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Frontiers in Bioinformatics

Frontiers Media SA

Preprints posted in the last 7 days, ranked by how well they match Frontiers in Bioinformatics's content profile, based on 49 papers previously published here. The average preprint has a 0.05% match score for this journal, so anything above that is already an above-average fit.

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Making Accelerating Medicines Partnership Data Findable and Interoperable through a Common Data Model: Extending OMOP for Multi-Source Multimodal Data

Tindall, C.; Long, R. A.; Naughton, B.; Mapes, B. M.; Vismer, D.; Skinner, H. G.; Malenfant, J.; Maurya, M. R.; Nalls, M. A.; Ramachandran, S.; Nguyen, T.; Peters, M. A.; Scheuermann, R. H.

2026-09-02 genetic and genomic medicine 10.64898/2026.08.31.26361831 medRxiv
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SysBio FAIRplex is a Common Fund Venture Program that catalogs and indexes data from the Accelerating Medicines Partnership(R) (AMP(R)) Program through a federated model in which data hosts retain custody of their datasets. The central piece of this work is the SysBio Common Data Model (SysBio CDM). AMP is a precompetitive public-private partnership started in 2014 that unites the resources of NIH and private partners to improve our understanding of disease pathways and transform current models for developing new treatments by: - identifying new targets, biomarkers, and development paradigms; - developing leading-edge tools and technologies; - collecting large-scale datasets and supporting analytics for open analysis by the public; and - generating consensus platforms and procedures. A multidisciplinary Task Force was chartered to design the SysBio CDM by extending the Observational Medical Outcomes Partnership (OMOP) Common Data Model into the -omics domain. The Task Force produced a Minimum Viable Product comprising nine OMOP tables; four extension tables for assay and file metadata; and a Common Data Element (CDE) Registry to specify field semantics. This manuscript describes the deliverable: the underlying design choices, the criteria applied in selecting and constructing the extension tables, how the extended model supports multimodal data integration across AMP projects, and what further work to support additional -omics modalities would entail. As an auxiliary methodology, the paper also describes the AI-assisted CDE harmonization workflow used to populate the model.

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AURORA: Analysing and understanding responses to oncological regimens with artificial intelligence

Lebmeier, A.; Lindner, T.; Karl, C.; Schöler, T.; Rank, A.

2026-09-02 health informatics 10.64898/2026.08.30.26361778 medRxiv
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Background: Immunochemotherapy (ICT) is considered standard in regards to care for small-cell lung cancer (SCLC) in extensive stages, yet reliable biomarkers for treatment response remain elusive. While previous univariate analyses suggest specific peripheral lymphocyte subsets correlate with survival, the systemic immune response involves complex, multivariate interactions that require advanced analytical approaches. Methods: This paper analysed high-dimensional flow cytometry data from 32 patients with stage IV SCLC treated with carboplatin, etoposide, and atezolizumab. Peripheral blood was analysed at baseline (V0) and longitudinally during treatment. To identify potential early predictive biomarkers and mitigate sample attrition in later cycles, we focused on baseline and measurements after two cycles of ICT (V1). We employed a rigorous machine learning framework utilising nested cross-validation, bootstrapping, and permutation-based statistical testing to evaluate eleven different regression and survival models. Results: Under model-appropriate metrics, regressors did not generalise (R2 <0); conversely, censoring-aware Random Survival Forests (RSF) successfully extracted robust prognostic signatures. Baseline immune profiles (V0) achieved a concordance index (C-index) of 0.66 (p= 0.015), while dynamic changes from V0 to V1 ({triangleup}V) achieved a C-index of 0.65 (p= 0.022). Crucially, absolute values measured after two cycles of ICT (V1) yielded no significant signal (p= 0.445). Feature importance analysis confirmed the prognostic value of Th17 normalisation and identified Naive Regulatory T cells and Memory B cells as candidate components. Conclusion: Machine learning validation confirms a predictive signal in the peripheral immune profile of SCLC patients. Early dynamic shifts in the balance between regulatory and effector immune arms are associated with prognosis, contrasting with the lack of signal in absolute counts after two cycles of ICT. These findings establish a proof of concept for multivariate liquid biopsy immune profiling, warranting confirmation in larger cohorts and highlighting the necessity of integrating systemic and tumour-intrinsic data.

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Network-based meta-analysis maps stage-dependent molecular programs in MASLD through MASLD-META NETWORK application

Kumak, E.; Darde, T.; Konu, O.

