Digital innovations hold immense potential to transform health care delivery, particularly in sub-Saharan Africa, where financial, geographical, and infrastructural constraints continue to hinder progress toward universal health care delivery. Although a growing health tech sector offers creative solutions, few digital health interventions reach scaled implementation. In this paper, we present the digital fit/viability model—an adapted determinant framework to describe facilitators and barriers to moving from digital tools to integrated digital health implementation. We then use this model to describe the specific challenges and recommended solutions when developing digital health tools for health systems in sub-Saharan Africa.

Nature, Published online: 14 January 2026; doi:10.1038/s41586-025-09940-w

In mice, a SPOCD1–TPR-dependent ‘nowhere-to-hide’ mechanism is required for complete non-stochastic piRNA-directed LINE1 DNA methylation by preventing transposons from escaping surveillance within heterochromatin.

arXiv:2601.08559v1 Announce Type: new Abstract: Sustainable water resource management in transboundary river basins is challenged by fragmented data, limited real-time access, and the complexity of integrating diverse information sources. This paper presents WaterCopilot-an AI-driven virtual assistant developed through collaboration between the International Water Management Institute (IWMI) and Microsoft Research for the Limpopo River Basin (LRB) to bridge these gaps through a unified, interactive platform. Built on Retrieval-Augmented Generation (RAG) and tool-calling architectures, WaterCopilot integrates static policy documents and real-time hydrological data via two custom plugins: the iwmi-doc-plugin, which enables semantic search over indexed documents using Azure AI Search, and the iwmi-api-plugin, which queries live databases to deliver dynamic insights such as environmental-flow alerts, rainfall trends, reservoir levels, water accounting, and irrigation data. The system features guided multilingual interactions (English, Portuguese, French), transparent source referencing, automated calculations, and visualization capabilities. Evaluated using the RAGAS framework, WaterCopilot achieves an overall score of 0.8043, with high answer relevancy (0.8571) and context precision (0.8009). Key innovations include automated threshold-based alerts, integration with the LRB Digital Twin, and a scalable deployment pipeline hosted on AWS. While limitations in processing non-English technical documents and API latency remain, WaterCopilot establishes a replicable AI-augmented framework for enhancing water governance in data-scarce, transboundary contexts. The study demonstrates the potential of this AI assistant to support informed, timely decision-making and strengthen water security in complex river basins.

arXiv:2511.19577v2 Announce Type: replace Abstract: Chronic pain (CP) and opioid use disorder (OUD) are common and interrelated chronic medical conditions. Currently, there is a paucity of evidence-based integrated treatments for CP and OUD among individuals receiving medication for opioid use disorder (MOUD). Wearable devices have the potential to monitor complex patient information and inform treatment development for persons with OUD and CP, including pain variability (e.g., exacerbations of pain or pain spikes) and clinical correlates (e.g., perceived stress). However, the application of large language models (LLMs) with wearable data for understanding pain spikes, remains unexplored. Consequently, the aim of this pilot study was to examine the clinical correlates of pain spikes using a range of AI approaches. We found that machine learning models achieved relatively high accuracy (>0.7) in predicting pain spikes, while LLMs were limited in providing insights on pain spikes. Real-time monitoring through wearable devices, combined with advanced AI models, could facilitate early detection of pain spikes and support personalized interventions that may help mitigate the risk of opioid relapse, improve adherence to MOUD, and enhance the integration of CP and OUD care. Given overall limited LLM performance, these findings highlight the need to develop LLMs which can provide actionable insights in the OUD/CP context.

Nature Medicine, Published online: 09 January 2026; doi:10.1038/s41591-025-04170-z

Analysis of a placebo-controlled trial of a BCMA-targeting CAR-T cell therapy in patients with myasthenia gravis shows that CAR-T cell infusion selectively remodels the systemic immune environment, with elimination of BCMA-high plasma cells and activated plasmacytoid dendritic cells and changes in the autoreactive B cell repertoire.

Nature Medicine, Published online: 09 January 2026; doi:10.1038/s41591-025-04171-y

In a randomized, double-blind, placebo-controlled trial comparing autologous mRNA-engineered BCMA-targeting CAR T cell therapy versus placebo in patients with generalized myasthenia gravis, a significantly higher percentage of patients exhibited a reduction in disease activity in the treatment arm than in the placebo arm.

