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An embedding-based framework enables statistical testing of gene-set function hypotheses inferred by large language models.

Emerging large language models (LLMs) can infer gene functions directly from gene lists, enabling hypothesis generation without predefined gene sets. However, these LLM-derived predictions are qualitative, and principled statistical validation is lacking. Here, we develop an embedding-based statistical framework that transforms gene and function descriptions into vector representations, enabling statistical testing of gene-gene and gene-function relationships and quantitative prioritization of de novo functional hypotheses inferred by LLMs. We benchmark seven state-of-the-art embedding models using curated and retrieval-augmented literature-derived gene descriptions across diverse biological contexts. OpenAI's text-embedding-3-large and Google's gemini-embedding-001 perform best, capturing gene-gene functional relationships in 88.7-92.5% of Gene Ontology biological processes and approximately 98.6% of canonical pathways. In gene-function association analyses, these models achieve high sensitivity (95.2-98.4%) and specificity (72.7-84.3%). Through contamination analysis and evaluation using experimentally informed protein assembly gene sets, our framework distinguishes biologically meaningful LLM-inferred hypotheses from noise, outperforming confidence-based inference and conventional enrichment analysis. We further develop the open-source R package DEGEmbedR and demonstrate its utility for interpreting a drug perturbation-derived differentially expressed gene (DEG) signature lacking significant conventional enrichment results. Together, these results establish LLM-derived embeddings as a quantitative foundation for functional genomics and the statistical validation of LLM-based gene function inference.

Large Language Models↗

CROP: a feature-independent context-aware method for CRISPR-Cas9 frameshift prediction.

MOTIVATION: The CRISPR-Cas9 complex has revolutionized genome-editing technologies. By designing a 20 nt-long guide RNA, a Cas9 nuclease can be guided to cleave almost any genomic target site (followed by NGG). The cleavage induces double-stranded DNA breaks, which are then repaired by cellular pathways. Accurate CRISPR-Cas9 repair-outcome prediction is essential for designing guide RNAs with desired genomic effects, such as gene knockout. A central challenge is quantifying the rate of frameshifts, i.e. repair-outcomes that lead to a change in the local length that is not a multiple of three. Previous methods for frameshift-rate prediction were trained on only a few experimental or cellular contexts, mostly relied on manually defined microhomology features, and were limited by sparse features and class labels. RESULTS: We developed CROP, a feature-independent context-aware repair-outcome prediction method. By aggregating specific repair outcomes as Δlength classes, CROP overcomes class sparsity. We designed CROP to work with variable input sequence lengths and output classes to utilize multiple datasets simultaneously. We benchmarked CROP against state-of-the-art repair-outcome prediction methods over 18 datasets, which we curated and standardized from various studies. Across all datasets, CROP outperformed all competing methods in frameshift-rate prediction. We performed cross-experiment and cross-cellular frameshift-rate predictions to investigate the generalizability of repair mechanisms. Finally, we show that CROP learned microhomology principles from raw sequences without explicit feature engineering, establishing an end-to-end architecture for CRISPR-Cas9 repair-outcome prediction that learns from multiple datasets. AVAILABILITY AND IMPLEMENTATION: CROP is available at https://github.com/OrensteinLab/CROP.

CRISPR-Cas Systems↗

Practicing surgeons lead in quality care, safety, and cost control.

OBJECTIVE: To report the experiences of 66 surgical specialists from 15 different hospitals who performed 43 CPT-based procedures more than 16,000 times. SUMMARY BACKGROUND DATA: Surgeons are under increasing pressure to demonstrate patient safety data as quantitated by objective and subjective outcomes that meet or exceed the standards of benchmark institutions or databases. METHODS: Data from 66 surgical specialists on 43 CPT-based procedures were accessioned over a 4-year period. The hospitals vary from a small 30-bed hospital to large teaching hospitals. All reported deaths and complications were verified from hospital and office records and compared with benchmarks. RESULTS: Over a 4-year inclusive period (1999-2002), 16,028 elective operations were accessioned. There was a total 1.4% complication rate and 0.05% death rate. A system has been developed for tracking outcomes. A wide range of improvements have been identified. These include the following: 1) improved classification of indications for systemic prophylactic antibiotic use and reduction in the variety of drugs used, 2) shortened length of stay for standard procedures in different surgical specialties, 3) adherence to strict indicators for selected operative procedures, 4) less use of costly diagnostic procedures, 5) decreased use of expensive home health services, 6) decreased use of very expensive drugs, 7) identification of the unnecessary expense of disposable laparoscopic devices, 8) development of a method to compare a one-surgeon hospital with his peers, and 9) development of unique protocols for interaction of anesthesia and surgery. The system also provides a very good basis for confirmation of patient safety and improvement therein. CONCLUSIONS: Since 1998, Quality Surgical Solutions, PLLC, has developed simple physician-authored protocols for delivering high-quality and cost-effective surgery that measure up to benchmark institutions. We have discovered wide areas for improvements in surgery by adherence to simple protocols, minimizing death and complications and clarifying cost issues.

