Nepal’s new science ministry must strengthen scientific capacity
Letter to the Editor
Academic Intelligence · Curated Daily
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Letter to the Editor
arXiv:2601.00921v3 Announce Type: replace-cross Abstract: Chronic obstructive pulmonary disease (COPD) affects hundreds of millions of people worldwide, and skeletal-muscle dysfunction is clinically important. Quantum machine learning is increasingly explored for biomedical prediction, but its value in small biomarker cohorts requires benchmarking against strong classical baselines. We analysed a cigarette-smoke COPD cohort of 213 animals with blood and bronchoalveolar-lavage biomarkers to predict tibialis anterior muscle weight, muscle quality, and force. We developed a kernel-geometric quantum hybrid method in which synthetic symmetric positive definite (SPD) references are mapped through a reproducing kernel Hilbert space, compressed using train-only random projection, normalised, and supplied to low-dimensional quantum regression circuits. We benchmarked this approach against classical ridge/kernel models, SPD relational representations, and quantum-kernel regression (QKR). All methods were evaluated using condition-stratified repeated cross-validation. The largest numerical improvement was observed for muscle weight, where the proposed method had the numerically lowest mean root mean squared error (RMSE), approximately 1.8% below the best classical comparator; paired fold-level testing did not establish statistically significant superiority after Holm adjustment, but the endpoint is biologically meaningful. The method also had the numerically lowest mean RMSE for muscle quality. For force, biomarker-only Ridge performed best, suggesting a more linear endpoint structure.
The clinical and molecular heterogeneity observed in amyotrophic lateral sclerosis (ALS) presents a challenge for diagnosis, prognosis, and treatment. RNA sequencing of post-mortem brain samples from ALS patients has identified several subtypes with distinct molecular signatures. We sought to evaluate these subtypes across diverse tissues and datasets and assess the feasibility of supervised machine learning models for sample classification. Unsupervised clustering and pathway analysis were performed to confirm the presence of ALS subtypes in motor cortex samples. Three machine learning strategies were then used to create models based on post-mortem motor cortex expression data of 112 people with ALS from the London Neurodegenerative Diseases Brain Bank. These models were subsequently improved through feature selection and evaluated in independent cohorts from motor cortex (n = 257, NYGC ALS Consortium) and blood (n = 96, Macquarie University Neurodegenerative Disease Biobank) samples. Multi-class linear discriminant analysis (LDA) models were then used for subtype classification. Clustering of ALS post-mortem motor cortex samples confirmed the presence of three subtypes: neuroinflammation (ALS-Neu), extracellular matrix organisation and muscle contraction (ALS-OxA), and synaptic and neuropeptide signalling (ALS-SNs). Among all machine learning strategies, random forests produced the most accurate and stable models for binary classification (~93% accuracy across the three subtypes). After feature selection, random forest models were able to classify samples from an independent post-mortem motor cortex cohort in their respective subtypes (AUC of ~0.98 across the three subtypes). When these models were evaluated in blood using LDA, we found consistent clustering patterns, with samples aligning in the same subtype regions of the post-mortem motor cortex samples, with ALS-SNs being the subtype in which samples were classified with the highest confidence (LDA class probability ~86%). Moreover, classification for this subtype improved when blood samples were collected closer to death. Our findings support the presence of three gene expression-based ALS subtypes in motor cortex samples and the utility of machine learning strategies for subtype classification. We also observed that the subtypes identified in the brain partially match those in the blood, with samples from the late stages of the disease more likely to be correctly predicted into the ALS-SNs cluster. This suggests a longitudinal effect in subtype identification that requires further investigation.
Despite its high prevalence and the discovery of hundreds of genetic associations, the genetic determinants and heterogeneous manifestations of asthma remain incompletely understood. Incorporating polygenic risk scores (PRS) into asthma research offers a powerful approach to quantify inherited susceptibility, refine risk profiles, and advance mechanistic understanding of disease development. For this study, we leveraged whole-genome sequencing (WGS) data from two family-based cohorts of childhood asthma - the Genetics of Asthma in Costa Rica Study (GACRS) and the Childhood Asthma Management Program (CAMP) - to examine the transmission profiles of externally derived asthma PRS and their associations with clinical phenotypes in children with asthma. To further elucidate molecular mechanisms, we integrated large-scale external genome-wide association study (GWAS) summary statistics and genetic prediction models of protein abundance in a two-step proteome-wide association study (PWAS) of asthma. Our findings provide robust evidence supporting the validity of externally derived asthma PRS (asthma PRS association p-value p={10}^{-24} [GACRS and CAMP trios combined] for the Global Biobank Meta-analysis Initiative [GBMI]) and reveal consistent associations with spirometry measures and atopy markers across both studies, as 13 of 21 traits (62%) were significantly associated with the GBMI-PRS in the meta-analysis after multiple-testing correction. Moreover, the results of the integrative proteomic analysis implicate IL-1 signaling in the etiology of asthma, reinforcing the candidacy of IL1R1 antagonists for drug repurposing.
