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01.

medRxiv (Medicine) 2026-06-17 DOI: HASH:9068ac2a8969f04f7c3a512262cf8695

Postoperative Cognitive Decline in Older Patients with Cardiovascular Disease and Preoperative Mild Cognitive Impairment

Authors:

Mata Gonzalez ↗Gonzalez-Colaco Harmand ↗Prada-Arrondo ↗P. C ↗Dominguez-Rodriguez ↗Barroso ↗Galtier ↗

Objective. Older adults undergoing cardiac surgery may be vulnerable to postoperative cognitive decline. However, no studies have examined postoperative cognitive outcomes in older patients with cardiovascular disease (CVD) according to preoperative mild cognitive impairment (MCI). This study examined 12-month postoperative cognitive outcomes in older CVD patients according to preoperative MCI diagnosis and explored predictors of postoperative cognitive decline. Method. Twenty-two older CVD patients ([≥]65 years) and twenty-five controls were included. Neuropsychological assessment was conducted at baseline in both groups and repeated 12 months after surgery in the CVD group. MCI was diagnosed using current clinical criteria. Postoperative cognitive change was examined across preoperative MCI groups. Results. Fifty percent of patients met criteria for postoperative MCI, showing high diagnostic stability relative to preoperative frequency (45.5%). The preoperative CVD-MCI group showed a decline in working memory, executive functions, visual memory, and naming, whereas CVD-nMCI group declined only in verbal memory. Furthermore, CVD-MCI showed more heterogeneous postoperative cognitive trajectories of change than CVD-nMCI, who showed stability. Estimated IQ, APACHE-II score, and postoperative frailty were important variables in predicting the postoperative pattern. Conclusions. MCI frequency remained high and stable in older CVD patients across the preoperative and one-year postoperative period. However, this apparent diagnostic stability masks subclinical cognitive decline, particularly among patients with preoperative MCI, who showed greater susceptibility to further impairment. Estimated IQ, APACHE-II score, and postoperative frailty may be considered relevant predictors of outcome. These results highlight the value of preoperative neuropsychological assessment for characterizing postoperative cognitive risk in older CVD patients.

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02.

bioRxiv (Bioinfo) 2026-06-18 DOI: HASH:8a4bd15b1bb88e911e6456a6dbab05a5

Calculation of sequence space coverage in a mutagenesis library

Authors:

Florez Prada ↗Uguzzoni ↗Hart ↗D. J ↗

Directed evolution requires screening of large mutagenesis libraries, but accurate calculation of library sizes needed to discover functional variants remains challenging. Existing models provide baseline estimates, yet current computational approaches for finding the best variants scale poorly with library complexity. Here, we introduce a scalable algorithmic framework to compute exact discovery probabilities in saturation mutagenesis libraries with no requirement for explicit sequence enumeration. By aggregating variants into a composition log–sum distribution and applying log-space convolution across randomisation blocks, it is possible to extend this to massive sequence spaces and mixed codon schemes. By inverting these calculations, absolute mathematical ceilings for experimental design are established. Ultimately, this framework provides a rapid, quantitative tool to balance the statistical coverage-diversity trade-off within the limitations of laboratory screening. Finally, this is implemented as an open-source web application (SSCC) that allows researchers to construct heterogeneous library designs and compute required sampling depths, coverage probabilities, and absolute randomisation limits.

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03.

bioRxiv (Bioinfo) 2026-06-11 DOI: HASH:cec7e12def0c3ca8f3ba7de28d5879ea

Integrating Spatially Adjusted Protein Summaries for Survival Prediction in Spatial Proteomics

Authors:

Ahn ↗Oh ↗E. J ↗Prada ↗Shojaie ↗

Recent advances in spatial proteomics, particularly imaging mass cytometry, enable the measurement of protein expression at the single-cell level while preserving a spatial context. Conventional survival analyses, however, typically rely on patient-level averages of protein intensities and therefore overlook spatial heterogeneity and tissue architecture. To address this limitation, we introduce a framework that incorporates spatial information into survival modeling by generating spatially adjusted protein summaries (SAPS). In this approach, cell-level protein intensities within each patient are modeled using spatial spline regression to capture spatial trends. From these models, we extract two complementary features: a spatially adjusted mean expression and a residual variance that reflects cell-to-cell variability unexplained by spatial effects. These summaries are then incorporated into Cox proportional hazards models in combination with clinical covariates. In simulation studies, our proposed framework achieved improved predictive performance compared to other alternative methods. The application of the method to breast cancer imaging mass cytometry data indicate that spatially adjusted summaries may enhance survival prediction and reveal biologically interpretable spatial protein patterns, suggesting high translational potential. This methodology offers an efficient means of translating complex spatial proteomics data into patient-level features, providing both improved survival prediction and new insights into the role of spatial heterogeneity in cancer outcomes.

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