2026-08-31 bioinformatics 10.64898/2026.08.26.747338 medRxiv
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Metabolic dysfunction-associated steatotic liver disease (MASLD), the leading cause of chronic liver pathologies worldwide, represents a growing clinical burden. Its diagnosis remains reliant on liver biopsy that limits early detection and the ability to capture molecular changes across disease progression. A systematic understanding of stage-dependent gene expression changes is essential to identify biomarkers and effectively characterize disease mechanisms. Therefore recent studies provided databases for searching genes as well as prediction of multi-gene signatures for disease progression. However, there is still a need for interactive and comprehensive meta-analysis of datasets of MASLD patients with available histological metadata. Herein, we performed a meta-analysis of RNA-seq datasets using NAFLD Activity Score (NAS; n = 897) and fibrosis stage (n = 856) upon conducting pairwise comparisons across histological stages and identified differentially expressed genes associated with disease progression. Most importantly, we provide our findings via a dedicated web server, the MASLD-META NETWORK (https://masld.scilicium.com), enabling users to interactively explore meta-analysis results across diverse network modalities. In addition, we characterized gene expression dynamics across increasing disease stages to identify consistent progression-associated pathways using Louvain clustering. Network-based parameters such as centrality in combination with meta-analysis scores further highlighted central genes and pathways implicated in disease mechanisms. Accordingly, MASLD-META NETWORK enabled an integrative reassessment of recently published gene signatures, identifying COL1A1, COL3A1, THBS2, FBLN5, and PDGFA as the most central genes, and SULF2, MMP14, IL32, GPNMB, and COL3A1 as candidate markers of earlier transcriptional alterations. Network analysis of MASLD associated biological modules further identified LAMA2 and LAMA3 as previously unrecognized central candidate targets.

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Toward Transportable Acute Kidney Injury Prediction: An Explainable XGBoost Model with Temporal Validation Using MIMIC-IV

Okundaye, D. O.; Isiekwene, C. C.

2026-09-03 health informatics 10.64898/2026.09.01.26360393 medRxiv
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Acute kidney injury (AKI) is a frequent complication within intensive care units, with its sudden onset often missed. This is especially important because a timely window for intervention is required as delayed detection leads to progressively worse outcomes. Existing machine learning and deep learning models have contributed to closing this gap, but their complexity, requiring hundreds to thousands of features, and lack of generalisation pose a limitation that prevents them from being integrated into clinical workflows across different electronic health-record ecosystems. This study presents a 37-feature XGBoost model trained on the MIMIC-IV dataset with 5.4% positive cases, with hyperparameters optimised via Optuna and probabilities calibrated using isotonic regression, designed for transportability across clinical settings. Validation was conducted internally using a temporal patient-level split simulating prospective deployment, training on 2008-2016 data and testing on 2017-2022 data"External validation was performed on the eICU Collaborative Research Database, a multi-centre dataset spanning 208 US hospitals, using the trained model without retraining. SHAP TreeExplainer was used to provide feature-level explainability for individual predictions. Internal testing yielded an AUROC score of 0.794 for predicting AKI onset within a 12-24 hour window. External validation produced a 0.750 AUROC without retraining. Equitable discrimination was observed across gender, age, chronic kidney disease presence, race, and AKI stages on both datasets, with a 95% internal CI of 0.789-0.799 confirming the model's estimate stability. These results suggest that clinically useful prediction systems are achievable with substantially fewer features than current models require.

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Modeling Joint Reference Regions for Omics Biomarkers in UK Biobank Proteomics

Pusparum, M.; Thas, O.; Ertaylan, G.

2026-09-04 health informatics 10.64898/2026.09.01.26361504 medRxiv
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Conventional univariate reference intervals (UniRIs) are widely used to identify abnormal biomarker values, but they evaluate each biomarker independently and do not account for coordinated deviations between biomarkers. We developed and evaluated a joint reference region (JRR) framework for plasma proteomics data using the Olink proteomics dataset generated by the UK Biobank Pharma Proteomics Project, covering approximately 3,000 plasma proteins. JRRs were estimated for selected protein pairs in a healthy reference subset, while UniRIs were estimated separately for individual proteins using the nonparametric method. Both approaches were then evaluated in ICD-defined disease subsets. Biomarker discovery revealed sparse and heterogeneous disease--protein associations, with some proteins recurring across multiple phenotypes and others showing more disease-specific patterns. The added value of JRRs varied across diseases and protein pairs. Across evaluated protein pairs, 56.5\% showed higher sensitivity under the JRR framework than the UniRI of the first protein, and 47.3\% showed higher sensitivity than the UniRI of the second protein. At the disease level, the median proportion of protein pairs with improved JRR sensitivity was 0.57. JRRs were most informative when univariate detection was limited but a subset of diseased observations was flagged only by the joint region. These findings suggest that JRRs provide a complementary approach to UniRIs by capturing abnormal joint biomarker configurations in high-dimensional proteomics data.

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Mural-VISTA: A tool for mural cell-vessel interaction assessment and multiscale single-cell topo-morphological analysis

Zeng, H.; Hu, M.; Phng, L.-K.; Matsunaga, Y. T.

