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01.
medRxiv (Medicine) 2026-06-22

Understanding and Usefulness of Effect Size and Certainty of Evidence: A Cross-sectional Survey of Evidence-Based Practice Competencies Among Registered Dietitians

Authors:
Ghosh↗N. R↗Neale↗E. P↗Hand↗R. K↗Ball↗G. D. C↗Riddle↗Klatt↗K. C↗Riviere↗…

Introduction: Understanding of absolute and relative estimates (i.e., effect size), and certainty of evidence corresponding to those estimates, is a fundamental evidence-based practice competency to promote informed clinical decision-making. While research has been conducted in the medical profession, there is no published research on these competencies in the nutrition and dietetics profession. Methods: Among registered dietitians, our main objectives were to assess (1) their understanding and perceived usefulness of three absolute and two relative estimate approaches to assess effect size, (2) their perceived usefulness of certainty of evidence, and (3) factors influencing their understanding and perceived usefulness. We conducted a web-based, cross-sectional survey among dietitians recruited from the Academy of Nutrition and Dietetics (United States). Participants received effect estimates based on hypothetical dietary interventions vs. usual diet for reducing myocardial infarction risk. Results: Of the 11,050 dietitians who received the survey link, 210 participated (2.0% response rate), and only completers (n=114) were included in the analysis. Participants demonstrated a similar understanding of the relative (27.6%) and absolute (27.5%) estimates, with Risk Difference (30.7% correct responses) being the best understood approach and Number Needed to Treat (24.6%) being the least. The understanding of five approaches was not different than random guessing (p>0.05). While perceived usefulness scores were similar between five approaches, they were highest when data was presented as Relative Risk [mean (SD): 4.82 (1.50)]. Dietitians rated the usefulness of certainty of evidence favorably [mean (SD): 5.07 (1.83), on a 7-point scale), and no factors were associated with correct understanding. Conclusion: Dietitians may have limited understanding of how to interpret effect sizes, a finding consistent with surveys of other health professionals. To optimize informed decision-making between dietitians and clients, dietetic programs and continuing education platforms should consider additional training on interpreting effect sizes and certainty of evidence for effect sizes.

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02.
medRxiv (Medicine) 2026-06-22

The impact of changes in age-based eligibility criteria on seasonal influenza vaccine uptake in England between 2019 and 2024: A retrospective cohort study

Authors:
Suffel↗A. M↗Walker↗Barry↗E. V↗Campbell↗C. N↗Lopez Bernal↗J. V↗McDonald↗S. L↗H. I↗…

Objectives: To examine changes in seasonal influenza vaccine uptake among clinical risk groups over periods of differing age-based eligibility. Design: Retrospective cohort study. Setting: Individuals in England registered in the Clinical Practice Research Datalink Aurum. Participants: Between 1,239,802 (2019/20) and 1,289,330 (2023/24) individuals aged 40-69 years in clinical risk groups. Interventions: Natural experiment involving temporary expansion of age-based eligibility for influenza vaccination to include 50-64-year-olds from 2020/21 to 2022/23. Main outcome measures: Influenza vaccine uptake from 1st September to 28th February, incidence rate ratio (IRR) of vaccine uptake across consecutive seasons within age groups, and the ratio of IRRs between age groups. Results: Influenza vaccine uptake increased in all age groups in 2020/21 relative to 2019/20. The increase was larger in individuals aged 50-64 years (13.3%; IRR 1.50, 95% CI 1.50-1.51) compared with those aged 40-49 years (8.3%; IRR 1.35, 95% CI 1.34-1.35) and 65-69 years (6.8%; IRR 1.34, 95% CI 1.33-1.35). From 2020/21 to 2022/23, vaccine uptake decreased, with a more pronounced decline among those aged 40-49 years (-5.4%) compared with age-eligible groups (50-64 years: -3.0%; 65-69 years: -3.1%). The reversion of age eligibility in 2023/24 was associated with a larger decrease in uptake among those aged 50-64 years (-9.6% vs 2022/23; IRR 0.79, 95% CI: 0.79-0.79) compared with those aged 40-49 years (-4.9%; IRR 0.87, 95% CI: 0.87-0.88) and 65-69 years (-3.3%; IRR 0.97, 95% CI: 0.96-0.97). Patterns were broadly consistent across clinical risk groups. Conclusions: The COVID-19 pandemic saw a general increase in seasonal influenza vaccine uptake in clinical risk groups. This increase was larger and more sustained in 50-64 year-olds who had also become eligible based on age. Our findings highlight the potential gains in vaccine coverage among clinical risk groups based on expanded age-based eligibility.

