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PubMed2026

Stratifying lung adenocarcinoma: a novel prognostic model based on mitochondrial outer membrane permeabilization activity.

UNLABELLED: Mitochondrial outer membrane permeabilization (MOMP) is a core apoptotic regulatory event that dictates mitochondrial integrity, where full activation drives cell death and sublethal dysregulation contributes to tumor genomic instability. We used the Cancer Genome Atlas lung adenocarcinoma cohort (TCGA-LUAD) as the training cohort and the Gene Expression Omnibus dataset GSE42127 as the validation cohort to identify prognostic genes related to MOMP activity in lung adenocarcinoma (LUAD) and to evaluate their potential biological significance. By intersecting MOMP-related genes with differentially expressed genes, combined with survival analysis, Mendelian randomization analysis, and 101 machine-learning algorithm combinations, seven prognostic genes, namely BIRC5, PSMD11, TNFRSF13C, YWHAZ, YWHAG, CYCS, and LTB, were identified. Next, an optimal prognostic model was constructed based on the gradient boosting machine (GBM) algorithm. Based on the risk score, LUAD patients were stratified into high- and low-risk groups, and patients in the high-risk group exhibited poorer overall survival in both the training and validation cohorts. Furthermore, a nomogram integrating the risk score and clinicopathological factors was developed and showed favorable predictive performance for 1-, 3-, and 5-year survival. Meanwhile, functional and immune analyses revealed that the high-risk group was enriched in DNA replication-related pathways and demonstrated a higher tumor mutation burden (TMB). Correlation analysis indicated that TNFRSF13C was positively correlated with activated B cells, whereas BIRC5 was negatively correlated with eosinophils, suggesting that MOMP-related genes might be involved in remodeling the immune microenvironment of LUAD. Drug sensitivity analysis showed differences in predicted half-maximal inhibitory concentration (IC50) values between the risk groups, suggesting the potential value of this model in assisting therapeutic stratification. Single-cell RNA sequencing (scRNA-seq) further identified T lymphocytes as a key cell type, with numerous prognostic genes exhibiting differential expression in T cells or dynamic changes during differentiation. We suggest that the MOMP-related signature established in this study may provide a reference for prognostic stratification in LUAD and offers candidate prognostic genes for subsequent experimental and clinical validation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s13205-026-05058-6.

Lung adenocarcinoma↗
PubMed1997

Evaluation of automatically learned intelligent alarm systems.

In this contribution it is investigated whether a combination of mathematical simulation and inductive machine learning can replace the usual knowledge elicitation techniques. To test this a domain was selected for which knowledge based systems had a high performance: intelligent alarm systems. A mathematical model of a breathing circuit and ventilated patient was implemented in PSpice. Airway pressure, gas flows and CO2 concentration were simulated with this model, during normal functioning of the breathing circuit and during several mishaps, for a wide range of simulated patients. With an inductive machine learning program, classification trees were created from the simulated patient data. The classification trees described each breathing circuit mishap in terms of changes in signal feature values with respect to the normal situation and were implemented as alarm system knowledge bases. The alarm systems were tested with data measured at 17 mechanically ventilated animals. During ventilation of the animals several mishaps were introduced. For each animal, 93-100% of all mishaps could be detected correctly by the alarm systems. The false alarm rate ranged on average from one false alarm per h to one false alarm every 2.5 h. It was concluded that the suggested approach to knowledge elicitation was successful.

Animals↗
PubMed2026

CCT2 defines a highly cisplatin-resistant and poor-prognosis subtype of lung adenocarcinoma.

