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The clinical utility of functional testing in fibroblasts to diagnose primary mitochondrial disease

Genome sequencing of the heterogeneous primary mitochondrial disorders (PMD) frequently reveals variants of uncertain significance that require functional tests for diagnosis, and does not identify variants in all patients. We analyzed mitochondrial enzyme assays, blue native polyacrylamide gel electrophoresis (BN-PAGE) with in-gel activity staining, complex I assembly blot, and select protein abundances in fibroblasts of a case series of 204 PMD patients divided into functional classes, in comparison to 51 controls and 53 differential diagnostic conditions. Overall, sensitivity and specificity for respiratory chain enzyme assays were 46% and 93% respectively, for BN-PAGE 40% and 98%, for complex I assembly assay 49% and 99%. The overall sensitivity of all tests was 76%, specificity 93%, with positive predictive value 96% and negative predictive value 67%. Categories with high sensitivity were isolated complex deficiencies, nuclear DNA-encoded mitochondrial protein synthesis defects, co-factor defects, and mitochondrial amino-acyl-tRNA synthetase conditions when aided by protein abundance. Mitochondrial DNA mutations and maintenance disorders showed poor sensitivities. Secondary dysfunctions were rare. A complete battery of functional tests showed strong diagnostic clinical utility in fibroblasts.

Informative Missingness to Generate Irregular Clinical Time Series

arXiv:2606.17106v1 Announce Type: new Abstract: Laboratory tests in electronic health records are collected irregularly, and the absence of a test order can be as informative as the measurement itself. Such missingness reflects clinicians' decisions and patient physiology, making it important to model it directly rather than treat it as a preprocessing artifact. Here we present a diffusion-based approach for generating clinical time series that jointly models laboratory values and their observation patterns using the public Data Analytics Challenge on Missing Data Imputation (DACMI) benchmark derived from MIMIC-III. To preserve realistic sampling, we align chart times into 4-hour intervals and segment admissions into 7-day windows, producing trajectories that pair each lab value with a corresponding observation indicator. Standard transformations and normalization are applied to stabilize training. Our method extends the TimeDiff framework to learn continuous lab values and discrete missingness patterns through complementary diffusion objectives. Experiments show that the generated data closely match real patient trajectories across individual lab distributions and joint value-missingness embeddings, demonstrating that diffusion models can capture clinically meaningful dependencies between patient physiology and clinicians' testing behavior under MNAR-like (missing-not-at-random) missingness. These preliminary results indicate that our model can serve as an initial component toward developing clinical foundation models. By producing synthetic priors that preserve key physiology-missingness relationships, this work motivates the subsequent training of Prior-Data Fitted Networks capable of leveraging informative missingness, which we will investigate in the extended work.

Why Commodity WiFi Sensors Fail at Multi-Person Gait Identification: A Systematic Analysis Using ESP32

WiFi Channel State Information (CSI) has shown promise for single-person gait identification, raising interest in its use for contactless biometrics, continuous authentication, and passive identification. However, the feasibility of multi-person identification on low-cost commodity devices remains unclear. A critical question is whether weak multi-person performance is primarily an algorithmic limitation, or whether it reflects a more fundamental sensing ceiling on commodity WiFi hardware. We address this question through a systematic empirical study using commodity ESP32 WiFi sensors. We evaluated six different signal separation methods–FastICA, SOBI, PCA-ICA, NMF, Wavelet, and Tensor decomposition–across seven scenarios spanning 1-10 people in both controlled and realistic indoor environments. To investigate beyond classification accuracy, we introduce three diagnostic metrics: intra-subject variability (ISV), inter-subject distinguishability (ISD), and performance degradation rate (PDR). In all methods, performance remains moderate (39%-56% accuracy), with limited evidence that algorithmic choice alone solves the problem. The best-performing method, NMF, reaches 56% accuracy, while all methods exhibit extremely high feature-space overlap (97%-99%), unstable within-subject representations, and marked environmental sensitivity. These findings suggest that, under commodity ESP32 CSI constraints, dense multi-person gait identification is limited more by sensing quality and spatial diversity than by the chosen separation algorithm. Our results have direct implications for security and privacy: they call into question the practicality of commodity WiFi CSI as a robust multi-user biometric primitive for authentication, while also placing important bounds on the passive identification capabilities achievable with low-cost off-the-shelf WiFi hardware.

ROAD-VLA: Robust Online Adaptation via Self-Distillation for Vision-Language-Action Models

arXiv:2606.25800v1 Announce Type: new Abstract: Effective online adaptation of vision-language-action (VLA) models remains challenging, as sparse rewards provide weak supervision for high-dimensional autoregressive action policies. Although self-distillation can in principle provide denser training signals, we find that text-based privileged teachers conditioned on demonstrations, retrieved experiences, or high-level plans are ineffective for VLA adaptation, exposing a modality gap between symbolic guidance and low-level robot actions. We propose ROAD-VLA, an advantage-guided self-distillation framework that constructs a proximal teacher directly in action space by perturbing action-token logits with calibrated advantage estimates. This converts sparse rewards into dense token-level supervision while keeping the teacher close to the current policy. We further derive a policy-improvement lower bound under calibrated advantages and accurate teacher matching. Across seven robotic manipulation environments with in-distribution and out-of-distribution shifts, ROADVLA outperforms PPO in nearly all settings, demonstrating robust online VLA adaptation.