arXiv:2606.12058v1 Announce Type: cross Abstract: Attention is the key mechanism underlying in-context learning in transformers, and attention patterns have been observed empirically to emerge abruptly during training. We present a Bayesian theory of feature learning in attention; we then focus on how the copy subcircuit in the first layer of an induction head is learned by analyzing a single-layer softmax attention network trained on a copy task. We derive a closed-form posterior over the attention matrix and reduce it to a low-dimensional order parameter space. This reduction reveals a phase transition in the amount of training data, which we verify using both Bayesian sampling and standard training with Adam. We contrast our results with linear attention and find that softmax attention exhibits a first-order phase transition while in linear attention an initial second-order phase transition is followed by a smooth, continuous evolution toward the structured attention pattern (crossover). Our work provides a first-principles theoretical account of the abrupt emergence of the copy subcircuit, reminiscent of the one observed in training large language models.
The South Africa National Department of Health have set ambitious targets to scale up TB testing, focusing primarily on clinic attendees. In the context of declining funding for TB care and prevention, the most cost-effective approaches for targeting testing should be identified. We developed a mathematical model of TB in South Africa, explicitly incorporating clinic attendance by sex and HIV/ART status. We simulated six screening approaches over 2026-2035 (individually and in combination): three clinic-based (symptom screening, intensified targeted universal TB testing [TUTT, symptom-agnostic sputum testing of clinic attendees in key risk groups], and intensified TUTT allowing saliva samples) and three targeted community-based (community radiographic screening, symptom screening, and universal Xpert Ultra testing), each implemented at a range of coverage levels. Model outputs were combined with a mechanistic cost function to estimate potential impact and cost-effectiveness from a societal perspective. The most cost-effective standalone approach was community radiographic screening at 10% annual population coverage, with an incremental cost-effectiveness ratio (ICER) of $421 per disability-adjusted life year (DALY) averted. 10/11 scenarios along the expansion path included community radiographic screening at progressively higher coverage, combined with a clinic-based approach. Combining complementary approaches to reach both groups at increased risk of TB (e.g. clinic-based screening) and groups with lower screening coverage (e.g. community-based screening) may increase cost-effectiveness of TB screening, compared to standalone approaches. When designing TB screening strategies, both population risk and existing screening coverage should be considered.
arXiv:2601.05746v2 Announce Type: replace Abstract: Recent years have witnessed the rapid development of Large Language Model-based Multi-Agent Systems (MAS), which excel at collaborative decision-making and complex problem-solving. Researchers have further investigated Multi-Agent Debate (MAD) frameworks, which enhance the reasoning and collaboration capabilities of MAS through information exchange and debate among multiple agents. However, existing approaches often rely on unguided initialization, causing agents to adopt identical reasoning paths that lead to the same errors. As a result, effective debate among agents is hindered, and the final outcome frequently degenerates into simple majority voting. To solve the above problem, we introduce Dynamic Multi-Agent Debate (DynaDebate), which enhances the effectiveness of multi-agent debate through three key mechanisms: (1) Dynamic Path Generation and Allocation, which employs a dedicated Path Generation Agent to generate diverse and logical solution paths with adaptive redundancy; (2) Process-Centric Debate, which shifts the focus from surface-level outcome voting to rigorous step-by-step logic critique to ensure process correctness; (3) A Trigger-Based Verification Agent, which is activated upon disagreement and uses external tools to objectively resolve deadlocks. Experiments show that DynaDebate achieves superior or highly competitive performance across the majority of benchmarks\footnote{The code is at https://github.com/nwpuLee2021/brianstorm.}.