Cisplatin-based chemotherapy is a standard treatment for lung adenocarcinoma (LUAD), yet acquired cisplatin resistance remains a marked cause of treatment failure. The molecular mechanisms driving cisplatin resistance in LUAD have not been fully elucidated. The present study integrated bulk transcriptomic data, genomic mutation profiles and single-cell RNA sequencing data to systematically investigate cisplatin resistance in LUAD. Resistance-associated genes were identified through differential expression, survival analysis and database integration. Unsupervised clustering was used to define cisplatin resistance-associated subtypes. Functional characteristics were explored using pathway enrichment, immune infiltration, tumor mutation burden and weighted gene co-expression network analysis. A machine learning framework incorporating 101 algorithms was applied to identify key genes and construct a prognostic model. Single-cell analyses and in vitro experiments were performed to validate the biological role of the core gene. Molecular docking and molecular dynamics simulations were conducted to identify potential therapeutic compounds. A total of two molecular subtypes with distinct cisplatin resistance levels and prognostic outcomes were identified. The high-resistance subtype exhibited enhanced cell cycle activity, DNA repair signaling and immune heterogeneity. Machine learning analysis revealed a five-gene signature, with chaperonin-containing TCP1 subunit 2 (CCT2) emerging as a key regulator of cisplatin resistance. Single-cell analyses showed that CCT2 was predominantly enriched in resistant epithelial cell subpopulations. Functional experiments demonstrated that CCT2 knockdown significantly inhibited cell proliferation and enhanced cisplatin sensitivity in LUAD cell lines. A number of candidate compounds targeting CCT2 exhibited stable binding in silico. The present findings identified CCT2 as a key mediator of cisplatin resistance in LUAD and provided potential therapeutic strategies to overcome chemotherapy resistance.

chaperonin-containing TCP-1 subunit 2↗
PubMed2026

Machine learning and multi-omics clustering to map cellular rewiring and immune evasion in ccRCC.

Immune checkpoint blockade (ICB) efficacy in clear cell renal cell carcinoma (ccRCC) is limited by tumor microenvironment (TME) heterogeneity. Because traditional bulk-derived models lack spatial resolution, we developed an integrated framework connecting macroscopic survival risks to microscopic TME structures. We applied ten algorithms to establish multi-omics subtypes and evaluated 101 machine-learning combinations across three independent cohorts to generate a Consensus Machine Learning-driven Signature (CMLS). The signature's spatial and cellular origins were decoded using spatial transcriptomics (ST) and a 140,000-cell scRNA-seq atlas. Expression of key genes was experimentally validated via RT-qPCR in 17 paired ccRCC clinical tissues. We identified two molecular subtypes with distinct clinical and epigenetic profiles. SuperPC optimization yielded a 24-gene CMLS serving as an independent prognostic factor. scRNA-seq and ST deconvolution revealed these signals predominantly originate from cancer-associated fibroblasts (CAFs) and malignant epithelial cells, which collaborate to drive spatial immune exclusion. RT-qPCR confirmed significant overexpression of five core CMLS genes in ccRCC versus adjacent normal tissues. Low CMLS scores correlated with enhanced ICB responsiveness, whereas high-CMLS tumors demonstrated specific vulnerability to dasatinib and dabrafenib. The CMLS translates spatial immune-exclusion dynamics into a quantifiable metric, outperforming tumor mutational burden in predicting ICB benefits, providing a robust tool for patient stratification in ccRCC.

Humans↗
PubMed1996

Concept formation vs. logistic regression: predicting death in trauma patients.

This study compares two classification models used to predict survival of injured patients entering the emergency department. Concept formation is a machine learning technique that summarizes known examples cases in the form of a tree. After the tree is constructed, it can then be used to predict the classification of new cases. Logistic regression, on the other hand, is a statistical model that allows for a quantitative relationship for a dichotomous event with several independent variables. The outcome (dependent) variable must have only two choices, e.g. does or does not occur, alive or dead, etc. The result of this model is an equation which is then used to predict the probability of class membership of a new case. The two models were evaluated on a trauma registry database composed of information on all trauma patients admitted in 1992 to a Level I trauma center. A total of 2155 records. representing all trauma patients admitted for more than 24 h or who died in the Emergency Department, were grouped into two databases as follows: (1) discharge status of 'died' (containing 151 records), and (2) any discharge status other than 'died' (containing 2004 records). Both databases contained the same variables.

Artificial Intelligence↗
PubMed2026

A transcription factor regulatory atlas for activity inference and perturbation prediction.

Inferring transcription factor (TF) activity from transcriptomes and predicting transcriptome-wide responses to TF perturbations remain challenging, in part because available TF-mRNA resources often face a trade-off between precision and coverage and typically lack signed regulatory information. Here, we present TFActProfiler, a TF-mRNA resource and computational framework that learns signed, quantitative TF-mRNA regulatory coefficients by integrating heterogeneous prior evidence (ChIP-based, motif-based, and curated TF-mRNA annotations) with large-scale bulk and single-cell RNA-seq atlases. TFActProfiler contains 2 606 176 signed TF-mRNA interactions and improves TF activity inference in TF knockdown benchmarks relative to widely used regulon resources while retaining broad TF and target coverage. In addition, because the same learned regulatory coefficients can be used to model downstream transcriptional effects, TFActProfiler enables prediction of transcriptome-wide gene expression responses to TF knockdown without training on task-matched perturbation data. When perturbation datasets are available, TFActProfiler can be further refined to achieve performance comparable to state-of-the-art machine-learning baselines. By providing a direction-aware representation of TF-mRNA regulation for both activity inference and perturbation-response modeling, TFActProfiler supports systematic dissection of gene regulatory programs across diverse cellular contexts.