2026-09-01 bioinformatics 10.64898/2026.08.27.747487 medRxiv
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Three-dimensional (3D) mural cell morphology is heterogeneous and coupled to vessel geometry, however, measurements from two-dimensional (2D) maximum intensity projections (MIP) obscure overlapping processes and cell-vessel contacts. Accordingly, we developed Mural-VISTA, a semi-automated Python workflow for mural cell-vessel interaction and single-cell topo-morphology analysis of reconstructed surface meshes. This workflow integrates mesh pretreatment, interactive centerline extraction, hierarchical segmentation of cell soma, main axis and secondary processes (branches), and extraction of 36 multiscale (cell process segment level, process level, and whole cell level) topo-morphological and vessel-referenced metrics. Mural-VISTA identified morphological changes in pericytes and vascular smooth muscle cells (vSMCs) with altered RhoA activity. Constitutive active RhoA (RhoA CA) over-expression reduced branch complexity and increased process alignment in both cell types, while increased whole-cell and branch solidity only in vSMCs. Dominant negative RhoA (RhoA DN) over-expression increased branch abundance and reduced branch solidity in pericytes but not vSMCs, suggesting cell-type specific effect of reduced RhoA activity. In conclusion, Mural-VISTA enables quantitative 3D profiling of mural cell architecture and its spatial relationship with the vessel.

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Automatic bioinformatic software named entity recognition from literature

Xuan, H.; Pasupuleti, R.; Liu, B.; Sun, H.; Zhang, J.; Yao, Z.; Zhong, C.

2026-09-01 bioinformatics 10.64898/2026.08.26.731133 medRxiv
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Bioinformatics software and databases are essential components of modern life science research, yet their mentions in the scientific literature are often inconsistent and difficult to systematically identify at scale. The lack of a comprehensive and up-to-date catalog of bioinformatics resources hinders efforts toward automated biomedical knowledge extraction and streamlined data analysis. Here we present SNAIL, a hybrid named entity recognition framework designed to automatically identify bioinformatics software and database (SW/DB) names from biomedical texts. SNAIL integrates complementary lexical and semantic modeling strategies. The lexical component captures orthographic patterns and contextual cues characteristic of SW/DB names, while the semantic component leverages contextual embeddings generated by transformer-based language models such as SciBERT, combined with an explicit token-masking strategy to enhance entity-focused representations. A large training corpus was constructed automatically through a hybrid pipeline that integrates citation-hinted extraction with large language model-assisted distillation. Evaluation on two independent benchmark datasets and real-world research articles demonstrates that SNAIL substantially outperforms existing approaches, including domain-specific methods such as bioNerDS2 and general-purpose large language models such as ChatGPT, Gemini, Grok and Claude. Applying SNAIL to large-scale literature analysis further reveals distinct journal-level preferences across bioinformatics subfields. These results demonstrate that SNAIL provides an accurate and scalable solution for identifying bioinformatics resources in scientific texts and enables systematic meta-analysis of tool usage and research trends.

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Immune-metabolic-redox ecosystems define spatially organized tumor states in head and neck squamous cell carcinoma.

Shukla, K.

2026-09-01 cancer biology 10.64898/2026.08.31.746545 medRxiv
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Background: Spatial organization is increasingly recognized as a key determinant of tumor-immune interactions in head and neck squamous cell carcinoma (HNSCC). The GSE300147 Xenium spatial transcriptomic resource generated by McCord and colleagues established a framework for mapping spatially coordinated T-cell states in HNSCC. However, how tumor-enriched epithelial immune states relate to metabolic, redox, and stress-adaptive transcript programs remains incompletely defined. Methods: A secondary, data-driven reanalysis of GSE300147 was performed, focusing on 17 confirmed HNSCC Xenium sections after exclusion of a non-HNSCC ameloblastoma specimen. A total of 1,148,244 cells were analyzed, including 558,867 EpCAM+ tumor-enriched epithelial cells. Tumor-enriched epithelial cells were classified into Hot, Intermediate, and Cold states using a Composite Hotness framework integrating T-cell inflammatory signature score, checkpoint-associated signaling, CD274 expression, IFN/antigen-presentation signature score (IFN/AP), and tumor-immune proximity. Six metabolic ecosystem states, neighborhood profiling, spatial permutation testing, and an integrated Immune-Metabolic-Redox Ecosystem Score (IMRES) were then applied. Results: Immune activation was spatially heterogeneous across HNSCC sections. Immune-hot tumor-enriched epithelial regions showed not only inflammatory, checkpoint-associated, and antigen-presentation signature scores, but also coordinated metabolic, oxidative-redox, and stress-response transcript programs. IMRES, derived from available immune, metabolic, redox, and stress-response transcript components represented in the Xenium panel, increased progressively from Cold to Intermediate to Hot tumor-enriched epithelial states and was associated with NFE2L2, GDF15, HLA-DRA, CD274, KEAP1, and MDM2. Integrating IMRES with Composite Hotness identified a distinct Hot+IMREShigh ecosystem comprising 106,874 tumor-enriched epithelial cells. This state showed the strongest immune-active and stress-adaptive features and was positioned closer to immune populations than expected by random assignment. An alternative rank-based robustness analysis reproduced the IMRES-associated ecosystem axis and correlated with the original module-based score (Spearman r = 0.597). Conclusions: This secondary reanalysis extends the original spatial T-cell framework by defining a complementary tumor-centered immune-metabolic-redox ecosystem in HNSCC. IMRES provides a transcript-derived framework for identifying Hot+IMREShigh neighborhoods where immune activation, checkpoint signaling, metabolic remodeling, and stress adaptation converge, providing a hypothesis-generating framework for studying immune resistance and therapeutic vulnerability.

