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Young Adults’ Interactions With Food and Nutrition Content on Social Media and Implications for Intervention Design: Semistructured Interview Study

Background: Young adults increasingly rely on social media for nutrition information. However, little is known about (1) which types of eating-related content they actively engage with and why, and (2) how they interpret, evaluate, and incorporate this content into their everyday food choices and health behaviors. Objective: This qualitative study explored how UK young adults (aged 18-25 years) interact with food and nutrition content across social media platforms to inform the design of future social media interventions. Methods: Semistructured online interviews, guided by the Capability, Opportunity, Motivation–Behavior (COM-B) model, were conducted with 25 active social media users (18/25, 72% women, mean age 22.2, SD 1.9 years, ethnically diverse) in the United Kingdom between August and October 2024. The study design was informed by patient and public involvement to ensure relevance and acceptability. Data were analyzed using reflexive thematic analysis. To guide intervention development, key findings (coded as barriers and facilitators) were systematically mapped to the Theoretical Domains Framework, and the COM-B. Ethics approval was obtained from the University of Cambridge (24.368). Results: Five key themes were identified: (1) evolving engagement patterns (passive scrolling to active interaction and mixed feelings on algorithmic control), (2) conflicted information seeking (frustration with contradictory advice, varied strategies to assess credibility), (3) multifaceted behavioral impact (simultaneous positive impacts such as cooking inspiration and negative impacts such as restrictive eating triggers), (4) shifting goals (a movement from appearance-focused to health-centered goals; yet, vulnerability to body-image issues), and (5) intervention preferences (demand for credible professionals, customizable content, and privacy protection). Participants demonstrated a reactive learning process, developing “digital nutrition literacy” often after negative experiences. Social influences were identified as the most frequently cited domain (mapped to TDF [theoretical domains framework]/COM-B) shaping interactions with social media content. Conclusions: This study challenges assumptions of passive social media consumption, showing that young adults actively develop protective strategies yet remain vulnerable to misinformation. Digital interventions should leverage user agency and address diverse perceptions through customizable, credible content delivered with privacy and emotionally safe messaging. The COM-B and TDF mapping provide specific, evidence-based behavioral targets, particularly within the domain of Social Opportunity and Reflective Motivation, to guide the development of effective eHealth interventions.

Telehealth Delivery of the Homeostasis–Enrichment–Plasticity Approach for Premature Infants With Developmental Risks: Exploratory Feasibility Study

Background: Preterm delivery is an increasing worldwide health concern linked to increased neurodevelopmental risks. Early intervention is crucial for harnessing neuroplasticity to enhance developmental and functional performance outcomes; however, access to early intervention is frequently hindered by logistical, financial, and labor constraints. The Homeostasis–Enrichment–Plasticity (HEP) Approach is a family-centered early intervention model based on enriched environments, designed to improve infants’ sensory-motor, cognitive, and socio-emotional development. Objective: This study aimed to assess the feasibility, safety, acceptability, and outcomes sensitivity to change of implementing the HEP Approach through telehealth for premature infants at developmental risk. Methods: A pre-post exploratory feasibility study was performed, including 16 preterm infants (aged 4-12 months corrected age), of whom 14 completed the study. The 12-week intervention included weekly remote sessions focused on environmental enrichment, active exploration, and parental guidance. The feasibility and acceptability were evaluated using a 24-item questionnaire. Developmental outcomes were assessed with the Young Children’s Participation and Environment Measure, Ages and Stages Questionnaire (ASQ), Alberta Infant Motor Scale, Infant Motor Profile, and Depression Anxiety Stress Scales. Results: High adherence (14/14, 100%) and retention (14/16, 87.5%) rates demonstrated robust feasibility. Parents indicated 86%-100% agreement across all feasible criteria, affirming safety, satisfaction, and acceptability. No adverse incidents were reported. Changes were identified in participation (Young Children’s Participation and Environment Measure), motor development (Alberta Infant Motor Scale, Infant Motor Profile, and ASQ), communication and social-emotional domains (ASQ), and caregiver well-being (Depression Anxiety Stress Scales) (P<.05). Conclusions: The telehealth implementation of the HEP Approach demonstrated feasibility, safety, and strong acceptance among families, along with quantifiable developmental and psychosocial changes. These initial findings endorse the model’s viability as an accessible, family-oriented telehealth framework for infants born preterm. Future randomized controlled and longitudinal studies are necessary to validate intervention efficacy and scalability.