Transcription Factors↗
PubMed2025

Adapting systems biology to address the complexity of human disease in the single-cell era.

Systems biology aims to achieve holistic insights into the molecular workings of cellular systems through iterative loops of measurement, analysis and perturbation. This framework has had remarkable success in unicellular model organisms, and recent experimental and computational advances - from single-cell and spatial profiling to CRISPR genome editing and machine learning - have raised the exciting possibility of leveraging such strategies to prevent, diagnose and treat human diseases. However, adapting systems-inspired approaches to dissect human disease complexity is challenging, given that discrepancies between the biological features of human tissues and the experimental models typically used to probe function (which we term 'translational distance') can confound insight. Here we review how samples, measurements and analyses can be contextualized within overall multiscale human disease processes to mitigate data and representation gaps. We then examine ways to bridge the translational distance between systems-inspired human discovery loops and model system validation loops to empower precision interventions in the era of single-cell genomics.

Humans↗
PubMed2025

Predicting host tropism in influenza a viruses: insights from multi-segment nucleotide signatures.

BACKGROUND: Influenza A virus (IAV) poses a significant public health threat due to its cross-species transmission and complex host adaptation mechanisms. This study integrated whole-genome data from avian, human, swine, and bovine IAV strains, using machine learning to predict viral host tropism based on nucleotide site features and to identify key sites driving host adaptation along with their synergistic effects. METHODS: A total of 64,000 IAV sequences from avian, human, swine, and bovine hosts were analyzed to build host-prediction models. A four-class classification framework (avian, human, swine, bovine) was constructed using nucleotide site features from all eight genomic segments (PB2, PB1, PA, HA, NP, NA, MP, NS). Eight machine learning algorithms (logistic regression, decision tree, random forest, SVM, KNN, gradient boosting, XGBoost, LightGBM) were benchmarked via 10-fold stratified cross-validation. Model performance was evaluated using accuracy, precision, recall, F1-score, AUPRC, and AUC. SHAP (SHapley Additive exPlanations) analysis prioritized critical nucleotide sites, while bivariate association tests identified synergistic/antagonistic interactions between sites. Nucleotide composition profiles were compared across host groups using hierarchical clustering and heatmap visualization. RESULTS: The XGBoost algorithm demonstrated the best and most stable performance, achieving an AUC value of over 0.95 in distinguishing human-derived sequences from non-human ones. SHAP analysis identified the top 20 critical nucleotide sites for each gene segment, such as sites 46 and 698 in the NS segment. Nucleotide composition analysis revealed high similarity between human and swine sequences in the HA and PB2 segments, and between avian and bovine sequences. The HA segment was particularly challenging in differentiating human from swine strains. Bivariate site association analysis uncovered significant synergistic or antagonistic effects between key sites within gene segments, forming complex networks. For instance, in the NS segment, a positive prediction contribution was observed when sites 371, 698, and 419 were all G. CONCLUSIONS: This study advances our mechanistic understanding of IAV host adaptation, identifies molecular determinants for zoonotic risk stratification, and establishes a scalable machine learning framework for predicting viral host tropism through nucleotide signature analysis, thereby enhancing surveillance strategies and informing preventive measures against emerging viral threats.

Influenza A virus↗
PubMed2026

Linking MRI radiomics to transcriptomics-based radiosensitivity in lower-grade glioma: A radiogenomic framework.