Adult↗

Detection of homologous proteins by an intermediate sequence search.

We developed a variant of the intermediate sequence search method (ISS(new)) for detection and alignment of weakly similar pairs of protein sequences. ISS(new) relates two query sequences by an intermediate sequence that is potentially homologous to both queries. The improvement was achieved by a more robust overlap score for a match between the queries through an intermediate. The approach was benchmarked on a data set of 2369 sequences of known structure with insignificant sequence similarity to each other (BLAST E-value larger than 0.001); 2050 of these sequences had a related structure in the set. ISS(new) performed significantly better than both PSI-BLAST and a previously described intermediate sequence search method. PSI-BLAST could not detect correct homologs for 1619 of the 2369 sequences. In contrast, ISS(new) assigned a correct homolog as the top hit for 121 of these 1619 sequences, while incorrectly assigning homologs for only nine targets; it did not assign homologs for the remainder of the sequences. By estimate, ISS(new) may be able to assign the folds of domains in approximately 29,000 of the approximately 500,000 sequences unassigned by PSI-BLAST, with 90% specificity (1 - false positives fraction). In addition, we show that the 15 alignments with the most significant BLAST E-values include the nearly best alignments constructed by ISS(new).

Algorithms↗

Learning and generalization in cascade network architectures.

Incrementally constructed cascade architectures are a promising alternative to networks of predefined size. This paper compares the direct cascade architecture (DCA) proposed in Littmann and Ritter (1992) to the cascade-correlation approach of Fahlman and Lebiere (1990) and to related approaches and discusses the properties on the basis of various benchmark results. One important virtue of DCA is that it allows the cascading of entire subnetworks, even if these admit no error-backpropagation. Exploiting this flexibility and using LLM networks as cascaded elements, we show that the performance of the resulting network cascades can be greatly enhanced compared to the performance of a single network. Our results for the Mackey-Glass time series prediction task indicate that such deeply cascaded network architectures achieve good generalization even on small data sets, when shallow, broad architectures of comparable size suffer from overfitting. We conclude that the DCA approach offers a powerful and flexible alternative to existing schemes such as, e.g., the mixtures of experts approach, for the construction of modular systems from a wide range of subnetwork types.

Generalization, Psychological↗

Audit of a diabetes clinic at Tawam hospital, United Arab Emirates, 2004-2005.

The aim of this audit was to determine the current management of patients with diabetes compared to international standards and to benchmark the results against current international standards. A retrospective audit of medical records of diabetic patients attending Tawam Hospital, a tertiary healthcare facility in the Al Ain region in the Emirate of Abu Dhabi, United Arab Emirates was performed. A random sample of 30 patients (5% of the target group) was selected from the total number of 600 patients who visited the diabetes clinics in August 2005. An audit form was developed based on the priority aims and measures contained in the Institute for Clinical Systems Improvement (ICSI) Guidelines for the management of type 2 diabetes mellitus. Data analysis was carried out based on measurement specifications in the ICSI Guidelines. All patients had their blood pressure checked at their most recent appointment. All except one patient had an HbA1c test and a lipid profile performed during the study period. Although 75% of patients were referred for a dilated eye examination, only 47% complied. Approximately two-thirds of all patients had evidence of self-monitoring of blood glucose. Less than half of the patients were referred to the nutritionist and only a relatively small proportion of patients had advice on diet and exercise documented in their medical record. There was also lack of documentation, particularly for smoking status, foot examination, and body mass index (BMI). All patients received aspirin (ASA) treatment. The majority had a systolic blood pressure of 130 mmHg or less; just under half of patients had HbA1c of less than 7%. In comparison to the Center for Diseases Control (CDC) targets, we exceeded targets in three areas in relation to HbA1c testing, ASA treatment, and self-report monitoring blood glucose. We did not meet the stated target of 75% for patients having a dilated eye exam due to lack of patient compliance (more than three-quarters of all patients were referred but did not attend for appointment). Documentation of a comprehensive foot examination was present for only one-quarter of all patients compared to the recommended target of three-quarters of patients. Documentation of advice on diet and exercise was present for 40%, which did not meet the CDC target of 60%. Overall, the audit highlighted that Tawam Hospital is providing a good level of care to diabetic patients and compares favorably with international targets; however, key recommended actions have been identified for implementation to improve patient care and maintain a continuous improvement process through effective monitoring with prioritization to those related to preventative care.