This study examines how deficiencies in one brain connectome modality propagate to the other, using the Krakencoder as a simulation framework. Structural and functional connectomes from 702 healthy participants in the Human Connectome Project were analyzed, with the impact of each of the Yeo-7 functional networks assessed separately. Seven scenarios were considered, each involving the removal of a single network while the remaining networks were preserved. The resulting perturbations in cross-modal predictions were quantified using three complementary metrics: KL divergence on eigenvalue spectra, Frobenius norm, and Wasserstein distance. In addition, the persistence of sex-specific information within the predicted connectomes was evaluated. Across all metrics and both prediction directions, the Default Mode Network produced the largest perturbations, whereas the Somatomotor network yielded the smallest. Sex differences in network-level perturbation signatures were subtle, with the best result being an accuracy of 66.09% from connectomes predicted under network-removal conditions. In contrast, connectomes predicted from intact inputs achieved substantially higher sex classification accuracy, reaching up to 84.76%. These findings confirm that full predicted connectomes retain considerably more sex-discriminative information than perturbation-derived signatures alone.
arXiv:2606.09039v2 Announce Type: replace Abstract: This study proposes the Behavioral Protocol Framework (BPF), an entropy-controlled pluralistic alignment framework designed to address two critical challenges in autonomous agent economies: the hivemind effect arising from excessive strategic convergence among agents and the lack of transparency in autonomous decision-making processes. The proposed BPF consists of three core modules: Mentalizing-based Social Intelligence (MbSI) grounded in Theory of Mind (ToM), Pluralistic Alignment (PA), and a Verifiable Execution Kernel (VEK). These modules are organically integrated within a closed-loop architecture that governs the entire lifecycle of agent behavior, from decision-making and execution to verification and feedback. To evaluate the proposed framework, a simulation environment implemented in Python and a Streamlit-based user interface will be developed. Through empirical experimentation, the study aims to examine whether the entropy-control mechanism of the PA module can effectively preserve strategic diversity among agents and mitigate collective convergence, while the VEK module provides a comprehensive and transparent audit trail of the decision-making process. The anticipated results are expected to demonstrate that the proposed framework can simultaneously enhance the stability, efficiency, and trustworthiness of autonomous agent economies. Consequently, this research offers a practical approach for developing robust, transparent, and accountable agent-native economic systems.
Idiopathic pulmonary fibrosis (IPF) is characterized by complex lung architecture and spatially heterogeneous remodeling, which have hindered integrated analysis of cell-intrinsic activity and intercellular communication during disease progression. Here we profiled six IPF lung specimens comprising more than 630,000 cells using the Xenium 5k panel and developed an epithelial-centered neighborhood profiling framework based on the local cellular composition around each epithelial cell. This approach captured fibrosis-associated variation in epithelial niches without requiring predefined histological regions. Pseudo-temporal continuum inference of these profiles reconstructed a continuous axis that reflected the spatial progression of fibrotic remodeling from relatively preserved alveolar regions to fibrotic and airway-like remodeled regions. Within this spatial dataset, we mapped coordinated changes in epithelial states, local microenvironments, epithelial intracellular pathway activities, and directional interactions with neighboring cell types along the same axis. Our findings provide a spatial framework that generates testable hypotheses for progressive epithelial niche remodeling in IPF.
arXiv:2605.10840v3 Announce Type: replace-cross Abstract: We present Clin-JEPA, a multi-phase co-training framework for joint-embedding predictive (JEPA) pretraining on EHR patient trajectories. JEPA architectures have enabled latent-space planning in robotics and high-quality representation learning in vision, but extending the paradigm to EHR data – to obtain a single backbone that simultaneously forecasts patient trajectories and serves diverse downstream risk-prediction tasks without per-task fine-tuning – remains an open challenge. Existing JEPA frameworks either discard the predictor after pretraining (I-JEPA, V-JEPA) or train it on a frozen pretrained encoder (V-JEPA 2-AC), leaving the encoder unaware of the rollout signal that the retained predictor must use at inference; co-training the encoder and predictor under a shared JEPA prediction objective would supply this grounding, but naïve co-training is unstable, with representation collapse and online/target drift causing autoregressive rollout to diverge. Clin-JEPA's five-phase pretraining curriculum – predictor warmup, joint refinement, EMA target alignment, hard sync, and predictor finalization – addresses each failure mode by phase, stably co-training a Qwen3-8B-based encoder and a 92M-parameter latent trajectory predictor. On MIMIC-IV ICU data, three independent evaluations support the framework: (1) latent $\ell_1$ rollout drift uniquely converges ($-$15.7%) over 48-hour horizons while baselines and ablations diverge (+3% to +4951%); (2) the encoder learns a clinically discriminative latent geometry (deteriorating-patient cohorts displace 4.83$\times$ further than stable patients in latent space, vs $\leq$2.62$\times$ for baseline encoders); (3) a single backbone outperforms strong tabular and sequence baselines on multi-task downstream evaluation. Clin-JEPA achieves mean AUROC 0.851 on ICareFM EEP and 0.883 on 8 binary risk tasks (+0.038 and +0.041 vs baseline average).