BACKGROUND: RSI is a transcriptomics-based biomarker associated with radiotherapy outcomes, but its clinical application is constrained by the requirement for tumor tissue and RNA sequencing. This study investigates whether MRI-derived radiomic features can reflect RSI-defined intrinsic radiosensitivity in lower-grade glioma.This addresses a critical gap arising from the limited availability of matched imaging and genomic data in routine clinical practice. METHODS: MRI-derived radiomic features were extracted from FLAIR images of lower-grade glioma patients obtained from TCIA and matched with transcriptomic data from TCGA. A total of 107 patients with both MRI and RNA sequencing data were included in the radiogenomic analysis. Radiomic features were ranked using a Borda-based ensemble feature selection strategy. Five supervised machine-learning classifiers were trained to predict RSI-based radiosensitivity classification, and model interpretability was assessed using SHAP within radiogenomic framework. RESULTS: Classification performance increased with feature number and stabilized at compact subset of 13 radiomic features. Logistic regression showed stable performance with an AUC of 0.82 (95 % CI: 0.71-0.93). SHAP analysis indicated that heterogeneity-related texture features were dominant contributors to model predictions, with many associated with the RR phenotype, while others were linked to the RS phenotype. CONCLUSION: An MRI-based radiomic signature enables non-invasive prediction of RSI-defined radiosensitivity in lower-grade glioma. Rather than offering an immediately deployable clinical tool, this study establishes a proof-of-concept radiogenomic framework demonstrating that intrinsic radiosensitivity, traditionally assessed through invasive molecular assays, can be approximated using quantitative imaging features. These findings highlight the potential of imaging-based radiosensitivity assessment and provide a foundation for future radiogenomic investigations.

Lower-grade glioma↗
PubMed2026

A leakage-aware genomic prediction pipeline for meropenem resistance in Klebsiella pneumoniae using transformer-based resistome representation learning.

MOTIVATION: Antimicrobial resistance (AMR) in Klebsiella pneumoniae, particularly to carbapenems such as meropenem, is a major global health problem. Machine learning is increasingly used to predict resistance from genomic markers; however, many models fail to capture high-level gene-gene interactions and may exhibit inflated performance due to lineage-biased prediction. Existing genomic prediction models largely rely on flat feature representations that fail to capture epistatic gene interactions, and commonly suffer from inflated performance estimates due to phylogenetic data leakage. To address these limitations simultaneously, a leakage-aware hybrid TabTransformer-CatBoost pipeline was developed, combining self-attention-based resistome representation learning with gradient boosting classification under clade-aware data partitioning. A self-attention encoder converts sparse gene presence-absence profiles into contextualized latent embeddings, which are subsequently classified using gradient boosting to capture lineage-aware AMR patterns. RESULTS: The proposed architecture outperformed classical baselines including Logistic Regression, Random Forest, XGBoost, and optimized CatBoost models. Internal accuracy reached 92.59% for the Chained Hybrid configuration (area under the receiver operating characteristic curve, AUROC = 0.8670, F1 = 0.8537). Performance gains primarily originated from the embedding stage, as confirmed by ablation analysis. External validation across independent multinational cohorts (n = 305) demonstrated generalizability (AUROC = 0.8105; F1 = 0.7552). Permutation testing produced near-zero Matthews Correlation Coefficient (MCC) = 0.0091, indicating predictions reflect genuine biological signal rather than noise. These results establish attention-based genomic embedding with gradient boosting as a scalable, interpretable, and leakage-aware framework for clinical AMR prediction. AVAILABILITY AND IMPLEMENTATION: The source code for the TabTransformer-CatBoost framework, including preprocessing pipelines and pre-trained embeddings, is available at https://github.com/SibelKervanci/kp-meropenem-tabtransformer.

Journal Article↗
PubMed2025

The signed two-space proximity model for learning representations in protein-protein interaction networks.

MOTIVATION: Accurately predicting complex protein-protein interactions (PPIs) is crucial for decoding biological processes, from cellular functioning to disease mechanisms. However, experimental methods for determining PPIs are computationally expensive. Thus, attention has been recently drawn to machine learning approaches. Furthermore, insufficient effort has been made toward analyzing signed PPI networks, which capture both activating (positive) and inhibitory (negative) interactions. To accurately represent biological relationships, we present the Signed Two-Space Proximity Model (S2-SPM) for signed PPI networks, which explicitly incorporates both types of interactions, reflecting the complex regulatory mechanisms within biological systems. This is achieved by leveraging two independent latent spaces to differentiate between positive and negative interactions while representing protein similarity through proximity in these spaces. Our approach also enables the identification of archetypes representing extreme protein profiles. RESULTS: S2-SPM's superior performance in predicting the presence and sign of interactions in SPPI networks is demonstrated in link prediction tasks against relevant baseline methods. Additionally, the biological prevalence of the identified archetypes is confirmed by an enrichment analysis of Gene Ontology (GO) terms, which reveals that distinct biological tasks are associated with archetypal groups formed by both interactions. This study is also validated regarding statistical significance and sensitivity analysis, providing insights into the functional roles of different interaction types. Finally, the robustness and consistency of the extracted archetype structures are confirmed using the Bayesian Normalized Mutual Information (BNMI) metric, proving the model's reliability in capturing meaningful SPPI patterns. AVAILABILITY: S2-SPM is implemented and freely available under the MIT license at https://github.com/Nicknakis/S2SPM.

