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PubMed2026

Cancer of unknown primary: the evolution of tissue of origin identification in the artificial intelligence era.

Cancer of Unknown Primary (CUP) presents substantial diagnostic and therapeutic challenges owing to its heterogeneous nature and the absence of an identifiable primary tumor site. This review provides a structured search of the pathogenesis, epidemiological characteristics, and limitations of traditional diagnostic and therapeutic approaches for CUP, with an emphasis on the evolution of Tissue of Origin (TOO) identification techniques. Recent advances in precision medicine have accelerated the development of machine learning-based TOO identification tools, representing a paradigm shift in CUP diagnostics. Deep learning (DL) algorithms that integrate multi-omics data (such as genomics and transcriptomics) with clinical features have markedly enhanced the accuracy of tracing tumor origin, and artificial intelligence (AI) driven TOO models are increasingly being incorporated into clinical practice, offering new insights for pathological diagnosis, treatment selection, and prognostic evaluation. Nevertheless, several challenges remain, including issues of data standardization, model generalizability, and interpretability. Ethical considerations related to data privacy, algorithmic fairness, and clinical implementation also warrant careful attention. Future research should focus on establishing standardized multi-center databases, developing more interpretable AI models, and fostering multidisciplinary collaborative strategies for CUP management. Through continued refinement of technical solutions and regulatory guidelines, TOO identification is anticipated to progress from research to routine clinical application, ultimately supporting precise and personalized care for patients with CUP.

Artificial intelligence↗

PubMed2026

Dataset Readiness Assessment With Large Language Model (DRAFT-LLM): A Multi-Axis Audit Guided by LLM.

This article details the Dataset Readiness Assessment for Training (DRAFT), a systematic method for determining whether a high-dimensional biological dataset is suitable for developing reliable, equitable (i.e., the extent to which model performance, error patterns, and potential benefits or harms are evaluated and found to be acceptably distributed across relevant demographic, biological, clinical, and contextual subgroups), and scientifically meaningful machine-learning models, and DRAFT Large Language Model (DRAFT-LLM), its optional human-in-the-loop extension for calibrating study-specific audits through structured, critically reviewed LLM guidance. Standard model validation often fails to detect when apparent performance is driven by spurious correlations, technical artifacts, or hidden stratification, leading to irreproducible and inequitable findings. DRAFT-LLM addresses this gap by shifting the focus from model tuning to structured dataset auditing, organized around Support Protocols 1 to 4 that capture the scientific intent, data structure, and governance constraints of a given study. These Support Protocols: (1) elicit and formalize investigator input into a study intake and dataset card; (2) compute standardized dataset statistics and structural summaries suitable for downstream analysis and LLM context; (3) configure the language model using form-based responses, safety guardrails, and governance rules; and (4) generate personalized instructions, prompts, and code templates for running DRAFT audits. Basic Protocols 1 to 3 are instantiated from this support layer for generalization, equity, and stability: they are reusable execution patterns whose concrete behavior is determined by the cards, statistics, and configurations defined in the Support Protocols. DRAFT-LLM and DRAFT are demonstrated in this article through an end-to-end case study on The Cancer Genome Atlas (TCGA). © 2026 Wiley Periodicals LLC. Support Protocol 1: Study intake and dataset card construction Support Protocol 2: Dataset structure and advanced summary statistics for LLM context Support Protocol 3: LLM configuration using structured form responses Support Protocol 4: Generation of personalized instructions for DRAFT audits Basic Protocol 1: Generalization audit Basic Protocol 2: Equity audit Basic Protocol 3: Stability audit.

Large Language Models↗

PubMed2026

Fairness-aware supervised hierarchical contrastive semantic learning for sexual dimorphism analysis.