Diabetes Mellitus↗

Optical quality measurements of hydrophobic acrylic intraocular lenses.

PURPOSE: To compare the optical quality of several models of hydrophobic acrylic intraocular lenses (IOLs). METHODS: Modulation transfer function (MTF) measurements were performed using a model eye system on four models of hydrophobic acrylic IOLs. Models tested were the AcrySof SA60AT, MA60AC, and MA60BM (Alcon, Ft Worth, Tex), as well as the model VA-60BB (Hoya, Tokyo, Japan). For benchmarking, the Alcon model MZ60BD polymethylmethacrylate (PMMA) lens was also measured. Three lenses of each model were tested at frequencies of 50 and 100 line pairs (lp)/mm (corresponding to 20/40 and 20/20, respectively). RESULTS: With a 3-mm aperture, the Alcon AcrySof models had mean MTF values ranging from 58.5% to 60.3% at 100 lp/mm and 78.0% to 79.7% at 50 lp/mm. The Hoya model VA-60BB provided statistically significantly lower (P<.05) MTF values than the Alcon AcrySof models at both frequencies (47.3 +/- 1.2% at 100 lp/mm and 71.8 +/- 1.9% at 50 lp/mm). With a 5-mm aperture, the Alcon AcrySof models had MTF values ranging from 32.9% to 34.3% at 100 lp/mm and 45.2% to 46.7% at 50 lp/mm. Under these larger aperture conditions, the Hoya model VA-60BB also had statistically significantly lower MTF values (20.9 +/- 0.8% at 100 lp/mm and 27.2 +/- 1.1% at 50 lp/mm). Under both apertures and frequencies, the Alcon PMMA lens had statistically significantly higher MTF values than the Hoya lens and statistically significant lower MTF values than all AcrySof models. CONCLUSIONS: Using both 3- and 5-mm aperture settings as well as frequencies corresponding to 20/20 and 20/40 vision, statistically significantly higher MTF values were obtained for AcrySof lenses, which were greater than the PMMA lens, which were greater than the Hoya model VA-60BB. The differences in MTF values between lens models are more exaggerated with a 5-mm aperture and may highlight differences in lens manufacturing processes.

Humans↗

Benchmarking fine-tunes health efforts for workers.

A need was seen for uniform data sets, identification of best practices. Benchmarking project helps reveal department's strengths and weaknesses. Using an outside consultant helped ensure objectivity.

Benchmarking↗

Cost-based pricing and the underperforming physician group.

Cost-based pricing may help healthcare organizations improve the revenue performance of their employed physician groups. Organizations considering a change to cost-based pricing strategies should be prepared to supply their major payers with the following supporting information: Physician compensation rates. Compensation methodology. New practice development. Operating benchmarks. Overhead benchmarks.

Costs and Cost Analysis↗

The effects of air cavities on X-ray dose distribution at 6 and 25 MV.

