gap with MKAN, a KAN with hard monotonicity guaranteed for all parameter values via exponential reparameterization of B-spline coefficients, positive edge weights, and a monotone base activation. Training reduces to standard unconstrained gradient descent. Our headline theoretical contribution is a representation-cost theorem: any $C^K, K >0$ feature extractor inducing a ball-shaped semantic-neighborhood partition admits a monotone realization of the equivalent neighborhood structure at $N' = N^* + k \le 2N^*$, where $k$ is the number of non-monotone coordinates of the original. The bound is architecture-agnostic and gives a principled sizing rule for monotone encoders. Empirically, MKAN is competitive with state-of-the-art monotone NNs on the SMM/ICML-2024 benchmark while being the only method that combines hard unconstrained monotonicity with KAN's per-edge functional transparency; the $2N^*$ prediction is validated in a self-supervised feature-size sweep on four real datasets, and on a controlled monotone-generative dataset MKAN recovers ground-truth factors with substantially higher Spearman alignment than KAN, MLP, and linear baselines.

05.
arXiv (quant-ph) 2026-06-16

The Distribution Postulate in Algorithmic Bohmian Mechanics

arXiv:2606.16165v1 Announce Type: new Abstract: In order to make the right empirical predictions Bohmian mechanics requires a special statistical boundary condition – the distribution postulate – but it is unclear how best to understand this condition. We show how one might use the theory of algorithmic randomness to formulate the distribution postulate as an objective constraining law. The framework requires us to say something about admissible quantum-mechanical states and measurements. In return, algorithmic Bohmian mechanics (aBM) guarantees the standard Born statistics for a collection of canonical quantum experiments in the limit, not just with high probability. The algorithmic distribution postulate provides a sharp typicality condition, clarifies the status of quantum probabilities in the deterministic theory, and provides a concrete example of how notions provided by the theory of algorithmic randomness can aid in specifying the content of a physical law.

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

Process-Verified Reinforcement Learning for Theorem Proving via Lean

arXiv:2606.20068v1 Announce Type: new Abstract: While reinforcement learning from verifiable rewards (RLVR) typically has relied on a single binary verification signal, symbolic proof assistants in formal reasoning offer rich, fine-grained structured feedback. This gap between structured processes and unstructured rewards highlights the importance of feedback that is both dense and sound. In this work, we demonstrate that the Lean proof assistant itself can serve as a symbolic process oracle, supplying both outcome-level and fine-grained tactic-level verified feedback during training. Proof attempts are parsed into tactic sequences, and Lean's elaboration marks both locally sound steps and the earliest failing step, yielding dense, verifier-grounded credit signals rooted in type theory. We incorporate these structured rewards into a GRPO-style reinforcement learning objective with first-error propagation and first-token credit methods that balances outcome- and process-level advantages. Experiments with STP-Lean and DeepSeek-Prover-V1.5 show that tactic-level supervision outperforms outcome-only baselines in most settings, delivering improvements on benchmarks such as MiniF2F and ProofNet. Beyond empirical gains, our study highlights a broader perspective: symbolic proof assistants are not only verifiers at evaluation time, but can also act as process-level reward oracles during training. This opens a path toward reinforcement learning frameworks that combine the scalability of language models with the reliability of symbolic verification for formal reasoning.

07.
arXiv (CS.CL) 2026-06-15

Indirect Computing Model with Indirect Formal Method

作者:

This paper,from the perspective of a collaborative intelligent computing system formed by combining human-computer interface and collaborative computing programs, discusses the principles of optimized cloud computing technology supported by the combination of an indirect computing model and an indirect formal method. On the basis of systematically reviewing the influence of previous theoretical achievements Turing's computability theory,Kleene's formal theory of small strings,von Neumann's digital computer architecture and Turing's hypothesis on AI judgment on the mainstream general-purpose digital computer paradigm,the author focuses on introducing an indirect computing model and an indirect formal theory compatible with both large and small strings. Using Chinese information data as an example,the design concept of a collaborative intelligent computing system prototype is presented. The significance is that this achievement facilitates optimization of cloud computing from data centers to knowledge centers.