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

Information-Theoretic Measures in AI: A Practical Decision Guide

Authors:
Nikolaos Al. Papadopoulos↗Konstantinos E. Psannis↗

arXiv:2604.23716v2 Announce Type: replace Abstract: Information-theoretic (IT) measures are ubiquitous in artificial intelligence: entropy drives decision-tree splits and uncertainty quantification, cross-entropy is the default classification loss, mutual information underpins representation learning and feature selection, and transfer entropy reveals directed influence in dynamical systems. A second, less consolidated family of measures, integrated information (Phi), effective information (EI), and autonomy, has emerged for characterizing agent complexity. Despite wide adoption, measure selection is often decoupled from estimator assumptions, failure modes, and safe inferential claims. This paper provides a practical decision framework for all seven measures, organized around three prescriptive questions for each: (i) what question does the measure answer and in which AI context; (ii) which estimator is appropriate for the data type and dimensionality; and (iii) what is the most dangerous misuse. The framework is operationalized in two complementary artifacts: a measure-selection flowchart and a master decision table. We cover both AI/ML and decision-making agent application domains per measure, with standardized Bridge Boxes linking IT quantities to cognitive constructs. Three worked examples illustrate the framework on concrete practitioner scenarios spanning representation learning, temporal influence analysis, and evolved agent complexity.

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04.
arXiv (quant-ph) 2026-06-17

Kinematic properties of the Pauli equation

Authors:
E. E. Perepelkin↗B. I. Sadovnikov↗N. G. Inozemtseva↗V. A. Svetovidov↗

arXiv:2606.17548v1 Announce Type: new Abstract: Based on the Wigner-Vlasov formalism, this paper investigates the kinematic properties of the Pauli equation. It is shown that the probability current associated with the Pauli equation can be represented as a superposition of two currents with certain expansion coefficients. Each of these currents corresponds to a particular component of the spinor. The expansion coefficients effectively serve as weighting functions that determine the probability contribution of the corresponding spinor component. Therefore, each spin projection corresponds to its own probability flux. A new system of the Hamilton-Jacobi equations and also a system of motion equations in electromagnetic fields are obtained, taking into account the interaction between the spin and the magnetic field. To illustrate how these equations can be applied we have investigated the quantum system kinematics in detail using an exact solution of the Pauli equation in the presence of a uniform magnetic field and an asymmetric quadratic potential.

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

Tensor Methods: A Unified and Interpretable Approach for Material Design

Authors:
Shaan Pakala↗Aldair E. Gongora↗Brian Giera↗Evangelos E. Papalexakis↗

arXiv:2602.10392v2 Announce Type: replace Abstract: When designing new materials, it is often necessary to tailor the material design to have some desired properties. As the set of design parameters grow, the search space grows exponentially, making the actual synthesis and evaluation of all material combinations virtually impossible. Even using traditional computational methods such as Finite Element Analysis becomes too computationally heavy to search the design space. Recent methods use machine learning (ML) surrogate models to more efficiently determine optimal material designs; unfortunately, these methods often (i) are notoriously difficult to interpret and (ii) under perform when the training data comes from a non-uniform sampling of the design space. We suggest the use of tensor completion methods as an all-in-one approach for interpretability and predictions. We observe classical tensor methods are able to compete with traditional ML in predictions, with the added benefit of their interpretable tensor factors (which are given completely for free, as a result of the prediction). In our experiments, we are able to rediscover physical phenomena via the tensor factors, indicating that our predictions are aligned with the true underlying physics of the problem. This also means these tensor factors could be used by experimentalists to identify potentially novel patterns, given we are able to rediscover existing ones. We also study the effects of both types of surrogate models when we encounter training data from a non-uniform sampling of the design space. We observe more specialized tensor methods that can give better generalization in these non-uniforms sampling scenarios. We find the best generalization comes from a tensor model, which is able to improve upon the baseline ML methods by up to 5% on aggregate $R^2$, and halve the error in some out of distribution regions.

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06.
Nature Medicine 2026-06-08

Apitegromab for lean mass preservation during tirzepatide-induced weight loss: a randomized, double-blind, placebo-controlled phase 2 trial

Authors:
Richard E. Pratley↗

Loss of lean mass in proportion to total weight loss is observed with incretin mimetic therapies such as tirzepatide and has the potential to adversely affect health and function. Apitegromab is an investigational, fully human monoclonal antibody that selectively inhibits myostatin activation and is, thereby, capable of increasing muscle mass. In the randomized, double-blind, placebo-controlled phase 2 EMBRAZE study, adults with overweight or obesity (n = 102) were randomized 1:1 to receive tirzepatide plus apitegromab (10 mg kg−1) or tirzepatide plus placebo. At week 24, apitegromab resulted in a least square mean (80% confidence interval (CI)) of 1.9 (1.2−2.7) kg less lean mass loss than placebo (P = 0.001), despite similar total body weight loss between groups, representing a 54.9% retention of lean mass relative to placebo. In participants receiving apitegromab, trough concentrations of apitegromab and total latent myostatin, a pharmacodynamic marker, both increased over time and reached a plateau after approximately 16 weeks. Incidence of adverse events (AEs) (% (95% CI)) was generally similar across apitegromab-treated participants and placebo-treated participants, with 39 of 51 (76% (63−86%)) and 36 of 51 (71% (57−81%)) participants experiencing an AE, respectively. Serious adverse events (SAEs) were balanced and experienced by one of 51 (2% (0−10%)) participants in each arm. In summary, this proof-of-concept study demonstrated that selective targeting of myostatin by apitegromab was well tolerated and effective in preserving lean mass when combined with tirzepatide. ClinicalTrials.gov identifier: NCT06445075 . In the phase 2 EMBRAZE study, participants receiving tirzepatide and apitegromab lost less lean mass compared to participants receiving tirzepatide and placebo.

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