arXiv:2601.21455v2 Announce Type: replace-cross Abstract: Conformal prediction(CP) has become a cornerstone of distribution-free uncertainty quantification, conventionally evaluated by its coverage and interval length. This work critically examines the sufficiency of these standard metrics. We demonstrate that the interval length might be deceptively improved through a counter-intuitive approach termed Prejudicial Trick(PT), while the coverage remains valid. Specifically, for any given test sample, PT probabilistically returns an interval, which is either null or constructed using an adjusted confidence level, thereby preserving marginal coverage. While PT potentially yields a deceptively lower interval length, it introduces practical vulnerabilities: the same input can yield completely different prediction intervals across repeated runs of the algorithm. We formally derive the conditions under which PT achieves these misleading improvements and provide extensive empirical evidence across various regression and classification tasks. Furthermore, we introduce a new metric interval stability which helps detect whether a new CP method implicitly improves the length based on such PT-like techniques. Code is available at https://github.com/benben-cd/PT-Conformal-Prediction.
arXiv:2606.14784v1 Announce Type: cross Abstract: Understanding human states and interaction dynamics is a core goal of human-computer interaction (HCI). As interaction paradigms become more immersive, virtual reality (VR) has emerged as a powerful platform for studying collaborative work. In such settings, evaluating team collaboration states, including team performance and team resilience, requires continuous and reliable inference of latent team-level cognitive and affective states from multi-modal sensor data, such as speech signals. However, generating ground truth labels for these latent states remains challenging due to sensor-induced noise, contextual variability, and sparse expert annotations. Traditional self-reporting approaches provide only static and delayed measurements and are therefore insufficient for capturing dynamic team processes reflected in continuous speech data. In this work, we propose a large language model (LLM)-driven, agentic inference workflow for automated emotion-related synthetic ground truth generation from streaming speech data in multi-user VR environments. Leveraging the generalization capabilities of LLMs, we use In-Context Learning (ICL) with few-shot demonstrations of paired audio-based samples and their corresponding transcriptions. ICL tends to achieve task adaptation comparable to model fine-tuning while circumventing the computational overhead of parameter updates. To construct informative and robust in-context prompts, we adopt a retrieval-based selection strategy that dynamically identifies relevant audio demonstrations based on similarity in the acoustic feature space.
Multi-center studies are crucial for advancing medical and radiological research. Data exploration, collaboration discovery, and study progress monitoring are essential for maximizing their potential. However, in practice these processes often rely on manual communication and shared tables, which quickly become outdated and hinder efficient coordination in large distributed studies. This highlights the need for dedicated monitoring solutions that provide transparent and up-to-date insights into study progress. We propose a lightweight, open-source monitoring architecture for multi-center studies based on the widely used Grafana-Prometheus stack. The framework collects aggregated monitoring metrics from distributed study sites and visualizes them through configurable dashboards. As a real-world deployment example, the framework is integrated into the medical imaging platform Kaapana and evaluated within a large multi-center research network. By deploying our solution within the Germany-wide RACOON consortium, we demonstrate its ability to enable privacy-preserving data exploration and study progress monitoring across all 38 German university clinics. The monitoring framework supports transparent coordination of distributed research activities and can facilitate more efficient management of large-scale multi-center studies. The source code and Kaapana integration are publicly available at https://github.com/MIC-DKFZ/study-monitoring-kaapana.