Three different air channels were constructed in solid water. These resemble upper respiratory and larynx geometry. Central-axis depth-dose distributions were measured on and beyond the distal surface of the air cavities. The measurements were made with a parallel-plate Markus ionisation chamber and TLDs for 6 and 25 MV X-ray beams of field sizes 4 cm x 4 cm and 4 cm x 7 cm. Measured dose was then compared to calculated dose for the Clarkson Scatter Integration and Equivalent Tissue-air Ratio (ETAR) algorithms. Both algorithms show errors in dose calculation at the distal surface of air cavities mainly because they fail to account for the effect of electronic disequilibrium. The magnitude of prediction error is found to depend on energy, field size and cavity geometry. For a 4 cm x 4 cm field at 6 MV the dose difference between the calculated value and the measured value, at the distal surface of square cavity is 8.2% and 13.7% for the ETAR and Clarkson algorithm respectively while that for a 4 cm x 7 cm field, the dose difference is reduced to 1.4% and 7.1% respectively. In general the ETAR algorithm shows better performance than the Clarkson algorithm because the Clarkson method calculates scatter dose assuming a homogeneous water medium while the ETAR uses a weighted sum of scatter components which is density dependent. The measured data can be used as benchmark data in the development and testing of new photon dose calculation algorithms.

Air↗

Determining cost drivers for pediatric home health services.

A variety of cost constraints threaten the financial viability of home health agencies. Thus, tools must be developed that expand the critical information resources that will be the key ingredient in successfully navigating the challenges in the volatile home health market. Identifying and analyzing the core processes with the pediatric home care team provided a template that could be used with other agency patient populations by producing cost trajectories based on anticipated care requirements and capturing information that could be used for both internal and external benchmarking. The cost drivers of key processes and activities must be known so that they can be controlled and appropriate rates for capitation contracts can be established. Activity-based management uses cost driver analysis, activity analysis and performance analysis, to determine strategies for redirecting the work processes and agency activities to achieve lasting cost reductions.

Child↗

Comparing the performance of FLUFF-BALL to SEAL-CoMFA with a large diverse estrogen data set: from relevant superpositions to solid predictions.

In this work a template-based molecular mechanistic superposition algorithm FLUFF (Flexible Ligand Unified Force Field) and an accompanying local coordinate QSAR method BALL (Boundless Adaptive Localized Ligand) are validated against the benchmark techniques SEAL (Steric and Electrostatic Alignment) and CoMFA (Comparative Molecular Field Analysis) using a large diverse set of 245 xenoestrogens extracted from the EDKB (Endocrine Disruptor Knowledge Base) maintained by NCTR (National Centre for Toxicological Research). The results indicate that FLUFF is capable of generating relevant superpositions not only for BALL but also for CoMFA, as both techniques give predictive QSAR models. When the BALL and CoMFA methods are compared, it is clear that the BALL algorithm met or even exceeded the results of the standard 3D-QSAR method CoMFA using alignments either from the tailor-made superposition technique FLUFF or the reference method SEAL. The FLUFF-BALL method can be easily automated, and it is computationally light, providing thus a good computational "sieve" capable of fast screening of large molecule libraries.

Algorithms↗

Functional task benchmarks for stroke rehabilitation.

OBJECTIVE: To determine typical outcome "benchmarks" for 18 functional tasks in patients undergoing stroke rehabilitation. The benchmarks are intended to serve as points of reference to which the outcomes of patients with similar impairments and degrees of disability can be compared. SUBJECTS: Records from 26,339 stroke patients discharged from 252 inpatient facilities across the United States that submitted 1992 data to the Uniform Data System for Medical Rehabilitation. METHODS: Stroke impairment was detailed as the presence or absence of hemiparesis resulting from stroke and the side(s) of involvement. Within each of five stroke impairment categories, patients were further classified by the Functional Independence Measure-Function-Related Groups (FIM-FRGs) into nine syndromes by degree of disability (admission motor and cognitive FIM scores) and by age. Outcomes were determined for each stroke syndrome at patients' discharge from medical rehabilitation. MAIN OUTCOME MEASURES: Patients' median performance levels on each of the 18 items making up the FIM, length of stay, and community discharge rates. RESULTS: The majority of patients whose admission motor FIM scores were above 37 were able to eat, groom, dress the upper body, and manage bladder and bowel functions independently by discharge. In addition to these tasks, most of those whose motor FIM scores were above 55 were able to dress the lower body, bathe, and transfer onto a chair/bed or toilet. The majority of patients whose initial motor FIM scores were above 62 points and whose cognitive FIM scores were above 30 gained independence in most tasks, including stair climbing and tub transfers. Community discharge rates ranged from 51.6% for the group of patients with the most severe disabilities to 99.2% for the group with the least severe disabilities. CONCLUSION: The clinician can apply these benchmarks to guideline development and quality improvement, and in establishing patient goals.