MOTIVATION: Sexual dimorphism is a fundamental biological determinant driving systematic differences in disease susceptibility, progression, and clinical outcomes. However, current sex-combined AI-based genomic models often exhibit algorithmic bias and fail to capture these sex-specific mechanisms, creating a critical barrier to unbiased precision medicine. Ensuring fairness in the context of sexual dimorphism requires understanding and addressing the distinct biological mechanisms functioning in each sex, rather than focusing solely on equalizing predictive performance. RESULTS: We propose a fairness-aware supervised hierarchical contrastive learning approach, called FairHICON, to discover unbiased sex-common and sex-specific predictive features. Evaluations on cancer and asthma transcriptomic datasets demonstrate that FairHICON significantly outperforms state-of-the-art benchmarks, improving predictive performance by up to 9% while effectively reducing the performance gap between male and female sexes. Furthermore, prognostic validation confirms that the identified sex-specific pathways stratify patient survival significantly better within their corresponding sex groups. This validates FairHICON to elucidate the molecular heterogeneity of sexual dimorphism, advancing inclusive precision medicine. AVAILABILITY AND IMPLEMENTATION: The source code and data is available at https://github.com/datax-lab/FairHICON.

Sex Characteristics↗

PubMed1979

Considerations in applying clustering techniques to speaker-independent word recognition.

Recent work at Bell Laboratories has demonstrated the utility of applying sophisticated pattern recognition techniques to obtain a set of speaker-independent word templates for an isolated word recognition system [Levinson et al.,IEEE Trans. Acoust. Speech Signal Process. ASSP-27 (2), 134--141 (1979); Rabiner et al., IEEE Trans. Acoust. Speech Signal Process.(in press)]. In these studies, it was shown that a careful experimenter could guide the clustering algorithms to choose a small set of templates that were representative of a large number of replications for each word in the vocabulary. Subsequent word recognition tests verified that the templates chosen were indeed representative of a fairly large population of talkers. Given the success of this approach, the next important step is to investigate fully automatic techniques for clustering multiple versions of a single word into a set of speaker-independent word templates. Two such techniques are described in this paper. The first method uses distance data (between replications of a word) to segment the population into stable clusters. The word template is obtained as either the cluster minimax, or as an averaged version of all the elements in the cluster. The second method is a variation of the one described by Rabiner [IEEE Trans. Acoust. Speech Signal Process. ASSP-26 (3), 34--42 (1978)] in which averaging techniques are directly combined with the nearest neighbor rule to simultaneously define both the word template (i.e., the cluster center) and the elements in the cluster. Experimental data show the first method to be superior to the second method when three or more clusters per word are used in the recognition task.

Humans↗

PubMed2026

The Role of Artificial Intelligence for Intimate Partner Violence Prevention: A Systematic Review.

INTRODUCTION: Intimate partner violence (IPV), encompassing physical, sexual, emotional and economic abuse, remains a pervasive global health concern. Traditional prevention efforts face obstacles such as underreporting, delayed detection and limited personalised support. Emerging artificial intelligence (AI) approaches offer new opportunities to enhance IPV prevention. AIM: This systematic review maps and synthesises evidence on AI-driven tools in IPV prevention based on studies published between 2004 and 2024. METHODS: Following PRISMA 2020 guidelines and PROSPERO registration, we searched PubMed, Embase, CINAHL, PsycINFO, IEEE Xplore and Web of Science. Eligible studies explicitly evaluated AI technologies targeting IPV prediction, screening, intervention or support delivery. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). RESULTS: Of 1304 records initially identified, 41 studies met eligibility criteria. AI applications ranged from machine learning (ML) for risk prediction and natural language processing (NLP) for IPV detection in clinical and social media data, to image analysis for forensic evaluation and chatbot-based support. Predictive modelling demonstrated strong discriminative performance, while NLP-based screening detected IPV with notable sensitivity. Chatbots showed feasibility and user acceptability, but evidence of their direct impact on reducing IPV incidence was limited, with one randomised controlled trial showing a modest reduction. Key challenges identified included algorithmic bias, data privacy risks and barriers to integration across health and social care systems. DISCUSSION: AI-informed interventions show promise for improving IPV detection, risk assessment, and scalable support, but questions remain about long-term effectiveness, ethical fairness, transparency and equitable implementation. Future interdisciplinary research should address these concerns to responsibly deploy AI in IPV prevention. RELEVANCE TO CLINICAL PRACTICE: The findings highlight the importance of trauma-informed, culturally responsive care and provider training in AI applications. Nurse-led innovation and policy advocacy will be crucial for safe, equitable integration of AI in IPV prevention.

Artificial Intelligence↗

PubMed1979

Stability mapping along the DNA double strand and its relation to the genetic map.