arXiv:2606.16987v1 Announce Type: new Abstract: Accurate Harmonized Tariff Schedule (HTS) code classification is essential for customs clearance, duty assessment, trade statistics, and regulatory compliance in maritime logistics. However, exact HTS classification remains challenging because product descriptions are often short, incomplete, or ambiguous, while correct classification depends on hierarchical tariff structures, legal notes, and jurisdiction-specific rules. This paper proposes an agentic large language model (LLM) framework for Canadian 10-digit HTS code classification in smart-port and maritime logistics environments. The framework integrates multi-agent information retrieval, semantic retrieval over official tariff documents, evidence-grounded reasoning, consensus-based validation, element-wise voting across hierarchical code components, confidence estimation, and human-in-the-loop escalation. We evaluate the framework on a private dataset of 3,300 domain-expert-labeled product records collected from logistics and delivery contexts. Experimental results show that exact 10-digit classification remains difficult even for advanced LLMs, with performance decreasing from coarse chapter-level prediction to fine-grained tariff and statistical suffix assignment. These findings demonstrate the need for evidence-grounded, uncertainty-aware, and human-centered classification workflows rather than fully autonomous single-step prediction. The proposed framework supports more interpretable, accountable, and compliance-oriented HTS classification for maritime logistics and smart-port operations. Our code is available at https://github.com/Analytics-Everywhere-Lab/hts.
arXiv:2606.15565v1 Announce Type: cross Abstract: Large Language Models (LLMs) are increasingly being used in museums to as role playing chatbots which let visitors talk to simulated versions of people and artefacts from the past. While such installations can be playful and engaging, they are also problematic because LLMs cannot be trusted to speak truthfully. I identify a fundamental dilemma for the use of LLMs in museum chatbots: LLMs cannot be trusted to tell the truth, and efforts to make them more reliable may ruin that which is attractive about the bots in the first place - their ability to engage in life-like conversation. In response, I propose designing for critical play with LLM-based bots: Designing for playful interactions with bots that are unreliable but still able to represent the past in an adequate and engaging manner - as fictional characters representing historical narratives, styles of discourse, diverse perspectives, humor and satire.
arXiv:2606.17093v1 Announce Type: new Abstract: Learning-based single-shot fringe projection profilometry (FPP) has been studied mostly at close range. The long-range regime (standoff beyond 1 m) remains largely unaddressed: inverse-square intensity falloff lowers fringe signal-to-noise ratio and degrades physical ground truth, the single-shot problem is ill-posed because fringe-order information is absent from one image, and these architectures have not been studied mechanistically. We present a diagnose-repair-verify study using mechanistic interpretability (MI) and conformal uncertainty quantification (UQ) as convergent diagnostics: they agree on one physical failure locus, driving and verifying an architectural repair. On a photorealistic synthetic benchmark (15,600 fringe images, 50 objects at 1.5-2.1 m), a best UNet baseline reaches 14.54 mm object mean absolute error (MAE). Three probes (linear probing, Grad-CAM, flat-plane out-of-distribution test) converge: the baseline solves the task via object-boundary shape priors rather than fringe-phase decoding. We repair this with PhiCalNet, which outputs wrapped phase rather than depth and applies a fixed differentiable calibration layer mapping phase to depth, removing the shape-prior solution from the hypothesis space architecturally rather than by a loss penalty. A physics-informed loss that enforces the same physics as a soft penalty on a depth-regressing network yields no measurable gain, isolating the architecture as the operative factor. PhiCalNet reduces object MAE 3.3x to 4.46 mm; the residual is carried by 0.103% of pixels at the +/-pi wrap discontinuity. Pixel-wise conformal UQ confirms the diagnosis: rejecting the top 5% of object pixels by snapshot disagreement cuts PhiCalNet RMSE by 64% (20.6->7.4 mm) versus 3.5% for the baseline. MI and UQ converge on the same failure locus.
Natural products such as polyketides and nonribosomal peptides (NRPs) are important sources of bioactive compounds, including many antibiotics. Many of them are assembled by modular enzyme complexes and further modified and diversified by tailoring reactions encoded by biosynthetic gene clusters (BGCs). Although natural products and their coding BGCs describe different data modalities of the same biochemical process, a unified language to jointly describe their biochemistry is lacking. Here we introduce a sequence-based representation of the core biosynthesis of modular natural products, which we call primary sequences, that bridges chemical structures and BGCs. We also present RetroMol, an algorithm that parses either natural product structures or their encoding BGCs into their primary sequences of natural product building blocks. RetroMol allows for similarity scoring between natural products and BGCs, enabling the retrieval of compounds, BGCs, and a combination of the two, based on their biosynthetic similarity. This can, for instance, be used to retrieve biosynthetically similar but structurally dissimilar compounds, or link natural products to candidate coding BGCs in large experimental datasets. We demonstrate the latter by rediscovering the nocardichelin B BGC as a proof of principle. We also exemplify the utility of biosynthetic similarity by showing various pairs of biosynthetically similar compounds with low structural similarity. Together, these results establish primary sequences as a shared biosynthetic encoding for natural product comparison and BGC prioritization.