08.
arXiv (CS.CL) 2026-06-15

CORA: Analyzing and bridging thinking-answer gap in Multimodal RLVR via Consistency-Oriented Reasoning Alignment

Reinforcement learning with verifiable rewards (RLVR) has successfully elicited the reasoning capabilities of large language models, motivating its extension to multimodal scenarios. Existing methods primarily focus on improving the visual coverage of reasoning traces and mitigating visual hallucinations, but underestimate the semantic inconsistency between the reasoning process and the final answer. In this paper, we delve into thinking-answer inconsistency in RLVR for large vision-language models (LVLMs), showing thorough analyses of rollouts collected throughout Group Relative Policy Optimization (GRPO) training process and post-RLVR evaluation outputs that this issue persists during training and remains present during inference. Motivated by the analysis, we propose Consistency-Oriented Reasoning Alignment (CORA), which introduces thinking-answer semantic consistency into RLVR through a lightweight plug-and-play consistency reward model, and further incorporates Hybrid Reward Advantage Splitting (HRAS) to stably coordinate task and consistency optimization. Extensive experiments across representative multimodal reasoning benchmarks and mainstream LVLMs show that CORA improves task performance while effectively mitigating thinking-answer inconsistency, leading to more faithful reasoning traces.

09.
arXiv (math.PR) 2026-06-15

A random approach to the multibonacci sequence

arXiv:2606.14294v1 Announce Type: cross Abstract: This paper presents a random approach to the multibonacci sequence. We generalise the model introduced by Benjamin, Levin, Mahlburg, and Quinn, which is based on a random tiling method using dominoes and squares that leads to the Fibonacci sequence, and which was extended to the tribonacci case in a previous work by the authors. Our approach employs tiling with linear $k$-ominoes, $k=1,\ldots,s$, combined with specific colouring, to generate a weighted multibonacci sequence. For a natural random variable~$X$ defined by this model, we establish the distribution of $X$ in terms of multibonacci numbers and compute $\mathbb{E}[X] = 2^{s+1}-3$.

10.
arXiv (quant-ph) 2026-06-19

Proposal of quantum arrival-time measurement with a Bose-Einstein condensate

arXiv:2606.20278v1 Announce Type: new Abstract: This work shows how a Bose-Einstein condensate of ultracold atoms could be used to address a long-standing question in quantum theory: how much time does it take for a particle to reach a detector? To this end, we propose a realistic experimental setup, whose key idea is not to measure arrival times directly, but the arrival flux on the detector as a function of its position. This novel approach not only solves practical issues with having a detector close to the system, but also results in signals that allow to unambiguously distinguish different theoretical predictions. This proposal raises prospects for resolving the decades-old debate on this fundamental issue.

11.
arXiv (CS.AI) 2026-06-16

From Overload to Convergence: Supporting Multi-Issue Human-AI Negotiation with Bayesian Visualization

arXiv:2603.22766v2 Announce Type: replace-cross Abstract: As AI systems increasingly mediate negotiations, understanding how the number of negotiated issues impacts human performance is crucial for maintaining human agency. We designed a human-AI negotiation case study in a realistic property rental scenario, varying the number of negotiated issues; empirical findings show that without support, performance stays stable up to three issues but declines as additional issues increase cognitive load. To address this, we introduce a novel uncertainty-based visualization driven by Bayesian estimation of agreement probability. It shows how the space of mutually acceptable agreements narrows as negotiation progresses, helping users identify promising options. In a within-subjects experiment (N=32), it improved human outcomes and efficiency, preserved human control, and avoided redistributing value. Our findings surface practical limits on the complexity people can manage in human-AI negotiation, advance theory on human performance in complex negotiations, and offer validated design guidance for interactive systems.

12.
arXiv (quant-ph) 2026-06-15

Efficient and simple Gibbs state preparation of the 2D toric code via duality to classical Ising chains

arXiv:2508.00126v2 Announce Type: replace Abstract: We introduce the notion of polynomial-depth duality transformations, which relates two sets of operator algebras through a conjugation by a poly-depth quantum circuit, and make use of this to construct efficient Gibbs samplers for a variety of interesting quantum Hamiltonians as they are poly-depth dual to classical Hamiltonians. This is for example the case for the 2D toric code, which is demonstrated to be poly-depth dual to two decoupled classical Ising spin chains for any system size, and we give evidence that such dualities hold for a wide class of stabilizer Hamiltonians. Additionally, we extend the above notion of duality to Lindbladians in order to show that mixing times and other quantities such as the spectral gap or the modified logarithmic Sobolev inequality are preserved under duality.