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From Prompt to Provenance: BloClaw, a Capability-Gated AI4S Workstation for Auditable Computational Biology

qin, y.; Pang, J.; Zhang, X.

2026-09-01 bioinformatics 10.64898/2026.08.26.747436 medRxiv
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Scientific agents can produce plausible answers while remaining unable to establish whether the computation behind an answer is executable, recoverable, or reproducible. We present BloClaw, an AI4S workstation built around a simple principle: a scientific agent should know what it can do, show how it did it, and state what remains unvalidated. Each capability declares an execution state, input constraints, dependencies, expected outputs, and scientific limitations. Natural-language requests are translated into structured tasks, validated against this registry, executed through scientific tools, and recorded in a provenance-aware Living Lab Notebook. The system is designed to detect invalid inputs, failed tool calls, missing dependencies, and remote timeouts, and to route them to repair, retry, or escalation. The implemented and tested scope comprises RDKit-based molecular property and rule screening, protein structure analysis, docking-pose inspection, 3D visualization, and structured reporting. We demonstrate the workflow on a PubChem-retrieved osimertinib structure and a supplied 6LU7 docking artifact: the former yields deterministic descriptors (molecular weight 499.619 Da, cLogP 4.5098, TPSA 87.55 A^2), while the latter contains 2,387 protein ATOM records, 309 residues, and nine pose records. These examples are workflow demonstrations, not efficacy or affinity studies. Beyond retrospective prediction, the manuscript specifies a prior-minimized constructive mode in which a desired function is compiled into explicit physical, chemical, and systems constraints, candidate mechanisms are simulated, and observations are reintroduced for calibration and falsification; this is a proposed extension rather than a result of the present case studies. We describe an evaluation protocol that compares BloClaw with a standard single-agent workflow and fixed-script execution using task completion, scientific correctness, recovery success, provenance completeness, reproducibility, human review time, latency, and cost. This manuscript reports the system design, verified capability boundary, deterministic software artifacts, and a reproducible evaluation protocol; it does not claim benchmark improvements before those experiments are run. BloClaw is an execution and accountability layer for AI-assisted research, complementing expert review and experimental validation rather than replacing them.

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Pan-cancer Graph-based Cancer Detection Using the Cell-free DNA Methylome

Zhao, L.; Zeng, Y.; Abelman, D. D.; Lin, W.; Luo, P.

2026-08-31 oncology 10.64898/2026.08.26.26361432 medRxiv
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Motivation: Cell-free DNA methylation provides a minimally invasive signal for early cancer detection and tissue-of-origin prediction. Most methods represent methylation measurements as independent fixed-window features and therefore do not explicitly model relationships among genomic regions. Results: We developed PANGEM (Pan-cancer Graph-based Cancer Detection Using the Cell-free DNA Methylome), a graph-learning framework that represents genomic bins as nodes and integrates CpG context, genomic proximity, and sample-specific methylation similarity in the graph topology. Across five repeated stratified train-test splits, PANGEM achieved the highest mean performance among evaluated methods, with an AUROC/AUPR of 0.997/1.000 for binary cancer detection and macro-AUROC/AUPR of 0.977/0.870 for multiclass tissue-of-origin prediction. In the independent INSPIRE cohort, 72 of 78 cancer cases (92.3%) exceeded the binary classification threshold, and PANGEM correctly classified 9 of 17 head and neck cancer cases (52.9%), the highest accuracy among evaluated methods. Subnetwork analysis further identified recurrent, graph-connected methylation patterns, including a 111-DMR subnetwork with increased methylation in cancer samples.

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Limits of Single-Pass Retrieval-Augmented Generation for AI-Powered Cancer Care Navigation: A Comparison of Retrieval Strategies

Hasan, E.; Zhang, Y.; Cook, O.; Loe, A.; Sha, M.; T'ien, L.; Ng, M.; Rauscher, C.; Raman, S.; Bender, J. L.; Ng, R. T.; Bates, A.; Nunez, J.-J.

