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Validating an Early Pregnancy HbA1c as the Screening Test for Gestational Diabetes Mellitus: Findings from PRISMA Pakistan Cohort

Background: Early identification of gestational diabetes mellitus (GDM) is critical to improving maternal and neonatal outcomes, particularly in resource-constrained settings where universal oral glucose tolerance testing (OGTT) is burdensome. We assessed whether early-pregnancy HbA1c alone or combined with common risk factors can predict GDM and reduce the burden of OGTT requirements in a peri-urban cohort in Karachi, Pakistan. Methods: We conducted a secondary analysis of the Pregnancy Risk Infant Surveillance and Measurement Alliance (PRISMA) Pakistan cohort. Women enrolled before 20 weeks' gestation with available early-pregnancy HbA1c and a 2-hour 75g OGTT at 24 to 28 weeks were included. We externally validated GDM prediction models originally developed in the STRiDE-India cohort. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). We assessed four models: HbA1c alone (Model 1a); age, BMI, and family history of diabetes mellitus (FH DM) (Model 1b); HbA1c combined with age, BMI, and FH DM (Model 2); and an extended model, i.e., Model 2 combined with socioeconomic status, gestational age, parity, systolic and diastolic blood pressure (Model 3). A dual-threshold approach was applied to assess rule-in and rule-out performance. Results: Among 2,489 women, GDM incidence was 7.5% (n=186). Models with a broader set of predictors demonstrated higher AUC values, with Model 2 achieving an AUC of 0.61 (95% CI: 0.57, 0.66). Including additional factors (Model 3) did not further improve predictive ability (AUC: 0.62; 95% CI: 0.58, 0.66). In addition, at predefined thresholds, Model 2 achieved sensitivity of 73.7% (rule-out) and specificity of 83.5% (rule-in), with the potential to reduce OGTT requirements (58.5%). Conclusions: Early-pregnancy risk stratification using HbA1c combined with simple clinical predictors offers a pragmatic approach to streamline GDM screening among high-risk pregnant women. A dual-threshold strategy using Model 2 could reduce reliance on universal OGTT while prioritizing high-risk women for confirmatory testing.

A Layered Security Framework Against Prompt Injection in RAG-Based Chatbots

Prompt injection is ranked as the most critical vulnerability in large language model (LLM) deployments by the OWASP Top 10 for LLM Applications, yet existing defenses operate at isolated pipeline stages and remain incomplete. Input filters cannot inspect retrieved documents, while output monitors cannot prevent malicious payloads from reaching the model. Consequently, retrieval-augmented generation (RAG) chatbots remain vulnerable to indirect injection, where a poisoned knowledge-base document compromises every user whose query retrieves it. We present a three-layer framework that intercepts both direct and indirect prompt injection throughout the inference pipeline. Layer 1 screens user input using a rule-based pattern library and a fine-tuned semantic anomaly classifier. Layer 2 enforces a provenance-based instruction hierarchy during context assembly, preventing retrieved content from overriding operator policy. Layer 3 audits model output using a policy rule engine and semantic drift detector before delivery. A continuous audit loop aggregates structured logs and supports retraining to adapt the classifier to emerging attack patterns. The framework is model-agnostic and deploys as middleware without modifying the underlying LLM. Evaluation on 5,080 samples across GPT-4o, Llama 3, and Mistral 7B shows that the framework reduces Attack Success Rate (ASR) from 71.4\% to 11.3\%, outperforming the best single-layer baseline by 27.3 percentage points and a published guardrail system by 23.8 percentage points, while maintaining a 4.8\% false positive rate and a median latency overhead of 61.2 ms. Ablation studies confirm that all three layers provide complementary protection and that their combined effect exceeds the sum of individual contributions.

Quantum thermodynamics, quantum correlations and quantum coherence in accelerating Unruh-DeWitt detectors in both steady and dynamical state

arXiv:2512.18123v2 Announce Type: replace Abstract: We investigate the interplay between quantum thermodynamics, quantum correlations, and quantum coherence within the framework of the Unruh-DeWitt (UdW) detector model. By analyzing both the steady and dynamical states of various quantum resources (including steerability, entanglement, quantum discord, and coherence), we study how these resources evolve under Markovian and non-Markovian environments. Furthermore, we investigate the impact of both the Unruh temperature and the energy levels on three key quantum phenomena: thermodynamic evolution, quantum correlations, and quantum coherence, considering different initial state preparations. The hierarchical structure relating quantum correlations and quantum coherence is determined. We further examine the thermodynamic performance of a quantum heat engine, highlighting the influence of memory effects and classical correlations on heat exchange, work extraction, and efficiency. Our results reveal that non-Markovian dynamics can enhance the preservation of quantum correlations and improve the engine's efficiency compared to purely Markovian regime. These findings provide insights into the role of quantum correlations and quantum coherence in quantum thermodynamic processes and open avenues for optimizing quantum devices operating in relativistic or open-system settings.

Standardized Methods and Recommendations for Green Federated Learning

arXiv:2602.00343v2 Announce Type: replace-cross Abstract: Federated learning (FL) enables collaborative model training over privacy-sensitive, distributed data, but its environmental impact is difficult to compare across studies due to inconsistent measurement boundaries and heterogeneous reporting. We present a practical carbon-accounting methodology for FL CO2e tracking using NVIDIA NVFlare and CodeCarbon for explicit, phase-aware tasks (initialization, per-round training, evaluation, and idle/coordination). To capture non-compute effects, we additionally estimate communication emissions from transmitted model-update sizes under a network-configurable energy model. We validate the proposed approach on two representative workloads: CIFAR-10 image classification and retinal optic disk segmentation. In CIFAR-10, controlled client-efficiency scenarios show that system-level slowdowns and coordination effects can contribute meaningfully to carbon footprint under an otherwise fixed FL protocol, increasing total CO2e by 8.34x (medium) and 21.73x (low) relative to the high-efficiency baseline. In retinal segmentation, swapping GPU tiers (H100 vs.\ V100) yields a consistent 1.7x runtime gap (290 vs. 503 minutes) while producing non-uniform changes in total energy and CO2e across sites, underscoring the need for per-site and per-round reporting. Overall, our results support a standardized carbon accounting method that acts as a prerequisite for reproducible 'green' FL evaluation. Our code is available at https://github.com/Pediatric-Accelerated-Intelligence-Lab/carbon_footprint.