Protein Interaction Mapping↗
PubMed2025

Development and Validation an Integrated Deep Learning Model to Assist Eosinophilic Chronic Rhinosinusitis Diagnosis: A Multicenter Study.

BACKGROUND: The assessment of eosinophilic chronic rhinosinusitis (eCRS) lacks accurate non-invasive preoperative prediction methods, relying primarily on invasive histopathological sections. This study aims to use computed tomography (CT) images and clinical parameters to develop an integrated deep learning model for the preoperative identification of eCRS and further explore the biological basis of its predictions. METHODS: A total of 1098 patients with sinus CT images were included from two hospitals and were divided into training, internal, and external test sets. The region of interest of sinus lesions was manually outlined by an experienced radiologist. We utilized three deep learning models (3D-ResNet, 3D-Xception, and HR-Net) to extract features from CT images and calculate deep learning scores. The clinical signature and deep learning score were inputted into a support vector machine for classification. The receiver operating characteristic curve, sensitivity, specificity, and accuracy were used to evaluate the integrated deep learning model. Additionally, proteomic analysis was performed on 34 patients to explore the biological basis of the model's predictions. RESULTS: The area under the curve of the integrated deep learning model to predict eCRS was 0.851 (95% confidence interval [CI]: 0.77-0.93) and 0.821 (95% CI: 0.78-0.86) in the internal and external test sets. Proteomic analysis revealed that in patients predicted to be eCRS, 594 genes were dysregulated, and some of them were associated with pathways and biological processes such as chemokine signaling pathway. CONCLUSIONS: The proposed integrated deep learning model could effectively predict eCRS patients. This study provided a non-invasive way of identifying eCRS to facilitate personalized therapy, which will pave the way toward precision medicine for CRS.

Humans↗
PubMed2026

Diagnostic Performance of Machine Learning for Systemic Lupus Erythematosus: Systematic Review and Meta-Analysis.

BACKGROUND: Early and accurate diagnosis of systemic lupus erythematosus (SLE) and its organ involvement is essential. Previous reviews of machine learning (ML) in SLE combined heterogeneous tasks and validation strategies and may have overinterpreted model performance. OBJECTIVE: This study evaluated the diagnostic performance of ML and deep learning (DL) models for 3 clinically distinct SLE-related tasks: SLE classification or diagnosis, lupus nephritis (LN) diagnosis, and neuropsychiatric systemic lupus erythematosus (NPSLE) discrimination. We also assessed methodological quality and certainty of evidence. METHODS: PubMed, Embase, Cochrane Library, Web of Science, and IEEE Xplore were searched from January 2014 to April 2026. Eligible peer-reviewed diagnostic accuracy studies developed or validated ML or DL models for 1 of the 3 prespecified tasks, used an accepted reference standard, and provided data for a 2×2 contingency table. Bivariate random-effects meta-analyses with the Hartung-Knapp-Sidik-Jonkman adjustment were used to pool sensitivity and specificity. We reported 95% prediction intervals (PIs), assessed risk of bias using the Quality Assessment of Diagnostic Accuracy Studies for Artificial Intelligence tool (QUADAS-AI; Viknesh Sounderajah [Imperial College London]), and evaluated certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation framework for diagnostic test accuracy. RESULTS: Twenty-nine studies were included: 17 for SLE classification, 5 for LN diagnosis, and 7 for NPSLE discrimination. In the primary task-stratified analysis, pooled sensitivity was 0.91 (95% CI 0.86-0.94; 95% PI 0.56-0.99), and pooled specificity was 0.94 (95% CI 0.91-0.96; 95% PI 0.69-0.99), with low heterogeneity (I²=23.9% and 22.9%, respectively). DL models showed a sensitivity of 0.93 and specificity of 0.95, compared with 0.88 and 0.94 for traditional ML models. Certainty of evidence was high for most analyses but low for LN diagnosis because of inconsistency and imprecision. All studies were retrospective, and only 9 of 29 (31%) performed independent external validation. Overall risk of bias was high or unclear in 22 of 29 (75.9%) studies. No study reported model calibration, decision-curve analysis, or net clinical benefit. CONCLUSIONS: ML models showed promising diagnostic accuracy across 3 distinct SLE-related tasks, but wide PIs, limited external validation, and pervasive risk of bias restrict conclusions about real-world generalizability. Prospective multicenter studies with standardized tasks and reference standards, independent external validation, and formal assessment of calibration and clinical utility are required before clinical implementation.