arXiv:2605.15435v2 Announce Type: replace Abstract: Standard deep-learning pipelines usually choose the network architecture before training and keep it fixed throughout optimization. In contrast, a model can also be adapted by editing its structure during training, for example by pruning existing hidden-neuron units or growing new ones. Although growth is appealing for adaptive and continual systems, we show that it is not simply the inverse of pruning. Pruning selects among units that have participated in training from the start, whereas growth inserts new units into an already specialized optimization trajectory. We isolate this insertion problem and show that newborn units are often forward-active but backward-starved: they participate in the forward computation, yet receive much weaker gradient signal than incumbent units. This disadvantage is minor in small MLP benchmarks, but becomes clear in harder image-classification settings with a convolutional trunk. In these settings, \textsc{Grow} can achieve high final accuracy during the structural-editing procedure, while \textsc{Prune} is stronger when performance is averaged over the training trajectory or when the final sparse network is retrained from scratch. Interventions targeting optimizer state, insertion, selection, and trainability show that improving the integration of newborn units can improve adaptive performance, but does not automatically produce better final subnetworks. In continual-learning benchmarks stressing plasticity loss, \textsc{Grow} becomes competitive mainly when new units have enough time to integrate. Together, these results suggest that \textsc{Grow} should be evaluated not only as an architecture-search operator, but as a time-sensitive optimization process whose success depends on insertion stability.
arXiv:2606.17062v1 Announce Type: cross Abstract: Radiology report evaluation must distinguish clinical compatibility from surface similarity, because negation, laterality, or normal-abnormal polarity can reverse a finding. We propose RadSEM (Radiology Sentence-Level Evaluation Metric), a constrained LLM-assisted metric for reference-based evaluation of radiology Findings. RadSEM rewrites reference and generated reports into ordered atomic finding sentences, each expressing one site-finding proposition. It then performs contradiction-constrained many-to-many matching: incompatible pairs such as "effusion" and "no effusion" receive no credit, while compatible granularity differences can receive partial credit. A deterministic stage weights pairs by part-whole and abnormal-detail relationships, counts unmatched findings, and produces an abnormal-focused weighted F1 score. Thus, the LLM supports structured rewriting and local alignment rather than acting as an opaque judge. We evaluate RadSEM with SSREE, a controlled monotonicity stress test built from 2,448 de-identified reports expanded into five graded corruption levels. RadSEM achieves Kendall tau_b of 0.957, all-pairs concordance of 97.8%, adjacent concordance of 95.0%, and strict five-level ordering for 81.9% of reports, outperforming radiology-specific and general text metrics while avoiding the failure in which polarity-inverted reports regain lexical overlap. On the same SSREE set, RadSEM outperforms the Ref-anchored RadSEM-Alt policy, improving adjacent concordance from 90.7% to 95.0% and strict ordering from 67.2% to 81.9%. On a 599-triplet synonym/antonym subset, RadSEM prefers synonyms in 597 cases (99.67%). These results suggest that explicit finding units, contradiction-aware matching, and abnormal-focused deterministic scoring make report scoring more interpretable and sensitive to clinically meaningful errors. Code is available at https://github.com/jdh-algo/RadSEM.
arXiv:2605.01894v2 Announce Type: replace Abstract: It is well known that a binomial $(n,p)$ can be approximated by a Poisson distribution with parameter $np$. The typical approach in undergraduate probability texts is to show a convergence result for the distribution of the binomial as $n$ goes to infinity and $np$ converges to some $\lambda$. In this note we use instead the coupling technique to show a much more general result. Moreover, we only use elementary results from probability.