Background: The rapid growth of social media as an information channel has enabled the swift spread of inaccurate or false health information, significantly impacting public health. This widespread dissemination of misinformation has caused confusion, eroded trust in health authorities, led to noncompliance with health guidelines, and encouraged risky health behaviors. Understanding the dynamics of misinformation on social media is essential for devising effective public health communication strategies. Objective: This study aims to present a comprehensive and automated approach that leverages Large Language Models (LLMs) and Machine Learning (ML) techniques to detect misinformation on social media, uncover the underlying causes and themes, and generate refutation arguments, facilitating control of its spread and promoting public health outcomes by inoculating people against health misinformation. Methods: We use two datasets to train three LLMs, namely BERT, T5, and GPT-2, to classify documents into two categories: misinformation and non-misinformation. Additionally, we employ a separate dataset to identify misinformation topics. To analyze these topics, we applied three topic modeling algorithms—Latent Dirichlet Allocation (LDA), Top2Vec, and BERTopic—and selected the optimal model based on performance evaluated across three metrics. Using a prompting approach, we extract sentence-level representations for the topics to uncover their underlying themes. Finally, we design a prompt text capable of identifying misinformation themes effectively. Codes are available at https://github.com/SamiraMalek/MDIP-MDIS. Results: The trained BERT model demonstrated exceptional performance, achieving 98% accuracy in classifying misinformation and non-misinformation, with a 44% reduction in false positive rates for AI-generated misinformation. Among the three topic modeling approaches employed, BERTopic outperformed the others, achieving the highest metrics with a Coherence Value (CV) of 0.41, Normalized Pointwise Mutual Information (NPMI) of -0.086, and Inverted RBO (IRBO) of 0.99. To address the issue of unclassified documents, we developed an algorithm to assign each document to its closest topic. Additionally, we proposed a novel method using prompt engineering to generate sentence-level representations for each topic, achieving a 99.6% approval rate as "appropriate" or "somewhat appropriate" by three independent raters. We further designed a prompt text to identify themes of misinformation topics and developed another prompt capable of detecting misinformation themes with 82% accuracy. Conclusions: This study presents a comprehensive and automated approach to addressing health misinformation on social media using advanced machine learning and natural language processing techniques. By leveraging large language models (LLMs) and prompt engineering, the system effectively detects misinformation, identifies underlying themes, and provides explanatory responses to combat its spread. The proposed method was tested on an English-language COVID-19–related dataset and has not been evaluated on real-world online social media data; the experiments were conducted offline.

arXiv:2511.00094v2 Announce Type: replace-cross Abstract: Robotic systems have become integral to smart environments, enabling applications ranging from urban surveillance and automated agriculture to industrial automation. However, their effective operation in dynamic settings - such as smart cities and precision farming - is challenged by continuously evolving topographies and environmental conditions. Traditional control systems often struggle to adapt quickly, leading to inefficiencies or operational failures. To address this limitation, we propose a novel framework for autonomous and dynamic reconfiguration of robotic controllers using Digital Twin technology. Our approach leverages a virtual replica of the robot's operational environment to simulate and optimize movement trajectories in response to real-world changes. By recalculating paths and control parameters in the Digital Twin and deploying the updated code to the physical robot, our method ensures rapid and reliable adaptation without manual intervention. This work advances the integration of Digital Twins in robotics, offering a scalable solution for enhancing autonomy in smart, dynamic environments.

npj Digital Medicine, Published online: 30 December 2025; doi:10.1038/s41746-025-02252-3

Computational network models for forecasting and control of mental health trajectories in digital applications

Many people use peer online forums to seek support for health-related problems. More research is needed to understand the impacts of forum use, and how these are generated. However, there are significant ethical and practical challenges with the methods available to do the required research. We examine the key challenges associated with conducting each of the most commonly used online data collection methods: surveys, interviews, forum post analysis; and triangulation of these methods. Based on our learning from the Improving Peer Online Forums (iPOF) study, an inter-disciplinary realist informed mixed methods evaluation of peer online forums, we outline strategies that can be used to address key issues pertaining to assessing important outcomes, facilitating participation, validating participants (users who consent to take part in one or more parts of the study), protecting anonymity, gaining consent, managing risk, multi-stakeholder engagement, and triangulation. We share this learning to support researchers, reviewers, and ethics committees faced with deciding how best to address these challenges. We highlight the need for ongoing open, transparent discussion to ensure the research field keeps pace with evolving technology design and societal attitudes to online data use.

