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Received — 26 November 2025 ⏭ Favourites

Clinician-Directed Large Language Model Software Generation for Therapeutic Interventions in Physical Rehabilitation

✇cs.AI, q-bio.NC updates on arXiv.org
By: Edward Kim · Yuri Cho · Jose Eduardo E. Lima · Julie Muccini · Jenelle Jindal · Alison Scheid · Erik Nelson · Seong Hyun Park · Yuchen Zeng · Alton Sturgis · Caesar Li · Jackie Dai · Sun Min Kim · Yash Prakash · Liwen Sun · Isabella Hu · Hongxuan Wu · Daniel He · Wiktor Rajca · Cathra Halabi · Maarten Lansberg · Bjoern Hartmann · Sanjit A. Seshia
25 November 2025 at 13:00
arXiv:2511.18274v1 Announce Type: cross Abstract: Digital health interventions are increasingly used in physical and occupational therapy to deliver home exercise programs via sensor equipped devices such as smartphones, enabling remote monitoring of adherence and performance. However, digital interventions are typically programmed as software before clinical encounters as libraries of parametrized exercise modules targeting broad patient populations. At the point of care, clinicians can only select modules and adjust a narrow set of parameters like repetitions, so patient specific needs that emerge during encounters, such as distinct movement limitations, and home environments, are rarely reflected in the software. We evaluated a digital intervention paradigm that uses large language models (LLMs) to translate clinicians' exercise prescriptions into intervention software. In a prospective single arm feasibility study with 20 licensed physical and occupational therapists and a standardized patient, clinicians created 40 individualized upper extremity programs (398 instructions) that were automatically translated into executable software. Our results show a 45% increase in the proportion of personalized prescriptions that can be implemented as software compared with a template based benchmark, with unanimous consensus among therapists on ease of use. The LLM generated software correctly delivered 99.78% (397/398) of instructions as prescribed and monitored performance with 88.4% (352/398) accuracy, with 90% (18/20) of therapists judged it safe to interact with patients, and 75% (15/20) expressed willingness to adopt it. To our knowledge, this is the first prospective evaluation of clinician directed intervention software generation with LLMs in healthcare, demonstrating feasibility and motivating larger trials to assess clinical effectiveness and safety in real patient populations.

AI-Assisted Cardiovascular Risk Assessment by General Practitioners in Resource-Constrained Indonesian Settings Using a Conceptual Prototype: Randomized Controlled Study

✇Journal of Medical Internet Research
By: Anindya Pradipta Susanto · David Lyell · Bambang Widyantoro · Dafsah Arifa Juzar · Anwar Santoso · Shlomo Berkovsky · Farah Magrabi
26 November 2025 at 05:30
Background: Preventive strategies integrated with digital health and artificial intelligence (AI), have significant potential to mitigate the global burden of atherosclerotic cardiovascular disease (ASCVD). AI-enabled clinical decision support (CDS) systems increasingly provide patient-specific insights beyond traditional risk factors. Despite these advances, their capacity to enhance clinical decision-making in resource-constrained settings remains largely unexplored. Objective: We conducted a randomised controlled study to assess the effect of AI-based CDS on 10-year ASCVD risk assessment and management in primary prevention. Methods: In a three-way within-subject randomised design, doctors completed nine clinical vignettes representative of primary care presentations in a resource-constrained outpatient setting. For each vignette, participants assessed 10-year ASCVD risk and made management decisions using either a conceptual prototype of AI-based CDS, automated CDS, or no decision support. The conceptual prototype represented contemporary risk calculators based on traditional machine learning models (e.g., random forest, neural networks, logistic regression) that incorporate additional predictors alongside traditional risk factors. Primary outcomes were correct risk assessment and patient management (prescription of aspirin, statins, and anti-hypertensives; referral for advanced examinations). Decision-making time and perceptions about AI utility were also measured. Results: 102 doctors from all seven geographical regions of Indonesia participated. Most participants were 26–35 years (83%), 56% male, with a median of six years of clinical experience (IQR=4.75). AI-based CDS improved risk assessment by 27% (2(2, n=102) = 48.875, P<.001 compared to unassisted or one additional correct risk classification for every patients where doctors use ai needed treat nnt="3.7;" ci the prescription of statins also improved by n="102)=" p in pairwise comparisons assisted with ai-based cds correctly assessed significantly more cases adjusted and prescribed appropriate statin often medium effect size r=".35)" control. ai-assisted required less time marginal means sec vs f however improvements aspirin anti-hypertensives did not reach statistical significance. no improvement was observed referral decisions. participants generally viewed positively agreeing strongly that they would follow its recommendations indicating it if given access. believed could enhance efficiency assessment particularly high-volume primary care settings while noting need verify against clinical guidelines each patient. conclusions: coupled reduced decision-making highlight potential utility ascvd resource-constrained efficient healthcare resources is crucial. further research ascertain whether this online study translate real-world low-resource settings.>

Decoding the cholesterol-apoptosis axis in HCC: a machine learning-based multi-omics integration and single-cell transcriptomic analysis

✇Omics in Hepatocellular
By: Yang Li · Jun Shi · Aiqing Zhao · Jing Huang · Lei Dai
25 November 2025 at 19:00

Discov Oncol. 2025 Nov 25;16(1):2162. doi: 10.1007/s12672-025-04010-z.