2026-09-04 health informatics 10.64898/2026.08.31.26361774 medRxiv
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Background: People affected by cancer often face difficulty finding relevant clinical, psychological, and practical support services. AI-powered navigation assistants may improve access to these resources, but their retrieval performance must be reliable. Objective: To develop a single-pass retrieval-augmented generation assistant for cancer-care navigation and compare the retrieval strategies, including their robustness to reworded questions. Methods: We created a database of 853 cancer-support resources reviewed by librarians, clinicians, researchers, and patient partners. We evaluated the system using 100 questions derived from questions submitted by patients. We compared keyword-based, semantic, and hybrid retrieval using Precision@K, Hit@K, and nDCG@K. The best-performing configuration was then tested using semantically equivalent rewordings of the original questions. Results: Keyword-based retrieval performed poorly, achieving a P@1 of 25.0% and Hit@5 of 43.0%. Semantic retrieval improved these results to 58.0% and 86.0%, respectively. The best hybrid configuration achieved a P@1 of 64.0%, Hit@5 of 90.0%, and nDCG@5 of 51.0%. Performance remained relatively stable when the questions were reworded, with a P@1 of 61.0%, Hit@5 of 88.0%, and nDCG@5 of 46.1%. Conclusions: Hybrid retrieval performed best and remained relatively stable when questions were reworded. However, its limited ability to rank a relevant resource first highlights the limitations of single-pass retrieval for patient-facing cancer navigation. Future work will explore metadata filtering and a multi-agent architecture to improve retrieval reliability.

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RedFuMOS: A novel approach for multi-omics and clinical data-driven patient stratification

De Luca, S.; Fava, C.; Rizzo, G.; Visconti, A.; Berchialla, P.

2026-08-31 health informatics 10.64898/2026.08.26.26361415 medRxiv
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Background. Patient stratification from multi-omics and clinical data is essential for uncovering disease heterogeneity and moving toward more personalized treatment strategies. However, integrating heterogeneous data layers while identifying robust patient strata remains challenging. Methods. We introduce Reduced Fusion of Multi-Omics Stratification (RedFuMOS), a novel three-step approach for patient stratification based on mixed-type multi-omics data. RedFuMOS extends Similarity Network Fusion to accommodate mixed-type data layers and layer-specific similarity measures for data integration, includes a dimensionality reduction step to mitigate the curse of dimensionality, and performs patient stratification using density-based hierarchical clustering with HDBSCAN. It also implemented an automated optimization procedure to identify the best set of hyperparameters, minimizing the need for manual tuning. Results. RedFuMOS outperformed six state-of-the-art tools for multi-omics patient stratification in a comprehensive simulated benchmarking study, which also confirmed that, although computationally expensive, the dimensionality reduction step is crucial for achieving good stratification performance. Additionally, RedFuMOS identified two clinically relevant patient strata in a small real-world cohort of patients with Philadelphia chromosome-positive chronic myeloid leukaemia. Conclusion. RedFuMOS provides a flexible framework for integrating heterogeneous multi-omics and clinical data. RedFuMOS is available as an R package at http://github.com/delucasara/RedFuMOS.

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Intelligent differential ion mobility spectrometry (iDMS): A deep neural network that predicts optimal space-resolved ion mobility parameters for isomeric monoglycosphingolipids

Nguyen-Tran, T.; Shi, X. X.; Hashimoto-Roth, E.; Organ, M. G.; Lavallee-Adam, M.; Perkins, T. J.; Bennett, S. A. L.

2026-09-01 bioinformatics 10.64898/2026.08.26.747394 medRxiv
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Simultaneous quantification of monoglycosphingolipid stereoisomers is required to monitor changes in defective enzymatic pathways linked to diseases such as Gaucher Disease, Parkinson's Disease, and Krabbe Disease. Resolution of beta-glucosyl and beta-galactosyl epimers cannot be achieved by standard liquid chromatography, electrospray ionization, tandem mass spectrometry (LC-ESI-MS/MS). Separation becomes possible when field asymmetric ion mobility spectrometry (FAIMS), also known as differential mobility mass spectrometry (DMS), is added as an orthogonal separation technique to LC. FAIMS/DMS separates epimeric ion clusters in a high versus low electric field (separation voltage, SV) then redirects the target epimeric ions to the mass spectrometer through the application of a direct current (compensation voltage, CoV). Resolving SVs and CoVs must be manually determined for each lipid. Manual derivation is a labour-intensive process that requires pure synthetic standards, limiting the number of stereoisomers a user can include in an assay. To address this problem, we introduce here intelligent DMS (iDMS). iDMS is an in silico supervised neural network model that learns the ion mobility relationships between SV and CoV and the monoglycosphingolipid structural features of sugar headgroup, N-acyl chain length, and N-acyl degree of unsaturation. iDMS predicts the SV and CoV combinations capable of resolving any stereoisomer pair from a training dataset of composed of measured signal intensities across a range of SVs and CoVs of 12 lipids. This machine learning alternative to manual DMS optimization promises to accelerate the deployment of multiple-reaction-monitoring mode (MRM) RPLC-ESI-DMS-MS/MS assays for the routine and rapid quantification of biologically relevant monoglycosphingolipid stereoisomers.