arXiv:2512.16512v1 Announce Type: cross Abstract: Achieving high efficiency on AI operators demands precise control over computation and data movement. However, existing scheduling languages are locked into specific compiler ecosystems, preventing fair comparison, reuse, and evaluation across frameworks. No unified interface currently decouples scheduling specification from code generation and measurement. We introduce XTC, a platform that unifies scheduling and performance evaluation across compilers. With its common API and reproducible measurement framework, XTC enables portable experimentation and accelerates research on optimization strategies.

arXiv:2512.01241v2 Announce Type: replace-cross Abstract: Large language models (LLMs) are routinely used by physicians and patients for medical advice, yet their clinical safety profiles remain poorly characterized. We present NOHARM (Numerous Options Harm Assessment for Risk in Medicine), a benchmark using 100 real primary care-to-specialist consultation cases to measure frequency and severity of harm from LLM-generated medical recommendations. NOHARM covers 10 specialties, with 12,747 expert annotations for 4,249 clinical management options. Across 31 LLMs, potential for severe harm from LLM recommendations occurs in up to 22.2% (95% CI 21.6-22.8%) of cases, with harm of omission accounting for 76.6% (95% CI 76.4-76.8%) of errors. Safety performance is only moderately correlated (r = 0.61-0.64) with existing AI and medical knowledge benchmarks. The best models outperform generalist physicians on safety (mean difference 9.7%, 95% CI 7.0-12.5%), and a diverse multi-agent approach improves safety compared to solo models (mean difference 8.0%, 95% CI 4.0-12.1%). Therefore, despite strong performance on existing evaluations, widely used AI models can produce severely harmful medical advice at nontrivial rates, underscoring clinical safety as a distinct performance dimension necessitating explicit measurement.

arXiv:2512.14640v1 Announce Type: cross Abstract: Timely and accurate lymphoma diagnosis is essential for guiding cancer treatment. Standard diagnostic practice combines hematoxylin and eosin (HE)-stained whole slide images with immunohistochemistry, flow cytometry, and molecular genetic tests to determine lymphoma subtypes, a process requiring costly equipment, skilled personnel, and causing treatment delays. Deep learning methods could assist pathologists by extracting diagnostic information from routinely available HE-stained slides, yet comprehensive benchmarks for lymphoma subtyping on multicenter data are lacking. In this work, we present the first multicenter lymphoma benchmarking dataset covering four common lymphoma subtypes and healthy control tissue. We systematically evaluate five publicly available pathology foundation models (H-optimus-1, H0-mini, Virchow2, UNI2, Titan) combined with attention-based (AB-MIL) and transformer-based (TransMIL) multiple instance learning aggregators across three magnifications (10x, 20x, 40x). On in-distribution test sets, models achieve multiclass balanced accuracies exceeding 80% across all magnifications, with all foundation models performing similarly and both aggregation methods showing comparable results. The magnification study reveals that 40x resolution is sufficient, with no performance gains from higher resolutions or cross-magnification aggregation. However, on out-of-distribution test sets, performance drops substantially to around 60%, highlighting significant generalization challenges. To advance the field, larger multicenter studies covering additional rare lymphoma subtypes are needed. We provide an automated benchmarking pipeline to facilitate such future research.