Background. Three disease-modifying therapies (DMTs) for spinal muscular atrophy (SMA) have been approved since 2016, yet many adults remain untreated. Identifying them depends on ICD-10 codes that capture SMA but do not reliably distinguish it from other related conditions. We examined, in one U.S. health system, both patients' engagement with therapy and the accuracy of the codes used to find them. Methods. We conducted a retrospective chart review of adults in an academic health system identified by SMA-associated ICD-10 codes, with manual adjudication of diagnosis and DMT status. Confirmed SMA-positive, DMT-naive patients were invited to a structured telephone interview on treatment awareness and barriers. Results. Of 60 charts, 22 (36.7%; 95% CI 25.6-49.3%) were appropriately coded for SMA or a related disorder; only 16 (26.7%) had molecularly confirmed SMA. The other 38 (63.3%) were miscoded, spanning spinal and bulbar muscular atrophy, asymptomatic carriers, prenatal screening, and conditions unrelated to SMA. Ten of the 16 confirmed patients (62.5%) were DMT-naive; one was interviewed, one declined, and eight could not be reached. The non-response is itself a finding: the patients least visible to administrative data are the hardest to reach. Conclusions. ICD-10 ambiguity is a barrier to treatment access in adult SMA, as is loss to follow-up. We make two recommendations: continuous documentation-coding alignment that uses natural language processing to verify the genetic precondition, and type-specific SMA codes (subcodes for Types 0-4) anchored on molecular SMN1 confirmation. Together these would support cohort identification, outreach, and evidence generation without adding to clinician burden.
arXiv:2606.12733v1 Announce Type: new Abstract: Privacy auditing provides an important safeguard by estimating the actual information leaked by a model, thus ensuring that theoretical privacy guarantees hold in practice. We study empirical privacy auditing for differentially private (DP) machine learning, focusing on efficient one-run methods for mechanisms such as DP-SGD. Prior one-run approaches threshold training examples or "canaries" into binary membership guesses, which discards useful information. We show that, in the white-box DP-SGD setting, canary-aligned signals naturally form a sequence of random variables whose normalized sum is asymptotically Gaussian. Leveraging this distributional perspective, we develop a DP-auditing framework that leads to tighter privacy lower bounds from a single training run.
Background: Hypertension is a leading modifiable cardiovascular risk factor prominently influenced by health-related social needs (HRSN). Whether detailed information on HRSN can improve identification of hypertension among minoritized women is unknown. Methods: Black and Latina women aged 18-65 years completed the Centers for Medicare and Medicaid Services Accountable Health Communities Screening Tool, assessing 13 HRSN domains. Hypertension was ascertained by a validated EHR-based algorithm or self-report of hypertension. Logistic regression tested associations of HRSN with hypertension. LASSO regression with 10-fold cross-validation was used to derive a poly-social risk score in the training set (random 70%) and tested in the validation set (30%) against a sociodemographic model (age, race, income, education). Results: Among 1302 participants (mean [SD] age 40.1 [11.3] years, 70.4% Black, 44.3% Latina), higher cumulative burden of HRSN was associated with increased odds of hypertension (adjusted odds ratio [aOR] for each additional domain of HRSN: 1.07 [95% CI 1.01-1.14], P=0.02). Food insecurity (aOR 2.30 [1.37-3.87], P= 0.002), lapse in utilities (aOR 1.44 [1.04-1.96], P=0.02), poor concentration (aOR 1.57 [1.13-2.17], P=0.007), and social isolation (aOR 1.77 [1.14-2.73], P=0.01) were associated with hypertension. In the validation set, the poly-social risk score did not improve discrimination for hypertension vs. the sociodemographic model (AUC 0.76 [95% CI 0.71-0.81] vs. AUC 0.80 [0.75-0.85]). Conclusion: In this cross-sectional analysis of Black and Latina women, greater cumulative social disadvantage was associated with hypertension. While inclusion of HRSN did not improve hypertension prediction beyond conventional sociodemographic indices, findings may inform targeted interventions among minorities at cardiometabolic risk.
Glioma segmentation in multiparametric MRI is a critical component of treatment planning. A segmentation model that fails silently on treatment-critical sub-regions represents a patient safety risk that overlap-based metrics such as Dice scores cannot expose. We ask whether voxel-level uncertainty estimation via Monte Carlo (MC) Dropout can reliably identify segmentation errors in clinically critical sub-regions, and whether calibration failure modes are detectable from standard reporting metrics alone. In an empirical two-model case study on 126 BraTS21 patients, we evaluate a high-performance pretrained SegResNet and a locally trained UNet with residual units (UNet-Res). MC dropout preserved segmentation accuracy ($|\Delta Dice|$ $