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Genetic Architecture and Sample Size Impact Relative Performance of Nonlinear Machine Learning and Standard Polygenic Risk Scores

Zhu, J.; Baousi, A.; Morris, A. P.; Guo, H.

2026-09-03 genetic and genomic medicine 10.64898/2026.08.29.26361109 medRxiv
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Standard polygenic risk scores (PRSs) are constructed based on additive genome-wide association study (GWAS) summary statistics. Nonlinear machine learning methods have been increasingly applied to construct PRSs directly from individual-level data, with the aim of improving predictive performance over standard PRSs through their ability to model non-additive genetic effects. However, their superiority across studies has been inconsistent, and the conditions under which they provide meaningful improvements remain unclear. We combined theoretical analysis, simulations and a real-world application to investigate when two widely used nonlinear machine learning methods, random forest and XGBoost, outperform standard PRSs. Theoretical analysis showed that standard PRSs can implicitly capture part of the genetic variance attributable to nonadditive genetic effects through their contributions to marginal SNP effects, thereby losing less information than commonly assumed. Although nonlinear models have a higher theoretical potential, their greater flexibility incurs a bias-variance trade-off that can limit predictive gains at finite sample sizes. Simulations showed that XGBoost outperformed the standard PRS only when the genetic architecture involves a sufficiently large proportion of interaction genetic variance concentrated across relatively few interaction effects and large training samples were available. Random forest consistently underperformed the standard PRS. In an application to ischemic heart disease prediction using UK Biobank data, XGBoost showed no meaningful improvement in predictive performance over the standard PRS, whereas random forest again performed worse. Together, these findings suggest that nonlinear machine learning do not uniformly outperform standard PRSs; rather, their relative performance depends jointly on genetic architecture and training sample size. Our study helps to reconcile the inconsistent results reported across previous studies and provides a framework for identifying settings in which more complex PRS models are likely to be beneficial.

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PCGS: biomarker and risk group identification for Pediatric Cancers via explainable Graph neural networks with Shapley values

Shi, Z.; Budhkar, A.; Amin, W.; Pollok, K. E.; Su, J.; Huang, K.

2026-09-01 health informatics 10.64898/2026.08.27.26361540 medRxiv
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Improvements in data availability, sharing, and integration, together with the development of explainable artificial intelligence (XAI) techniques, are advancing precision medicine for pediatric cancer by facilitating diagnosis, biomarker discovery, and drug development. Data sharing commons and initiatives like the Childhood Cancer Data Initiative (CCDI) provide access to pediatric-specific genomic and clinical data cohorts and improve data availability for pediatric cancer research. Based on CCDI, a scalable AI platform, Graph Artificial Intelligence for Pediatric Oncology (GAIPO), integrates various data modalities from bulk and single-cell omics data to clinical information. Such multi-modal data facilitates the training and development of advanced XAI models for pediatric cancers. We then developed an end-to-end multi-modality framework, PCGS, for pediatric cancer by incorporating omics-specific representation learning via GNN models with cross-attention fusion and multi-objective learning for downstream tasks such as classification, clustering, and survival analysis. This framework outperforms previous supervised multi-omics integration baseline approaches based on glioma and Wilms tumor cohorts and enables GNN model explainability via Shapley value-based feature attribution approaches to explain the contributions of gene-level features across various biomedical tasks, including classification and survival. Given specific background samples (e.g., age groups, sex, grades) as baselines, this explainable GNN model estimates and ranks the importance scores for input features from each omics modality. It identifies background-specific key features for biomarker discovery, risk group identification, and survival analysis in glioma and Wilms tumor, with potential applicability to other pediatric cancers.

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When medical credentials conflict with stated accuracy: A factorial study of source credibility and answer revision in medical LLM interactions

Wojcik, S.; Rulkiewicz, A.; Domienik-Karłowicz, J.

2026-09-01 health informatics 10.64898/2026.08.28.26361634 medRxiv
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Large language models perform well on medical examinations, but users routinely challenge their answers and invoke professional roles, and it is unclear what a system does when a medical credential and a stated task-specific accuracy point in opposite directions. In a factorial experiment on 480 items from four Polish specialty examination sets and three consumer large language model systems (ChatGPT, Claude, Gemini), each item and system received eleven independent conversations. Conditions crossed attributed source role (medical student, experienced specialist), stated prior accuracy on similar questions (2/10, 8/10) and suggestion correctness. The primary outcome was adoption of a prespecified incorrect option when the baseline answer matched the official key, comparing a specialist described as 2/10 with a student described as 8/10. Baseline agreement with the key was 87.2% across 15,683 analyzable conversations. The incorrect option was adopted more often from the specialist described as 2/10 than from the student described as 8/10 (10.2% vs. 7.6%; adjusted risk difference +2.82 percentage points, 95% CI +0.65 to +4.99). Estimates varied across the three systems and only one system-specific interval excluded zero. In a prespecified exploratory analysis with a shared eligibility rule, correct suggestions were adopted far more often than incorrect ones (risk difference +35.7 percentage points, 95% CI +30.8 to +40.7), indicating selective rather than indiscriminate compliance. An incorrect suggestion from a specialist with low stated accuracy was therefore slightly more influential than the same suggestion from a student with high stated accuracy, although the difference was modest and varied across systems. Agreement reached only after a user has disclosed a preferred answer should not automatically be treated as an independent second opinion, and medical large language model systems should be evaluated on how they revise answers after such disclosure, not solely on initial accuracy.