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

Learning Dynamics Reveal a Hierarchy of Weight-Induced Layerwise Gram Metrics

arXiv:2606.09744v3 Announce Type: replace Abstract: We study feed-forward ReLU networks with fixed readout and quadratic loss. The aim is to rewrite gradient descent not primarily as a dynamics in weight space, but as a collective dynamics closed in terms of fields defined on the training-set space. For a single hidden layer, the weight variables can be eliminated from the activation dynamics, yielding a closed equation for the residuals governed by a collective kernel that factorizes into an input-geometric matrix and a dynamical co-activation matrix. For deeper networks, the residual dynamics retains a clean layer-wise kernel structure. However, from depth three onward, closure requires a hierarchy of weight-induced Gram operators that mediate information transport across layers. Moreover, the conjugate-field dynamics is governed by operators satisfying a backward pullback recursion, of which the weight-induced Gram operators are the first nontrivial instances.

14.
arXiv (CS.AI) 2026-06-24

DynaWM: Dynamics-Aware Distillation with World Model and Momentum Targets for Smooth Locomotion over Continuous Stairs

arXiv:2606.24089v1 Announce Type: cross Abstract: Recent advances in control have enabled bipedal-wheeled robots to traverse slopes and single-step obstacles, yet long staircase traversal remains challenging as current teacher-student frameworks suffer from weakened dynamics-aware representations and incomplete terrain geometry encoding. To bridge this gap, we propose DynaWM, a dynamics-aware representation learning framework. To enhance terrain encoding capability and enable transparent assessment, we introduce a world model as a regularizer to enforce forward-dynamics awareness, preserving comprehensive terrain geometry while facilitating hierarchical encoding visualization. To stabilize knowledge transfer, we employ a momentum target encoder to provide consistent distillation targets, preventing dimensional collapse from non-stationary teacher updates. Evaluation of the learned representations through Principal Component Analysis (PCA) visualization and quantitative metrics reveals that our encoder hierarchically captures terrain geometry with higher terrain encoding capability, leading to enhanced terrain adaptability and motion smoothness. Experimental results in simulation and real hardware demonstrate that our method achieves superior terrain adaptability and motion smoothness, enabling bipedal-wheeled robots to overcome diverse continuous stairs, as shown in Fig. 1.

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

Detecting undisclosed LLM-generated content in parliamentary texts

In this paper, we evaluate the extent of undisclosed LLM-generated content in texts from the parliaments of the United Kingdom and Sweden. In many areas, such as in journalism or in academic writing, there are often requirements to clearly disclose whether AI tools, such as LLMs, have been used. In the case of parliamentary texts, the guidelines on disclosure of AI use are more vague. However, in order to maintain transparency and retain public trust, it is generally recommended that parliamentarians should state whether or not they have used AI when writing texts, such as parliamentary motions. Here, we train an interpretable (glass-box) text classifier using pre-LLM parliamentary texts and LLM-generated versions of such texts. We then apply the classifier to a test set containing recent parliamentary texts, finding a steady increase in undisclosed LLM use, in both parliaments, from 2022 onwards.

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

TENSO: Software Package for Numerically Exact Open Quantum Dynamics Based on Efficient Tree Tensor Network Decomposition of the Hierarchical Equations of Motion

arXiv:2603.17711v2 Announce Type: replace-cross Abstract: TENSO is a versatile and powerful open-source software package for numerically exact simulations of the dynamics of quantum systems immersed in structured thermal environments. It is based on a tree tensor network decomposition of the hierarchical equations of motion (HEOM) that efficiently curbs its curse of dimensionality with bath complexity. As such, TENSO enables exact non-Markovian open quantum dynamics simulations even with complex environments typical of chemistry and quantum information science. TENSO allows for time-dependent drive in the system, and for non-commuting fluctuations. More generally, TENSO efficiently propagates the dynamics for any method with a generator of the dynamics that can be expressed in a sum-of-products form, including the HEOM and multi-layer multiconfigurational time-dependent Hartree methods. TENSO enables simulations using tensor trees and trains of arbitrary order, and implements three propagation strategies for the coupled master equations; two fixed-rank methods that require a constant memory footprint during the dynamics and one adaptive rank method with a variable memory footprint controlled by the target level of computational error. In contrast to the accompanying theory and algorithmic paper [J. Chem. Phys. 163, 104109 (2025)] the focus here is on the practical usage and applications of TENSO with underlying theoretical concepts introduced only as needed.