Feasibility and Acceptability of AI-Powered Tools for Early Autism Screening in Egypt: Semistructured Focus Group Study

Background: Autism spectrum disorder (ASD) is often underdiagnosed in low- and middle-income countries due to limited specialist access, sociocultural stigma, and fragmented screening systems. Artificial intelligence (AI)–powered screening tools may improve early detection by enabling low-cost, accessible assessments. However, adoption depends on stakeholder trust, ethical safeguards, and alignment with local health system capacities. Objective: This study explored the feasibility, acceptability, and perceived ethical and practical enablers and barriers to implementing AI-powered tools for early ASD screening in Egypt, with attention to urban–rural disparities and integration into existing care pathways. Methods: We used a qualitative design with semistructured focus group discussions with 49 participants (21 parents of children with ASD and 28 health care professionals) recruited from urban and rural governorates. Discussions were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s reflexive thematic analysis, supported by NVivo software (Lumivero). Methodological integrity was ensured through reflexivity, triangulation, and peer debriefing. Thematic saturation was monitored across groups, and participant diversity was prioritized across contexts. Results: Five themes emerged: (1) AI as a supportive tool rather than a replacement for clinicians, emphasizing scalability and assistance for nonspecialists; (2) the need for cultural and contextual adaptation to ensure local relevance; (3) privacy, trust, and transparency concerns, including data security, consent, and algorithmic opacity; (4) reducing diagnostic inequities by addressing urban–rural disparities and strengthening community-based deployment; and (5) the preference for hybrid AI–human models, with conditions for adoption including cultural sensitivity, human oversight, and digital literacy support. Counts (n/N) of parents and health care professionals contributing to each theme were used descriptively as indicators of pattern salience rather than as statistical estimates of prevalence. Participants expressed cautious optimism, with parents emphasizing accessibility and speed, while health care professionals highlighted concerns about reliability, cultural adaptation, and data governance. Conclusions: AI-powered ASD screening has potential to advance equitable early detection in underserved areas. Adoption requires transparent data governance, integration into hybrid human–AI models, culturally adaptive design, and targeted digital literacy initiatives. These findings provide an evidence-based roadmap for policymakers, technologists, and health system leaders to implement AI screening tools that are ethically sound, contextually relevant, and equity-focused.

Electrocardiogram-Based Mental Stress Detection Amid Everyday Activities Using Machine Learning: Model Development and Validation Study

Background: Frequent, sustained stress is linked to poor health and requires monitoring for early intervention. Electrocardiograms (ECG) are promising biomarkers because they can be recorded noninvasively and continuously using wearable devices. However, tracking stress with ECG is challenging because daily activities elicit responses similar to mental stress (MS), and various mental stimuli that individuals encounter complicate the use of machine learning (ML) models trained on a limited set of stressors. Objective: We (1) evaluated the ability of ML models to distinguish MS episodes from a composite “no-stress” background, including rest and low- to moderate-intensity activities; (2) assessed their generalizability to new stressors and participants; and (3) tested robustness to lower sampling rates and fewer features, to explore their suitability for lightweight wearables. Methods: We used a comprehensive ECG dataset sampled at 1000 hertz from 127 participants who underwent various mental stressors and engaged in diverse physical activities. A 30-second window was used to extract 55 features from time, frequency, nonlinear, and morphological domains. We trained a logistic regression (LR) model and an extreme gradient boosting (XGBoost) model, splitting the data into 60/20/20 for training, validation, and testing. Shapley additive explanation values were computed to explain model predictions. Additional analyses included leave-one-stressor-out; downsampling to 500, 250, and 125 hertz; a time-window sensitivity analysis; and reducing the number of features to as few as 5. Results: XGBoost achieved an area under the receiver operating characteristic curve (AUROC) of 0.741 (95% CI 0.701‐0.783) and an area under the precision-recall curve (AUPRC) of 0.706 (95% CI 0.658‐0.753), compared with 0.724 (95% CI 0.678‐0.772) and 0.691 (95% CI 0.639‐0.742) for LR. The mean performance difference between XGBoost and LR was 0.017 for AUROC (95% CI 0.001‐0.032) and 0.015 for AUPRC (95% CI −0.001 to 0.037; clustered bootstrap analysis using 2000 participant-level resamples), suggesting that LR performs comparably to the nonlinear XGBoost model. Both models were robust to downsampling and feature reduction (10 features retained >93% of performance). Extending the analysis window to 60 seconds improved model performance across all sampling rates, highlighting a trade-off between rapid detection and overall performance. When evaluating discrimination from physical activity, models achieved acceptable specificity for light physical activity (XGBoost: 0.787; LR: 0.794) but poor specificity for moderate physical activity (XGBoost: 0.418; LR: 0.444). Both models generalized to most unseen stressors, although performance varied across stressors, with limited transfer to the social-evaluative stressor. Feature importance analysis revealed fuzzy entropy and frequency-based features as key predictors. Conclusions: ML models can detect MS with high sensitivity and remain robust to lower sampling rates and fewer features. Generalization to novel stressors was stressor-dependent. Importantly, our results highlight challenges in distinguishing stress-related cardiac responses from those caused by physical exertion, revealing critical limitations of single-sensor ECG approaches for MS detection.