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Pan-cancer analysis identifies nine conserved miRNA regulators of tumor cytolytic activity and clinically actionable immune targets

Bagherlou, N.; Aliyari, S.; Salehi, Z.; Pirouzkhah, M.; Weis, C.-A.

2026-08-31 cancer biology 10.64898/2026.08.30.748071 medRxiv
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Abstract Background: Cytolytic activity (CYT), a widely used transcriptomic surrogate of anti-tumor immune cytotoxicity derived from GZMA (granzyme A) and PRF1 (Perforin 1) expression, is associated with clinical outcomes across cancers. MicroRNAs (miRNAs) are key post-transcriptional regulators of tumor immunity, yet their pan-cancer roles in modulating cytolytic activity remain incompletely understood. Objective: This study aimed to identify conserved miRNA regulators of tumor cytolytic activity and their downstream gene-mediated networks across diverse cancer types, while evaluating their clinical and therapeutic relevance. Methods: Matched miRNA and mRNA expression profiles from 9,288 primary tumors across 31 TCGA cancer types were analyzed. A multi-stage framework was applied: per-cancer Spearman correlations (|{rho}| >= 0.30, FDR < 0.05) identified recurrent CYT-associated miRNAs (at least 3 cancer types); these were integrated with TargetScan-predicted targets and subjected to pan-cancer and cross-cancer triple filtering (miRNA-gene and gene-CYT associations). All associations underwent tumor purity adjustment using Consensus Purity Estimate (CPE), with LUMP (Leukocytes Unmethylation for Purity) as sensitivity analysis. Candidates were further prioritized by random forest modeling with bootstrap stability, cancer-type-adjusted Cox regression, mediation analysis, immune cell deconvolution, k-means molecular subtyping, pathway enrichment, and DGIdb-based drug-target prioritization. Results: The analysis converged on 38 high-confidence miRNA-gene-CYT regulatory triplets involving 9 conserved miRNAs and 31 target genes after stringent purity adjustment and multi-layer validation. All nine miRNAs exhibited complete bootstrap stability. Mediation analysis confirmed significant gene-level mediation in 37 of 38 triplets (FDR < 0.01), with mediated proportions up to 94%. The final miRNA signature defined two distinct pan-cancer immune subtypes (immune-hot vs. immune-cold) with significantly different cytolytic activity and overall survival (OS) (HR = 0.754, FDR = 1.12 x 10^-4). The network was enriched for T-cell activation and lymphocyte differentiation pathways and highlighted multiple druggable targets, including CTLA4 and CD274 (PD-L1), nominating 124 candidate compounds. Conclusions: In conclusion, this tumor purity-adjusted pan-cancer study defines a compact, reproducible, and clinically relevant miRNA network that regulates cytolytic activity across diverse malignancies. By linking miRNA biology to immune subtyping and actionable therapeutic targets, the present work provides a valuable foundation for advancing precision immuno-oncology.

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Point-of-Care Breath Volatile Organic Compound Analysis as a Tool for Lung Cancer Screening: A Pilot Feasibility Study

Pichkar, Y.; Manolakos, S.; Phillips, K. M.; Schabath, M. B.; Chaudhary, A.

2026-08-31 oncology 10.64898/2026.08.26.26361331 medRxiv
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Background: Low-dose computed tomography (LDCT) screening reduces lung cancer mortality but is limited by low uptake and associated with high rates of false-positives and indeterminate-nodules. Breath volatile organic compound (VOC) analysis is a non-invasive candidate biomarker approach that could complement LDCT, but prior work has relied on laboratory-based high-resolution mass spectrometry (HRMS), limiting point-of-care deployment. Methods: In this pilot study, breath samples were collected from 40 patients with treatment-naive, pathologically confirmed non-small cell lung cancer (NSCLC) and 25 lung-cancer-screening-eligible healthy controls. Paired samples were analyzed via a compact point-of-care GC-MS platform (CLARION) and a laboratory HRMS reference. Diagnostic classification models were built independently for each platform using elastic net logistic regression with leave-one-out cross-validation, and performance was evaluated by area under the receiver operating characteristic curve (AUC). Results: CLARION identified 103 VOCs across breath specimens, compared to over 900 identified by HRMS. Despite this difference in panel size, CLARION achieved diagnostic performance nearly identical to HRMS for distinguishing NSCLC cases from controls (AUC 0.864 vs. 0.863). Compared to controls, performance statistics were similar for early-stage NSCLC (AUC 0.854 vs. 0.841) and adenocarcinoma (AUC 0.770 vs. 0.787). VOCs of interest include p-cymene, phenol, propylbenzene, tetradecane, {beta}-ocimene, 2,3-dihydro-indole, and 1-methylthio-(Z)-1-propene. Conclusion: A compact, point-of-care breath GC-MS platform achieved diagnostic performance for NSCLC detection comparable to a laboratory HRMS reference despite a substantially smaller detected VOC panel. These findings support continued development of point-of-care breath VOC testing as a non-invasive, field-deployable complement to LDCT-based lung cancer screening.