17.
Nature Medicine 2026-06-15

Activity-dependent adaptive deep brain stimulation improves gait in Parkinson’s disease

Parkinson’s disease leads to a spectrum of locomotor deficits that vary in severity with the nature of daily activities and the fluctuating physiology of patients. Many of these deficits remain inadequately addressed by existing deep brain stimulation therapies that rely on activity-agnostic parameters optimized for cardinal motor symptoms. By contrast, therapies embedding activity-specific parameters have the potential to better address the entire range of symptoms. Here we expose physiological principles that enable real-time decoding of ongoing locomotor activities across motor fluctuations from the neural dynamics of the subthalamic nucleus. This decoding steered activity-dependent adaptations of deep brain stimulation therapies that improved locomotor deficits while preserving efficacy for cardinal motor symptoms across activities of daily living. Our activity-dependent framework provides a blueprint for next-generation neuromodulation therapies that continuously select parameters optimized to the behavioral context and fluctuating physiology of each patient. ClinicalTrials.gov registration NCT06791902 . Neural decoding algorithms that leverage physiological principles of locomotor encoding support activity-dependent deep brain stimulation therapies that improve locomotor deficits in people with Parkinson’s disease.

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

ArtNet: A JEPA-Like Articulatory Predictive Framework for Robust Zero-Shot Phoneme Recognition

arXiv:2606.16595v1 Announce Type: cross Abstract: Zero-shot cross-lingual phoneme recognition is often hindered by the fragility of direct acoustic-to-symbol mapping, which is susceptible to language-specific variations. Echoing joint-embedding predictive architecture (JEPA) work in vision, we propose ArtNet, a framework that explores a structured feature prediction task based on articulatory features to enhance acoustic robustness. Specifically, ArtNet integrates an articulatory predictor, designed to extract universal articulatory representations from self-supervised learning (SSL) features, with a variational information bottleneck (VIB) to suppress language-specific variations. Experiments on seven unseen languages demonstrate that ArtNet, particularly when synergized with the proposed vector-space inventory alignment (VSIA) strategy, significantly outperforms competitive baselines, achieving a 20.56\% relative reduction in phoneme error rate (PER) and 7.01\% in phoneme feature error rate (PFER).

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

Multi-Modal Spatio-Temporal Graph Neural Network with Mixture of Experts for Soil Organic Carbon Prediction

Top-soil organic carbon (SOC) prediction is fundamental to agricultural sustainability, land use policy and fertilization planning. Existing approaches face two limitations: they pair hand-crafted covariates with classical ML or single-modal deep models that miss rich spectral and temporal information, and grid-based architectures ignore the irregular spatial structure of field measurements. We introduce SpTGNN, a multi-modal spatio-temporal graph neural network addressing both. SpTGNN represents soil measurements as nodes in a heterogeneous graph with three edge types (spatial proximity, spectral similarity, elevation), and applies relational graph attention to learn separate patterns per relation. A fine-tuned TerraMind encoder extracts node features from Sentinel-2, Sentinel-1 and DEM signals, combined with per-sample environmental covariates and learned positional and temporal embeddings. A sparse Mixture-of-Experts module fuses the four streams via top-$k$ routing. Uncertainty is captured by pairing heteroscedastic regression (aleatoric) with deep ensembles (epistemic), and a Moran's $I$ penalty regularizes spatial autocorrelation. We evaluate on a global SOC corpus split into three regional instances ($\sim$49k samples globally, Africa $\sim$26k, Europe $\sim$14k). Our 5-member deep ensemble reports $R^2=0.762$, RMSE $=3.51\pm0.48$ g/kg and MAPE $=22.9\%$ on the Africa test split, improving over a tabular XGBoost baseline; the best single checkpoint reaches validation $R^2=0.864$. Ablations confirm the heterogeneous graph, MoE fusion and fine-tuned backbone each contribute substantively, and the ensemble UQ stack achieves post-calibration ECE of $0.031$ (hybrid) and $0.026$ ($\beta$-NLL). To our knowledge, this is the first framework to unify foundation-model feature extraction, heterogeneous graph attention and decomposed uncertainty quantification for SOC estimation.