Activities of Daily Living↗

Turnaround times for reports on uncomplicated biopsies in five major anatomical pathology laboratories in NSW, Australia.

This paper reports on the findings of a 1997 survey of the turnaround times (TATs) of small, uncomplicated biopsies performed in five major anatomical pathology (AP) departments in NSW over a period of four weeks. A comparative analysis of the performance of the departments shows that in the majority of cases the standard of two working days between specimen receipt and availability for dispatch after verification (as proposed by the College of American Pathologists) is met. This is within the two working days of the Clinical Indicator of the Australian Council on Healthcare Standards. Notwithstanding the apparent adequacy of this result, there is an emerging-although still a minority-view in which it is suggested that the TAT between specimen accession and verification of reports for uncomplicated cases should be one day. This more stringent benchmark is readily achievable, as is demonstrated in the results obtained. In this study a one day TAT was obtained in 73.4% of cases.

Biopsy↗

Reducing adverse drug events: lessons from a breakthrough series collaborative.

BACKGROUND: In January 1996, 38 hospitals and health care organizations (for a total of 40 hospitals) in the United States came together in an Institute for Healthcare Improvement (IHI; Boston) Breakthrough Series collaborative to reduce adverse drug events-injuries related to the use or nonuse of medications. METHODS: The participants were taught the Model for Improvement, a method for rapid-cycle change and evaluation, and were then coached on how to identify their own problem areas and develop changes in practice for rapid-cycle testing. These changes could be implementation of one or more known medication error prevention practices or new practices developed. RESULTS: During a 15-month period the 40 hospitals conducted a total of 739 tests of changes. Process changes accounted for 63% of the cycles; the remainder consisted of preliminary data gathering, consensus-building, or education cycles. Eight types of changes were implemented by seven or more hospitals, with a success rate of 70%. These changes included non-punitive reporting, ensuring documentation of allergy information, standardizing medication administration times, and implementing chemotherapy protocols. DISCUSSION: Success in making significant changes was associated with strong leadership, effective processes, and appropriate choice of intervention. Successful teams were able to define, clearly state, and relentlessly pursue their aims, and then chose practical interventions and moved early into changing a process. They did not spend months collecting data before beginning a change. Changes that were most successful were those that attempted to change processes, not people. Health care organizations committed to patient safety need not regard current performance limits as inevitable.

Adverse Drug Reaction Reporting Systems↗

Shot noise measurements on a single molecule.

We report measurements of shot noise in the current through a single D2 molecule. The molecular junctions were formed by means of the mechanically controllable break junction technique. The configuration of the D2 molecule bridging the gap between two Pt tips is verified by use of point contact spectroscopy. Maintaining the same junction shot noise measurements were performed and the observed quantum suppression shows that conductance is carried dominantly by a single, almost fully transparent conductance channel. This observation allows us to decide between conflicting model calculations for this system, and this may serve as a benchmark for further computations on molecular junctions.

Deuterium↗

An experimental comparison of min-cut/max-flow algorithms for energy minimization in vision.

After [15], [31], [19], [8], [25], [5], minimum cut/maximum flow algorithms on graphs emerged as an increasingly useful tool for exact or approximate energy minimization in low-level vision. The combinatorial optimization literature provides many min-cut/max-flow algorithms with different polynomial time complexity. Their practical efficiency, however, has to date been studied mainly outside the scope of computer vision. The goal of this paper is to provide an experimental comparison of the efficiency of min-cut/max flow algorithms for applications in vision. We compare the running times of several standard algorithms, as well as a new algorithm that we have recently developed. The algorithms we study include both Goldberg-Tarjan style "push-relabel" methods and algorithms based on Ford-Fulkerson style "augmenting paths." We benchmark these algorithms on a number of typical graphs in the contexts of image restoration, stereo, and segmentation. In many cases, our new algorithm works several times faster than any of the other methods, making near real-time performance possible. An implementation of our max-flow/min-cut algorithm is available upon request for research purposes.

Algorithms↗