Humans↗
PubMed2026

Proteo-metabolomic integration identifies stage-specific candidate biomarkers for Parkinson's disease.

Parkinson's disease (PD) is a progressive neurodegenerative disorder with a prolonged prodromal phase and complex motor symptoms. Despite improved clinical criteria, early diagnosis and longitudinal monitoring remain challenging. While cerebrospinal fluid (CSF) and plasma metabolites and proteins show biomarker potential, their utility in predictive models is insufficiently characterized. We employed a secondary computational approach to integrate proteometabolomic profiles from CSF and plasma samples of >1100 Parkinson's Progression Markers Initiative (PPMI) participants. Using multi-omics machine learning, we identified biofluid-specific signatures and evaluated predictive performance. Twenty-one biomarker candidates were validated across three models (SVM, GLMNET, RF); SVM and GLMNET achieved the highest recall (83-86%) and AUCs of 0.84-0.89. Longitudinal mixed-effects modeling revealed eight candidates associated with progression across diagnostic stages. We identified a three-part molecular framework characterizing neurodegeneration: a diagnostic subpanel reflecting early microbiome dysregulation (secretory granins and metabolites) and synaptic breakdown; a second subpanel monitoring phenoconversion via neurogenesis precursors and extracellular matrix proteins; and a third subpanel tracking progression through chronic neuroinflammation and immune activation. This integrated multi-omics approach provides a robust framework for stage-specific PD monitoring and potential clinical deployment.

Journal Article↗
PubMed2025

Stochastic epigenetic mutation profiles as biomarkers of clinical activity in juvenile idiopathic arthritis: a multi-omic machine learning approach for gene prioritization.

BACKGROUND: Juvenile idiopathic arthritis (JIA) is a rare autoimmune disease arising from a complex interplay between genetic and environmental factors. Epigenetic modifications such as DNA methylation (DNAm) have been described as potential mediators in gene-environment interactions, contributing to immune system dysregulation. Emerging evidence suggests that DNAm profiles also predict therapeutic responses in autoimmune diseases. This study aims to identify epigenetic biomarkers and epigenetic-driven gene expression changes associated with JIA clinical activity. METHODS: We reanalyzed a publicly available dataset of 44 JIA patients, with whole-genome DNAm and gene expression from CD4 + T cells measured at two points: at anti-TNF therapy withdrawal (T0) and eight months later (Tend). At Tend, 30 patients maintained inactive disease (ID) while 14 did not (NO ID). We investigated differences between ID and NO ID patients in the epigenetic mutation load and various epigenetic clocks through linear regression models, and prioritized genomic regions with significantly higher number of epimutations in NO ID patients through machine learning. RESULTS: We found a higher mutation load in NO ID than ID patients, both at T0 and at Tend, with the differences at Tend reaching statistical significance (p = 0.02). In contrast, we found no evidence of association between epigenetic clocks and JIA clinical activity. Using a multi-omic approach, we identified a List of candidate epigenetically-driven differentially expressed genes, 80 up-regulated and 77 down-regulated, in NO ID patients. Finally, comparing our candidate gene list with the Connectivity Map database, we identified new candidate potential therapeutic targets. Key findings were validated in independent datasets: DNAm profiles from CD4 + T cells (56 JIA patients, 57 controls) and transcriptomic data from PBMCs of JIA patients with active or inactive disease, confirming dysregulation of pathways such as TNF-α signaling via NF-kB and TGF-β signaling among others. CONCLUSIONS: We described a significant association of epigenetic mutations with JIA clinical activity, indicating that epigenetic changes might precede clinical symptoms and may serve as biomarkers for early disease monitoring. Further, our results shed light on biomolecular mechanisms of JIA, supporting the development of more effective treatments.