20.
arXiv (CS.CV) 2026-06-24

Bridging the Manifold Gap: Riemannian Residual Line Search for One-Step Image Editing

One-step diffusion editors are fast because they avoid inversion and iterative optimization, but a single transport update must be aggressive enough to realize the target prompt and conservative enough to preserve the source image–and no fixed update strength satisfies both demands across edit types. We treat this tension as a post-hoc candidate-selection problem on top of energy-field transport rather than as a new editing model. Our proposed method, Riemannian Residual Line Search, first builds a stronger edit by estimating the local time curvature of the prompt-delta field and projecting the corrected direction back onto the update norm of the original first-order energy-field transport estimation. It then forms a small residual path from the source image to this strong edit, retains the original first-order output as one candidate, and picks the final image by maximizing target-prompt CLIP alignment. On a 700-sample PIE-Bench++ evaluation across 10 edit type IDs, our method achieves state-of-the-art (SOTA) performance among current one-step update algorithms.

21.
medRxiv (Medicine) 2026-06-22

National trends and operational drivers of vaccine wastage in Uganda, 2020-2025: a descriptive analysis of four tracer antigens

Background Vaccine wastage reduces immunisation efficiency, increases costs, and complicates supply forecasting. Uganda routinely monitors vaccine use, but national evidence comparing observed wastage with World Health Organization (WHO) and Uganda-specific planning thresholds has been limited. We described national and sub-national trends for four tracer antigens to inform supply-chain planning and forecasting. Methods We conducted a retrospective descriptive analysis of routinely reported immunisation data from Ugandas District Health Information Software 2, 2020-2025. We analysed Bacille Calmette-Guerin (BCG), measles-rubella (MR), oral polio vaccine (OPV), and diphtheria-tetanus-pertussis-containing vaccine (DPT). Vaccine wastage was calculated as the proportion of issued doses not administered. Annual wastage rates were summarised using medians, and temporal trends were assessed using the Mann-Kendall test. Observed wastage was compared with WHO thresholds: BCG[≤]50%, MR[≤]25%, OPV[≤]10%, DPT[≤]15%, and Ugandas planning thresholds: BCG[≤]70%, MR[≤]40%, OPV[≤]15%, DPT[≤]10%. Effective Vaccine Management reports were reviewed to summarise reported reasons for wastage. Results During 2020-2025, median national wastage was 40.6% for BCG, 25.9% for MR, 10.0% for OPV, and 9.2% for DPT. OPV wastage declined from 12.8% in 2020 to 8.0% in 2025, with a significant downward trend ({tau}b=-1.00; p=0.008). OPV and DPT wastage remained largely within their respective Uganda in-country thresholds ([≤]15% and [≤]10%) for most of the study period, while BCG generally remained below the WHO threshold ([≤]50%) and MR frequently exceeded the WHO threshold ([≤]25%) but remained within Uganda's planning threshold ([≤]40%) in most years. The proportion of districts exceeding both WHO and Uganda thresholds declined for OPV from 36.3% to 5.5% (p=0.024) and for DPT from 22.6% to 1.4% (p=0.013). Wastage was consistently higher in lower-level (Health Centre II and III) facilities, compared to hospitals. Among 50 service delivery points, reported reasons included low session attendance (66%), multi-dose vial policy non-compliance (28%), and vaccine expiry (12%). Conclusion Uganda achieved reductions in OPV wastage and district-level improvements in DPT wastage, while BCG and MR remained more variable and frequently had higher wastage. Strengthening adherence to the multi-dose vial policy and improving session planning at lower-level facilities could strengthen vaccine utilisation and forecasting.

