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MITF-SCD1 Lipid Metabolic Axis Prevents Ouabain-Induced Spiral Ganglion Neuron Ferroptosis and Hearing Loss

Ouabain triggers cochlear spiral ganglion neuron (SGN) ferroptosis and hearing loss via SCD1 downregulation. MITF directly activates Scd1 transcription, and the MITF–SCD1 axis mitigates SGN ferroptosis and hearing impairment in ototoxic ouabain and cisplatin models, revealing a lipid metabolic vulnerability and therapeutic target for sensorineural hearing loss.

Context-CoT: Enhancing Context Learning via High-Quality Reasoning Synthesis

arXiv:2605.25354v1 Announce Type: new Abstract: While LLMs excel at reasoning over prompts using static pretrained knowledge, they struggle significantly with context learning-the ability to dynamically extract, internalize, and apply new knowledge from complex, task-specific contexts. Recent evaluations on the CL-Bench reveal a critical capability gap: frontier models solve only 17.2% of context-dependent tasks on average.

A clinical environment simulator for dynamic AI evaluation

Nature Medicine, Published online: 12 March 2026; doi:10.1038/s41591-026-04252-6

The authors propose a framework for clinical AI evaluation within simulated digital hospital environments that capture the evolving constraints, and cascading effects, of clinical decisions.

An Agentic System for Rare Disease Diagnosis with Traceable Reasoning

arXiv:2506.20430v3 Announce Type: replace-cross Abstract: Rare diseases affect over 300 million individuals worldwide, yet timely and accurate diagnosis remains an urgent challenge. Patients often endure a prolonged diagnostic odyssey exceeding five years, marked by repeated referrals, misdiagnoses, and unnecessary interventions, leading to delayed treatment and substantial emotional and economic burdens. Here we present DeepRare, a multi-agent system for rare disease differential diagnosis decision support powered by large language models, integrating over 40 specialized tools and up-to-date knowledge sources. DeepRare processes heterogeneous clinical inputs, including free-text descriptions, structured Human Phenotype Ontology terms, and genetic testing results, to generate ranked diagnostic hypotheses with transparent reasoning linked to verifiable medical evidence. Evaluated across nine datasets from literature, case reports and clinical centres across Asia, North America and Europe spanning 14 medical specialties, DeepRare demonstrates exceptional performance on 3,134 diseases. In human-phenotype-ontology-based tasks, it achieves an average Recall@1 of 57.18%, outperforming the next-best method by 23.79%; in multi-modal tests, it reaches 69.1% compared with Exomiser's 55.9% on 168 cases. Expert review achieved 95.4% agreement on its reasoning chains, confirming their validity and traceability. Our work not only advances rare disease diagnosis but also demonstrates how the latest powerful large-language-model-driven agentic systems can reshape current clinical workflows.
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