arXiv:2505.05019v2 Announce Type: replace-cross Abstract: The generation of synthetic clinical trial data offers a promising approach to mitigating privacy concerns and data accessibility limitations in medical research. However, ensuring that synthetic datasets maintain high fidelity, utility, and adherence to domain-specific constraints remains a key challenge. While hyperparameter optimization (HPO) improves generative model performance, the effectiveness of different optimization strategies for synthetic clinical data remains unclear. This study systematically evaluates four HPO objectives across nine generative models, comparing single-metric to compound metric optimization. Our results demonstrate that HPO consistently improves synthetic data quality, with Tab DDPM achieving the largest relative gains, followed by TVAE (60%), CTGAN (39%), and CTAB-GAN+ (38%). Compound metric optimization outperformed single-metric objectives, producing more generalizable synthetic datasets. Despite improving overall quality, HPO alone fails to prevent violations of essential clinical survival constraints. Preprocessing and postprocessing played a crucial role in reducing these violations, as models lacking robust processing steps produced invalid data in up to 61% of cases. These findings underscore the necessity of integrating explicit domain knowledge alongside HPO to generate high-quality synthetic datasets. Our study provides actionable recommendations for improving synthetic data generation, with future work needed to refine metric selection and validate findings on larger datasets.

Background: Complex and expanding datasets in clinical oncology applications require flexible and interactive visualization of patient data to provide physicians and other medical professionals with maximum amount of information. In particular, interdisciplinary tumor conferences profit from customized tools to integrate, link, and visualize relevant data from all professions involved. Objective: Our objective was to identify and present currently available data visualization tools for tumor boards and related areas. We wanted to provide an overview of not only the digital tools currently used in tumor board settings but also of the data they include, their respective visualization solutions, and their integration into hospital processes. Methods: This scoping review was based on the scoping study framework by Arksey and O’Malley and attempted to answer the following research question: “What are the key features of data visualization solutions used in molecular and organ tumor boards, and how are these elements integrated and used within the clinical setting?” The following electronic databases were searched for articles: PubMed, Web of Science, and Scopus. Articles were deemed eligible if published in English in the last 10 years. Eligible articles were first deduplicated, followed by screening of titles and abstracts. Full-text screening was then conducted to decide on article selection. All included articles were analyzed using a data extraction template. The template included a variety of meta-information, as well as specific fields aiming to answer the research question. Results: The review process started with 2049 articles, of which 1014 (49.49%) were included in the title and abstract screening. A total of 5.47% (112/2049) of the publications were eligible for full-text screening, leading to 2.93% (60/2049) of the publications being eligible for final inclusion. They covered 49 distinct visualization tools and applications. We discovered a variety of innovative visualization solutions, most often driven by the complexity of omics data, represented in 96% (47/49) of the tools. Tables remained the most used tool for the visualization of data types described in the articles. Approximately one-third of the identified tools (16/49, 33%) were systematically evaluated in some form. For most discovered tools (37/49, 76%), there was no documentation of implementation into the clinical routine. A significant number of applications (21/49, 43%) were available through open-source access. Conclusions: There is a wide range of projects providing visualization solutions for tumor boards and clinical oncology applications. Among the few tools that have made their way into clinical routine settings, there are both commercial and academic solutions. While tables for a variety of data types remain the dominant visualization strategy, the complexity of omics data appears to be the driving force behind many visualization innovations in the domain of tumor boards. Trial Registration:

arXiv:2512.05270v1 Announce Type: cross Abstract: As mobile robots increasingly operate alongside humans in shared workspaces, ensuring safe, efficient, and interpretable Human-Robot Interaction (HRI) has become a pressing challenge. While substantial progress has been devoted to human behavior prediction, limited attention has been paid to how humans perceive, interpret, and trust robots' inferences, impeding deployment in safety-critical and socially embedded environments. This paper presents XR-DT, an eXtended Reality-enhanced Digital Twin framework for agentic mobile robots, that bridges physical and virtual spaces to enable bi-directional understanding between humans and robots. Our hierarchical XR-DT architecture integrates virtual-, augmented-, and mixed-reality layers, fusing real-time sensor data, simulated environments in the Unity game engine, and human feedback captured through wearable AR devices. Within this framework, we design an agentic mobile robot system with a unified diffusion policy for context-aware task adaptation. We further propose a chain-of-thought prompting mechanism that allows multimodal large language models to reason over human instructions and environmental context, while leveraging an AutoGen-based multi-agent coordination layer to enhance robustness and collaboration in dynamic tasks. Initial experimental results demonstrate accurate human and robot trajectory prediction, validating the XR-DT framework's effectiveness in HRI tasks. By embedding human intention, environmental dynamics, and robot cognition into the XR-DT framework, our system enables interpretable, trustworthy, and adaptive HRI.