22.
medRxiv (Medicine) 2026-06-23

Socioeconomic Determinants of Guideline-Concordant Therapy for Early-Stage Non-Small Cell Lung Cancer: A Population-Based Analysis from Appalachian and Non-Appalachian Ohio, 2004-2015

Purpose: To examine the relative contributions of insurance, county-level poverty, and other socioeconomic factors, as compared with Appalachian geography, to receipt of guideline-concordant therapy for early-stage non-small cell lung cancer (NSCLC) in Appalachian and non-Appalachian Ohio. Methods: Retrospective population-based cohort study using the Ohio Cancer Incidence Surveillance System. We identified adults diagnosed with early-stage NSCLC between 2004 and 2015 (N=26,756). The primary outcome was receipt of guideline-concordant local therapy (surgery or definitive radiation). Rural-urban classification used USDA Rural-Urban Continuum Codes. Multivariable logistic regression and Cox proportional hazards models assessed predictors of treatment and survival, with E-values, race-stratified models, and propensity score weighting as sensitivity analyses. Findings: Median age was 71 years; 50.3% were male, 83.8% non-Hispanic White, and 20.4% Appalachian. Overall, 83.6% received guideline-concordant local therapy (59.6% surgery, 24.0% radiation). In adjusted analysis, Medicaid (adjusted odds ratio [OR] 0.53, 95% confidence interval [CI] 0.44-0.63; adjusted risk ratio [RR] 0.94, 0.91-0.96), county-level poverty >20% (OR 0.77, 95% CI 0.68-0.87; RR 0.96, 0.95-0.98), and unmarried status were independently associated with lower therapy receipt, whereas Appalachian residence was associated with modestly higher receipt (OR 1.17, 95% CI 1.06-1.29; RR 1.02, 1.01-1.04). Therapy rates converged across regions over the study period (year x Appalachian interaction p20% (HR 1.13, 95% CI 1.07-1.20). Conclusions: Socioeconomic factors, particularly Medicaid insurance and county-level poverty, were the patient characteristics most strongly associated with lower receipt of guideline-concordant therapy, whereas Appalachian residence was not a barrier. Findings support targeted interventions addressing insurance-related and poverty-related barriers to lung cancer care in high-poverty communities regardless of geographic designation.

23.
arXiv (CS.LG) 2026-06-19

PaAno+: Multiscale Encoding and Cross-Variable Attention for Time Series Anomaly Detection

arXiv:2606.20055v1 Announce Type: new Abstract: Time-series anomaly detection has significant practical value for industrial and medical monitoring, as well as other critical domains. Current Transformer- and large-model-based detection approaches incur excessive computational overhead, while existing lightweight alternatives are constrained by insufficient feature extraction and inadequate modeling of dependencies across multivariate variables. To mitigate the above drawbacks, this study develops a lightweight, efficient anomaly detection model, dubbed PaAno, within the patch-oriented representation learning paradigm. In the encoder module, a multiscale feature-extraction backbone is constructed using convolutional kernels with differentiated receptive fields to capture hierarchical temporal characteristics; subsequent cross-scale adaptive attention aggregation, combined with residual connection optimization, further stabilizes feature representation learning. A cross-variable fusion attention module is embedded to explicitly characterize inter-variable correlations, empowering the model to identify anomalous patterns amid intricate operational conditions. Moreover, a novel pretext task based on temporal patch-window sorting is customized to uncover intrinsic structural properties of time series, and triplet loss is leveraged to optimize the patch embedding space for enhanced feature discrimination. Extensive experiments on the TSB-AD benchmark demonstrate that the proposed PaAno achieves state-of-the-art detection accuracy on both univariate and multivariate tasks, yielding significant performance gains across evaluation metrics, including VUS-PR, relative to the original PaAno. Leveraging a compact network design, the presented model achieves favorable computational efficiency, enabling deployment on resource-limited terminals for real-time anomaly inference.