ABSTRACT

Liver hepatocellular carcinoma (LIHC), a predominant form of primary hepatic malignancy, demonstrates a progressively escalating global incidence, imposing substantial health and economic burdens on patients and society. Early diagnosis remains challenging, often resulting in late-stage detection, which limits the efficacy of current therapeutic strategies. This study systematically examines the transcriptional signatures of apoptosis-associated and cholesterol metabolic pathways in LIHC, providing insights into its underlying mechanisms and identifying potential prognostic markers. We employed multi-omics and machine learning to evaluate gene expression variations and construct a prognostic risk scoring model. This study identified apoptosis- and cholesterol metabolism-related differentially expressed genes (ACMRDEGs). Importantly, LASSO regression analysis identified six hub genes (EPHX2, FABP5, SQLE, ADH4, HMGCS2, and CYP7A1) as critical prognostic biomarkers, demonstrating significant correlation with overall survival (OS). Furthermore, immune cell infiltration analysis indicated significant differences in 12 immune cell types within LIHC microenvironment, underscoring the immune system's involvement in disease progression. cholesterol and alcohol metabolism pathways were significantly enriched among hub gene modules, as quantified by multiple gene enrichment analyses. Single-cell analysis identified six major cell types, providing a deeper understanding of the cellular heterogeneity within LIHC. In summarize, this study presents the first integrated apoptosis-cholesterol metabolic pathway-based six-gene prognostic model for LIHC, validated for robustness across multiple cohorts, which may facilitate personalized therapeutic strategies and refined risk assessment in clinical practice.

PMID:41288805 | PMC:PMC12647489 | DOI:10.1007/s12672-025-04010-z

Decoding the cholesterol-apoptosis axis in HCC: a machine learning-based multi-omics integration and single-cell transcriptomic analysis

✇(Multiomics OR Omics) AND (Lung OR gastric OR Hepatocellular)
By: Yang Li · Jun Shi · Aiqing Zhao · Jing Huang · Lei Dai
25 November 2025 at 19:00

Discov Oncol. 2025 Nov 25;16(1):2162. doi: 10.1007/s12672-025-04010-z.

ABSTRACT

Liver hepatocellular carcinoma (LIHC), a predominant form of primary hepatic malignancy, demonstrates a progressively escalating global incidence, imposing substantial health and economic burdens on patients and society. Early diagnosis remains challenging, often resulting in late-stage detection, which limits the efficacy of current therapeutic strategies. This study systematically examines the transcriptional signatures of apoptosis-associated and cholesterol metabolic pathways in LIHC, providing insights into its underlying mechanisms and identifying potential prognostic markers. We employed multi-omics and machine learning to evaluate gene expression variations and construct a prognostic risk scoring model. This study identified apoptosis- and cholesterol metabolism-related differentially expressed genes (ACMRDEGs). Importantly, LASSO regression analysis identified six hub genes (EPHX2, FABP5, SQLE, ADH4, HMGCS2, and CYP7A1) as critical prognostic biomarkers, demonstrating significant correlation with overall survival (OS). Furthermore, immune cell infiltration analysis indicated significant differences in 12 immune cell types within LIHC microenvironment, underscoring the immune system's involvement in disease progression. cholesterol and alcohol metabolism pathways were significantly enriched among hub gene modules, as quantified by multiple gene enrichment analyses. Single-cell analysis identified six major cell types, providing a deeper understanding of the cellular heterogeneity within LIHC. In summarize, this study presents the first integrated apoptosis-cholesterol metabolic pathway-based six-gene prognostic model for LIHC, validated for robustness across multiple cohorts, which may facilitate personalized therapeutic strategies and refined risk assessment in clinical practice.

PMID:41288805 | DOI:10.1007/s12672-025-04010-z

When Alignment Fails: Multimodal Adversarial Attacks on Vision-Language-Action Models

✇cs.AI, q-bio.NC updates on arXiv.org
By: Yuping Yan · Yuhan Xie · Yixin Zhang · Lingjuan Lyu · Handing Wang · Yaochu Jin
25 November 2025 at 13:00
arXiv:2511.16203v2 Announce Type: replace-cross Abstract: Vision-Language-Action models (VLAs) have recently demonstrated remarkable progress in embodied environments, enabling robots to perceive, reason, and act through unified multimodal understanding. Despite their impressive capabilities, the adversarial robustness of these systems remains largely unexplored, especially under realistic multimodal and black-box conditions. Existing studies mainly focus on single-modality perturbations and overlook the cross-modal misalignment that fundamentally affects embodied reasoning and decision-making. In this paper, we introduce VLA-Fool, a comprehensive study of multimodal adversarial robustness in embodied VLA models under both white-box and black-box settings. VLA-Fool unifies three levels of multimodal adversarial attacks: (1) textual perturbations through gradient-based and prompt-based manipulations, (2) visual perturbations via patch and noise distortions, and (3) cross-modal misalignment attacks that intentionally disrupt the semantic correspondence between perception and instruction. We further incorporate a VLA-aware semantic space into linguistic prompts, developing the first automatically crafted and semantically guided prompting framework. Experiments on the LIBERO benchmark using a fine-tuned OpenVLA model reveal that even minor multimodal perturbations can cause significant behavioral deviations, demonstrating the fragility of embodied multimodal alignment.
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