Humans↗
PubMed2026

Toward a Better Paradigm for Head and Neck Cancer Treatment Applying AI (HNC-TACTIC): Protocol for an International Cohort Study of Electronic Health Records.

BACKGROUND: Head and neck squamous cell carcinomas (HNSCCs) cause considerable morbidity and mortality. Multimodal treatment strategies can cause significant toxicity, and therapy options are limited for recurrent disease. Immunotherapy has emerged as a promising approach. However, patient response variability underscores the need for better predictive markers. OBJECTIVE: This study aims to use artificial intelligence to develop two predictive models in patients with HNSCC to assess (1) progression or recurrence following primary curative treatment and (2) long-term survival after immunotherapy schemes in recurrent and metastatic disease. This study will also describe the characteristics of patients with early, locally advanced, and recurrent or metastatic cancers. METHODS: This is a retrospective, observational study of data captured in electronic health records (EHRs) from participating hospitals between January 1, 2014, and December 31, 2021. This study's population comprises adults diagnosed with HNSCC at any stage. Study variables, including demographics, comorbidities, clinical variables, treatments, and outcomes, will be extracted using EHRead, a technology that applies natural language processing and machine learning to extract and analyze structured and unstructured clinical information in deidentified EHRs. Predictive models based on dynamic risk stratification for treatment response and progression or recurrence will be developed using multivariable logistic regressions, decision tree classifiers, and random forest approaches. Descriptive and outcome analyses will be shown for different anatomic subsites and stratified by stage and treatment. RESULTS: This study began enrolling sites in July 2021 and is currently ongoing. By December 2025, data from 10 centers has been collected, comprising a total of 151,934,990 EHRs from 2,159,719 patients. CONCLUSIONS: Development of predictive models using artificial intelligence will advance clinical understanding of HNSCC to improve patient outcomes.

Humans↗
PubMed2026

AI-Supported, Integrative Prediction of Postoperative Delirium: Protocol for the CONFUSED Study.

BACKGROUND: Postoperative delirium (POD) is a frequent and serious complication in older surgical patients, characterized by acute cognitive dysfunction and fluctuating levels of consciousness. POD is associated with prolonged hospitalization, long-term cognitive decline, reduced quality of life, and increased mortality. Despite its clinical relevance, the underlying pathophysiological mechanisms remain poorly understood, and reliable biomarkers for early prediction and prevention are lacking. OBJECTIVE: The CONFUSED study aims to identify molecular and clinical predictors of POD by integrating clinical data with proteomic, transcriptomic, and epigenetic analyses. The primary objective is to develop predictive models for POD using multimodal data. Secondary objectives include the identification of delirium-associated genes, proteins, and epigenetic signatures, as well as the exploration of patient subgroups at increased risk for POD. METHODS: CONFUSED is a prospective observational cohort study conducted at a German university hospital. Adult patients undergoing major surgery under general anesthesia will be enrolled until 100 cases of POD have been observed, which is expected to require a total sample size of approximately 200 to 300 patients. Blood samples are collected at 4 predefined time points: before premedication, immediately after surgery, and on postoperative days 2 and 5. Samples undergo comprehensive proteomic profiling, transcriptomic analysis using RNA microarrays, DNA methylation analysis, and genotyping of selected polymorphisms. Clinical data, including demographics, comorbidities, perioperative variables, medications, and delirium assessments using the Confusion Assessment Method (CAM) and CAM for the intensive care unit, are systematically recorded. Statistical analyses include univariate and multivariate methods, as well as machine learning approaches such as random forests and support vector machines, to identify relevant biomarkers and develop predictive models. The study protocol follows STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) and TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) guidelines and was approved by the responsible ethics committees. RESULTS: The study was registered in the German Clinical Trials Register (DRKS00033854) on March 18, 2024. Recruitment started in January 2024 and is ongoing at the time of manuscript submission. As of now, 135 patients have been enrolled. Sample collection and laboratory analyses are ongoing. Data analysis began in January 2026, with first results anticipated in July 2026. Final data lock is anticipated after the completion of recruitment. CONCLUSIONS: By integrating multimodal molecular data with clinical parameters and applying advanced machine learning techniques, the CONFUSED study aims to improve the prediction and understanding of POD. The results are expected to support the development of personalized preventive strategies and contribute to improved perioperative care for patients at risk of POD.

Humans↗