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01.
medRxiv (Medicine) 2026-06-12

Immunologically Optimized Zmp1 Peptides Reveal a Translational Serological Biomarker Platform for Tuberculosis Diagnosis Across Disease Manifestations

Authors:
Zade↗O. S↗Yandrapally↗Choudhari↗Gaikwad↗A. V↗Panda↗Neela↗V. S. K↗Devalraju↗K. P↗Eedara↗…

Tuberculosis (TB) diagnosis remains challenging, particularly for extrapulmonary TB (EPTB), where invasive sampling, low bacillary burden, and suboptimal sensitivity of nucleic acid-based tests in peripheral specimens hinder timely detection. Here, we report an immunology-driven strategy for biomarker discovery and development of a peptide-based serological assay targeting Mycobacterium tuberculosis zinc metalloprotease-1 (Zmp1). Leveraging fundamental principles of adaptive immunity that antigenic regions containing overlapping B-cell and CD4 T-helper cell epitopes would preferentially generate high antibody titers through linked recognition and cognate T-cell help, we used an immunoinformatics pipeline to identify two nested immunodominant peptide regions within Zmp1 (Mtb-Zp-NT and Mtb-Zp-CT) enriched for overlapping B- and T-cell epitopes. The diagnostic potential of these peptides was evaluated through ELISA-based serological assays. A blinded pilot study (N=137) demonstrated a clear discrimination between active TB and TB-recovered individuals. The assay was subsequently validated in an expanded cohort (N=875) by screening 6,086 individuals, which identified 457 TB-positive cases. The cohort included pulmonary TB (PTB), EPTB, TB-recovered individuals, household contacts, non-specific infections, and healthy controls. Receiver operating characteristic analyses, supported by DeLong and bootstrap comparisons, revealed superior diagnostic performance of the peptide-based assays relative to full-length Zmp1. Mtb-Zp-CT exhibited the highest accuracy (AUC=0.93; specificity >90%), while Mtb-Zp-NT also demonstrated strong discriminatory power (AUC{approx}0.89). These findings establish that the immunologically optimized Zmp1 peptides are highly promising serological biomarkers for TB and EPTB. More broadly, they demonstrate how mechanistically informed epitope selection can accelerate translation of pathogen-specific immune signatures into sensitive, minimally invasive, and potentially point-of-care diagnostic platforms for resource-limited settings.

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02.
arXiv (CS.CV) 2026-06-12

Cascade Classification of Dermoscopic Images of Skin Neoplasms with Controllable Sensitivity and External Clinical Validation

Authors:
Elena S. Kozachok↗Sergey S. Seregin↗Aleksandr V. Kozachok↗Ilya P. Latyshev↗Oleg I. Samovarov↗

Purpose. To compare deep learning architectures and classification schemes for dermoscopic images of skin neoplasms and assess their generalization on transfer from open international datasets to independent clinical datasets of Russian practice. Methods. Four architectures (ViT-B/16, Swin-S, ConvNeXt-S, EfficientNetV2-S) were compared in three schemes: binary (malignant/benign), single-stage four-class (benign, MEL, SCC, BCC), and a two-stage cascade (binary triage, then three-class differentiation MEL/SCC/BCC). All models used ImageNet-pretrained weights and a single augmentation protocol on aggregated open ISIC Archive data, and were evaluated on an internal held-out sample and two clinical datasets (Melanoscope AI mobile system; Sechenov University). Results. Internally the binary stage attains ROC-AUC 0.952-0.966; on Sechenov University it drops to 0.797-0.893, sensitivity to 0.53-0.67, and ECE rises from 0.02 to 0.27-0.39 with underestimation of malignancy, quantifying a generalization gap in ranking and calibration. Paired tests confirm one inter-architecture result on clinical data: the deficit of ViT-B/16 at the binary stage (p

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03.
arXiv (CS.LG) 2026-06-15

Trust but Verify: Mitigating Medical Hallucinations via Post-Hoc Adversarial Auditing and Multi-Agent Feedback Loops

Authors:
Muhammad Osama↗Maheera Amjad↗Zartasha Mustansar↗Arslan Shaukat↗Muhammad U. S. Khan↗

arXiv:2606.14149v1 Announce Type: new Abstract: Large Language Models (LLMs) are increasingly deployed in healthcare settings, yet their tendency to hallucinate poses risks when clinical decisions are involved. This study examine whether LLMs recommend recently banned or withdrawn pharmaceuticals when answering clinical questions and tests an agent-based method for reducing such errors. We developed a five-agent "Trust but Verify" system using a single LLM backbone. To measure regulatory knowledge obsolescence, we created an adversarial dataset of 103 clinical MCQs where historically correct answers now refer to banned substances. This scale ensures statistical significance across various therapeutic classes. We evaluated three open-access model families (GPT-OSS, Llama-3, Falcon-3) under vanilla and agentic conditions. Performance was measured via pointwise score, label accuracy, Hallucination Error Rate (HER), and Component Fidelity (CF) score. We also observed clinical safety regression in proprietary models. In default configurations, all models showed high hallucination rates, consistently selecting banned drugs that matched training data patterns. Our proposed agentic architecture reduced HER by approximately 53% across models. Pointwise scores shifted from -0.25 (unsafe recommendation) toward 0.0 (appropriate refusal). The safety audit intercepted dangerous outputs even when models' parametric knowledge favored the banned substance. The proposed multi-agent framework offers a model-agnostic method for enforcing regulatory compliance that prioritizes patient safety over fluent text generation. Our work demonstrates a practical approach for deploying autonomous AI systems in safety-critical healthcare settings. It shows how real-time regulatory data can be integrated into LLM pipelines to support clinical decision-making.