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The first OpenBind release: An open experimental structure-affinity dataset and benchmark for structure-based AI

Nelen, J.; Khan, O.; Adams, E.; Aschenbrenner, J. C.; Thompson, W.; Ebrahim, A.; Capkin, E.; Vallee, C.; OpenBind, ; Shotton, E. J.; Griffen, E. J.; Chodera, J. D.; Deane, C. M.; von Delft, F.; AlQuraishi, M.; Imrie, F.

2026-09-01 bioinformatics 10.64898/2026.08.27.747600 medRxiv
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High-quality experimental datasets that link protein-ligand structures with binding affinity data are essential for developing and evaluating structure-based machine learning methods. To help address this need, we established OpenBind as an open-science initiative to generate large-scale experimental datasets for structure-based AI and molecular discovery. Here, we describe the first public OpenBind release, which, to the best of our knowledge, is the largest public single-target experimental structure-affinity dataset. The dataset focuses on enteroviral 2A protease, comprising 925 crystallographic binding events from 699 compounds and associated affinity measurements for 601 compounds. It combines structures from an initial fragment screen and follow-on molecules, together with affinity data, linking experimentally determined protein-ligand binding modes to biophysical measurements within a coherent antiviral discovery campaign. We used this dataset to evaluate protein-ligand structure prediction, binding-affinity prediction, and virtual screening using representative structure-based methods, including docking and cofolding. This exposed several challenges that are central to practical structure-based modelling: docking performance depends strongly on binding-pocket conformation, poses are difficult to rank, and structure-based affinity prediction remains challenging. Fine-tuning OpenFold3-p2 on the fragment-screen structures substantially improved pose prediction and virtual screening for related follow-on compounds, demonstrating how early-stage experimental structures can support target-specific model adaptation.

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Individual-Level Counterfactual Analysis of SGLT2 Inhibitors Versus DPP4 Inhibitors in Diabetic Kidney Disease Using Causal Machine Learning

Yano, Y.; Nagasu, H.; Hiroshi, K.; Ohashi, M.; Isaka, Y.; Okada, H.; Nangaku, M.; Kashihara, N.

2026-09-03 health informatics 10.64898/2026.08.30.26361750 medRxiv
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Background: Traditional real-world studies comparing SGLT2 and DPP4 inhibitors on renal outcomes rely on propensity score matching, which causes high-dimensional data loss. We used causal machine learning (Causal ML) to unmask heterogeneous treatment effects in diabetic kidney disease (DKD). Methods: Using data from 4,588 patients within the Japanese J-CKD-DB-Ex registry, we implemented a doubly robust (DR) learning framework (Linear DR-learner with XGBoost) to compare SGLT2 and DPP4 inhibitors. Outcomes included the chronic eGFR slope and a composite renal endpoint ([&ge;] 50% eGFR decline or end-stage kidney disease). Heterogeneity was explored via causal SHAP and decision trees. Results: At the population level, SGLT2 inhibitors modestly slowed chronic eGFR decline (average treatment effect [ATE] = 0.14 [95% CI: -0.86, 1.15] mL/min/1.73m^2/year) and reduced composite endpoint risk by 9% (ATE: -0.09 [-0.11, -0.08]) versus DPP4 inhibitors. However, individual-level counterfactual analysis suggested that for the chronic eGFR slope, non-glinide users with stable pre-treatment trajectories who were also taking ACE inhibitors had a greater benefit from SGLT2 inhibitors (ATE: 2.95 [-0.68, 6.58]). Conversely, glinide users with steep pre-treatment decline had a greater benefit from DPP4 inhibitors (ATE: -8.98 [-16.11, -1.85]). For composite renal events, SGLT2 inhibitors had a 28% absolute risk reduction within the algorithmically identified high-risk subgroup (eGFR [&le;] 28.1 mL/min/1.73 m^2 and positive proteinuria; ATE: -0.28 [-0.33, -0.23]). Even non-proteinuric decliners demonstrated a 8% risk reduction with SGLT2 inhibitors (ATE: -0.08 [-0.10, -0.06]). Conclusion: Causal ML advances precision medicine in DKD, shifting from uniform prescribing to individualized, data-driven therapy targeting distinct intrarenal pathways.