The distribution of the stability of the double helical structure along the whole DNA of fdphage and its restriction fragments is calculated. In this calculation, Poland's method, which has been established as a rigorous algorithm for taking the base sequence explicitly into consideration, is used. The molecular thermodynamic parameters in the calculation have been determined so as to best reproduce the melting profile of the DNA and its fragments. The results, which are presented as melting maps, show fairly good agreement with those experimentally obtained by the present authors earlier. A close correlation with genes in the genetic map is apparent for some cooperatively melting regions observed in the stability map.

Chemical Phenomena↗

PubMed2026

A flexible framework for robust and efficient Mendelian randomization with debiasing.

Mendelian randomization (MR) has been widely used to infer causal relationships between exposures and outcomes in epidemiological studies. However, classical MR assumptions can be violated when genetic variants are associated with outcomes through pathways other than the exposure, leading to uncorrelated and/or correlated pleiotropy. Additionally, measurement error arising from the inherent uncertainty in summary statistics obtained from large-scale genome-wide association studies can introduce bias into the causal effect estimate. To address these issues, we develop a debiased mixture inverse variance weighting ($\mathsf{dmIVW}$) method with three major advantages. First, it is capable of simultaneously handling various types of pleiotropy and eliminating the bias caused by uncertainty. Second, it can guard against distortion caused by invalid genetic variants while effectively harnessing their information. Third, our unified framework facilitates a fair comparison and combination of a series of submodels, encompassing several popular MR methods as special cases. Through real data applications, the effectiveness and robustness of $\mathsf{dmIVW}$ in estimating the causal effects of risk factors on common diseases are demonstrated.

Mendelian Randomization Analysis↗

PubMedDate not supplied

Treatment of male infertility with human gonadotrophins: selection of cases, management and results.

To obtain optimal results with gonadotrophic therapy (HMG/hCG) in infertile males, strict selection of patients is of paramount importance. The use of algorithmic schemes permits the exclusion of patients with primary testicular failure, genetic and non-endocrine causes of infertility. This paper describes a retrospective study on the results of gonadotrophic therapy in 25 severe oligozoospermic males, preselected according to the above scheme and in whom levels of FSH, LH and Testosterone before and during GnRH stimulation were assessed. This study indicates that low basal levels of FSH, concomitant with low or lack of FSH response to GnRH stimulation may be useful in selection of patients with a fair chance of success for gonadotrophic therapy.

Chorionic Gonadotropin↗

PubMed2026

Externally validated risk prediction models for gestational diabetes mellitus: A systematic review and meta-analysis.

INTRODUCTION: Risk prediction models for gestational diabetes mellitus (GDM) offer potential for early identification and targeted prevention. External validation is crucial to assess model performance across diverse populations. Despite the availability of numerous GDM prediction models, limited evidence exists on their external validation frequency, methodological quality, and clinical applicability. This systematic review evaluated externally validated GDM prediction models, focusing on methodological rigor, reporting standards, and clinical relevance to inform future research and implementation. MATERIAL AND METHODS: Databases including Ovid MEDLINE, Embase, Scopus, Emcare, and CINAHL were searched up to May 1, 2025. Studies reporting external validation of GDM risk prediction models were included. Two reviewers independently screened studies. Data were extracted using the CHARMS framework, and risk of bias and applicability were assessed using PROBAST+AI. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251125758). RESULTS: Twenty-six studies validated 33 models, with validation sample sizes ranging from 50 to 75 161. Over half used the IADPSG criteria to define GDM. Discrimination metrics were commonly reported, but calibration, overall performance, and clinical utility were often lacking. Meta-analysis was feasible for only four models: Teede et al., Nanda et al., Naylor et al., and Van Leeuwen et al., each showing fair discrimination. The Teede et al. model was the most widely validated, with 11 external validations across six continents and a pooled AUC of 0.72 (95% CI: 0.67-0.76). Despite fewer validations, the Nanda et al. model achieved the highest pooled discrimination (5 validations; pooled AUC 0.77, 95% CI: 0.74-0.80). The Naylor et al. and van Leeuwen et al. models also underwent meta-analysis, as sufficient external validation studies were available to support comparative performance assessment. Notably, 69.23% of studies had a high risk of bias. CONCLUSIONS: While many models showed acceptable predictive performance, most validations were methodologically weak. Future studies should follow best-practice guidelines and promote scalable validation strategies, such as algorithm sharing, to enhance clinical utility.

Humans↗