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04.
arXiv (quant-ph) 2026-06-16

Controlled Quantum Metrology with Anisotropic Heisenberg Spin Interactions under Intrinsic Decoherence

Authors:
S. K. Singh↗Jia-Xin Peng↗Y-J Zhu↗Mohammad Khalid↗

arXiv:2606.16918v1 Announce Type: new Abstract: We theoretically investigate quantum parameter estimation in a two-qubit anisotropic Heisenberg spin system with Dzyaloshinskii-Moriya (DM) interaction in the presence of intrinsic decoherence described by the Milburn model. Using the Quantum Fisher Information (QFI), we study the estimation of both the uniform magnetic field and the DM interaction strength. Analytical expressions for the time-evolved density matrix are obtained and used to explore the effects of exchange anisotropy, intrinsic decoherence, and probe-state preparation on the achievable estimation precision. Our results show that suitable tuning of the anisotropic exchange coupling and the initial entangled state can considerably enhance the estimation performance, with different optimal parameter regimes emerging for magnetic-field and DM-interaction sensing. To better understand the role of quantum resources in metrology, we also examine the behaviour of concurrence, quantum coherence, and von Neumann entropy. Overall, our findings demonstrate that anisotropic Heisenberg spin systems with DM interaction provide a promising and flexible platform for high-precision quantum metrology even in the presence of intrinsic decoherence.

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05.
arXiv (quant-ph) 2026-06-11

Exploring Variational Entanglement Hamiltonians

Authors:
Yanick S. Kind↗Benedikt Fauseweh↗

arXiv:2505.10530v3 Announce Type: replace Abstract: Recent advances in analog and digital quantum-simulation platforms have enabled exploration of the spectrum of entanglement Hamiltonians via variational algorithms. In this work we analyze the convergence properties of the variationally obtained solutions and compare them to numerically exact calculations in quantum critical systems. We demonstrate that interpreting the cost functional as an integral permits the deployment of iterative quadrature schemes, thereby reducing the required number of measurements by more than an order of magnitude even in the presence of noise. We further show that a modified ansatz captures deviations from the Bisognano-Wichmann form in lattice models, improves convergence, improves trainability and provides a cost-function-level diagnostic for quantum phase transitions. Finally, we establish that a low cost value does not by itself guarantee convergence in trace distance. Nevertheless, it faithfully reproduces degeneracies and spectral gaps, which are essential for applications to topological phases.

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

Beyond Rebalancing: Benchmarking Binary Classifiers Under Class Imbalance Without Rebalancing Techniques

Authors:
Ali Nawaz↗Amir Ahmad↗Shehroz S. Khan↗

arXiv:2509.07605v2 Announce Type: replace-cross Abstract: Class imbalance poses a significant challenge to supervised classification, particularly in critical domains like medical diagnostics and anomaly detection where minority class instances are rare. While numerous studies have explored rebalancing techniques to address this issue, less attention has been given to evaluating the performance of binary classifiers under imbalance when no such techniques are applied. Therefore, the goal of this study is to assess the performance of binary classifiers "as-is", without performing any explicit rebalancing. Specifically, we systematically evaluate the robustness of a diverse set of binary classifiers across both real-world and synthetic datasets, under progressively reduced minority class sizes, using one-shot and few-shot scenarios as baselines. Our approach also explores varying data complexities through synthetic decision boundary generation to simulate real-world conditions. In addition to standard classifiers, we include experiments using undersampling, oversampling strategies, and one-class classification (OCC) methods to examine their behavior under severe imbalance. The results confirm that classification becomes more difficult as data complexity increases and the minority class size decreases. While traditional classifiers deteriorate under extreme imbalance, advanced models like TabPFN and boosting-based ensembles retain relatively higher performance and better generalization compared to traditional classifiers. Visual interpretability and evaluation metrics further validate these findings. Our work offers valuable guidance on model selection for imbalanced learning, providing insights into classifier robustness without dependence on explicit rebalancing techniques.

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07.
medRxiv (Medicine) 2026-06-17

Multi-strain Probiotics Alter Gut Microbiota and Estrobolome Pathways in Primary Dysmenorrhea

Authors:
Kiraman↗S. K↗Zakaria↗I. A↗Loh↗S. Y. E↗Norfuad↗F. A↗Abdul Ghani↗N. A↗Ahmad↗H. F↗…

Background: Exact cause of primary dysmenorrhoea is unknown but recent evidence uncovers a potential link between gut dysbiosis and benign gynaecological disorder via disruption of estrobolome. Methods: A randomized controlled trial to investigate the effects of multi-strain oral probiotics on primary dysmenorrhoea has been conducted. This is a secondary analysis comparing the stool microbiome in women with primary dysmenorrhoea and those without (control), and the effects of treatment with probiotics versus placebo. Results: Although microbial richness and evenness were comparable between groups (alpha diversity, p > 0.05), gut microbial community composition differed significantly (Bray Curtis PERMANOVA, p = 0.015), characterised by reduced Bifidobacterium adolescentis and Blautia and enrichment of Faecalibacterium in dysmenorrhoea, alongside condition-specific core taxa. Post-intervention analysis revealed significant shifts in microbial community structure between pre- and post-treatment groups (PERMANOVA, F = 2.11, p = 0.005), with probiotic supplementation inducing more consistent and directed microbiome changes than placebo, without altering alpha diversity (p > 0.05). Functional prediction showed no significant difference in overall beta glucuronidase pathway abundance (p > 0.05); however, dysmenorrhoea was associated with higher abundance of beta glucuronidase producing taxa (MaAsLin2, q < 0.05) that were differentially modulated by probiotic treatment. Conclusion: This discovery provides evidence on the microbial disruption in primary dysmenorrhoea as well as the benefit of probiotics to modulate the intestinal microbiota to improve the condition.

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