24.
medRxiv (Medicine) 2026-06-16

Enteral docosahexaenoic and arachidonic acid supplementation and retinopathy of prematurity: a re-analysis of randomized controlled trials in preterm infants

Background. A recent meta-analysis by Dang et al. [1] concluded that enteral supplementation with docosahexaenoic acid (DHA), with or without arachidonic acid (ARA) did not significantly affect retinopathy of prematurity (ROP) outcomes in preterm infants. Of four eligible trials that supplemented both DHA and ARA, only two contributed to each ROP outcome analyzed, and severe ROP was not assessed. Methods. We replicated the eligibility criteria and search strategy of Dang et al., restricted to trials that supplemented both DHA and ARA, and reanalyzed three ROP endpoints (any ROP, ROP requiring treatment, and severe ROP [stage 3 and/or treated]) using complete outcome records from all eligible trials. Crude risk ratios (RR) were pooled by Mantel-Haenszel fixed-effect meta-analysis. Gestational age-adjusted odds ratios (adjOR) were pooled on the log scale by inverse-variance random-effects meta-analysis with restricted maximum likelihood (REML) estimation of between-study variance and Hartung-Knapp confidence intervals. Results. Five trials were included; one trial was identified in our replicated search but was excluded by Dang et al. without a stated rationale. The pooled estimate for any ROP was consistent with Dang et al. (RR 0.87 [95% CI 0.71-1.08]; adjOR 0.70 [0.46-1.08]). For ROP requiring treatment, the crude RR suggested a lower risk but did not reach statistical significance (RR 0.60 [0.35-1.04]), whereas the gestational age-adjusted estimate indicated lower odds (adjOR 0.47 [0.23-0.94]). For severe ROP, DHA+ARA supplementation produced a significant protective effect in both unadjusted and adjusted models (RR 0.56 [0.36-0.86]; adjOR 0.42 [0.19-0.96]). Conclusions. When all eligible trials contribute to each endpoint and severe ROP is included as an outcome, enteral DHA+ARA supplementation reduces severe ROP and is associated with lower odds of ROP requiring treatment after adjustment for gestational age. These findings differ from the conclusions of Dang et al. and support reconsideration of DHA+ARA supplementation as a strategy to reduce sight-threatening ROP in preterm infants.

25.
medRxiv (Medicine) 2026-06-18

Biomedical Capacity, Governance, and Health Security: A Dominican Republic Research Analysis of Stakeholder Perspectives

The COVID-19 pandemic exposed critical vulnerabilities in globally concentrated biomedical supply chains and accelerated interest in nearshoring and hemispheric health-security strategies. The Dominican Republic, already the third-largest medical device exporter in Latin America, occupies a strategically significant but institutionally constrained position within this realignment. This study evaluates stakeholder perceptions of the principal opportunities and barriers affecting biomedical ecosystem development in the Dominican Republic, with particular attention to governance, workforce capacity, and value-chain upgrading pathways. Methods. A concurrent mixed-methods design was employed, integrating a cross-sectional electronic survey of 142 purposively sampled domain experts (administered September-December 2025) with a qualitative executive consultation with senior government and industry leaders. Survey analyses combined descriptive statistics, one-sample t-tests against the scale neutral midpoint, chi-square goodness-of-fit tests, Friedman non-parametric ranking, Spearman rank correlations, and exploratory linear and logistic multivariable regression. Qualitative responses were analyzed using a framework approach grounded in the Triple Helix model of innovation systems. Results. Perceived government support was significantly below neutral (mean = 2.67, SD = 1.12; p = 0.034). Workforce shortages (83.3%) and weak academia-industry collaboration (71.4%) were the most frequently endorsed barriers ({chi}2(5) = 18.7, p = 0.002). Regulatory modernization (88.1%) and workforce development (85.7%) ranked as the highest-priority policy levers (Friedman p = 0.005). Clinical trials and contract research organization services were the dominant sub-sector priority (76.2%, binomial p < 0.001). In multivariable analysis, perceived government support, talent availability, and confidence in IP protection jointly explained 46% of the variance in sector competitiveness (R2 = 0.46, p < 0.001). Strong majority support existed for a formal public-private biomedical coordination authority (73.8%, p < 0.001).Conclusion. Institutional credibility and advanced human capital–rather than geography or market access–are the perceived binding constraints on the Dominican Republics biomedical trajectory. Regulatory modernization, targeted workforce investment, and the establishment of a national biomedical coordination authority represent the highest-leverage interventions for positioning the country as a hemispheric hub for biomedical manufacturing, clinical research, and health security.