Initial Insights Into an Institutional Secure Large Language Model for Magnetic Resonance Imaging Examination Requests: Retrospective Study

Background: Incomplete clinical details on magnetic resonance imaging (MRI) examination requests (MERs) can lead to suboptimal protocol selection. An institutional secure large language model (sLLM) with access to manually retrieved salient data from the electronic medical record (EMR) may improve request completeness and protocol accuracy across multiple MRI subspecialties. Objective: The objective of this study was to compare clinician MERs with sLLM-augmented MERs for information quality and to evaluate the protocoling accuracy of the sLLM versus board-certified radiologists across body, musculoskeletal, and neuroradiology MRI. Methods: This retrospective study included 608 random outpatient MRI examinations performed between September 2023 and July 2024 (body 206, musculoskeletal 203, neuroradiology 199). The cohort comprised 528 patients (mean 51.2 years, SD 19.2; range 4‐93; n=279, 52.8% women, n=249, 47.2% men). MERs without EMR access were excluded. A privately hosted Anthropic Claude 3.5 model (temperature 0) augmented each MER with manually retrieved salient EMR data and, via rule-based parsing, mapped the extracted elements onto predefined institutional criteria to recommend region or coverage and contrast use. Two experienced radiologists established a consensus reference standard. Two board-certified general radiologists (Rad 3 and Rad 4) and the sLLM were compared with this standard. Clinical information quality was graded using the Reason-for-Exam Imaging Reporting and Data System (RI-RADS). Interrater reliability was quantified with Gwet AC1. Paired accuracies were compared with the McNemar test to determine whether there was a statistically significant difference. Results: Interreader agreement for RI-RADS was almost perfect for sLLM-augmented MERs (AC1 0.97, 95% CI 0.94‐0.99) and moderate for clinician MERs (AC1 0.43, 95% CI 0.34‐0.52). Limited or deficient clinical information (RI-RADS C/D) fell to 0% to 0.7% (0/608 to 4/608) with sLLM augmentation vs 4.1% to 20.4% (25/608 to 124/608) for clinician MERs. Overall protocol accuracy was 93.1% (566/608; 95% CI 89.6‐96.6) for the sLLM, 91.4% (556/608; 95% CI 87.6‐95.3) for Rad 3, and 92.1% (560/608; 95% CI 88.4‐95.8) for Rad 4 (sLLM vs Rad 3 =.23 vs Rad 4 =.40). Region or coverage accuracy was similar (sLLM: 579/608, 95.2%; Rad 3: 585/608, 96.2%; Rad 4: 573/608, 94.2%; =.46 and =.36). Contrast decisions were more accurate using the sLLM at 94.4% (574/608; 95% CI 91.3‐97.5) vs Rad 3 at 92.1% (560/608; 95% CI 88.4‐95.8; =.027) and were not significantly different to Rad 4 at 92.9% (565/608; 95% CI 89.4‐96.4; =.16). Subspecialty analyses showed similar patterns, with the sLLM outperforming Rad 4 for musculoskeletal MRI contrast decisions (96.6% vs 91.1%; =.006) and matching readers elsewhere. Manual review indicated that sLLM improvements arose from EMR details not listed on the MER (infection/inflammation, tumor history, prior surgery). No clinically significant hallucinations were identified in a manual review of discordant cases. Conclusions: Across body, musculoskeletal, and neuroradiology MRI, sLLM-augmented examination requests improved clinical context and enhanced contrast selection while demonstrating accuracy comparable to general radiologists for region or coverage. Integrating sLLMs into routine vetting workflows may reduce manual workload in protocol selection for more efficient, standardized protocoling.

Social Media Intervention Based on the Information-Motivation-Behavioral Skills Model Promotes HIV Testing and Reduces High-Risk Behaviors Among Men Who Have Sex With Men in Resource-Limited Settings in China: Randomized Controlled Trial

Background: Social media intervention may enhance HIV prevention among men who have sex with men, but the effect of this intervention in resource-limited settings remains unclear. Objective: This randomized controlled trial evaluated whether a social media intervention grounded in the information-motivation-behavioral skills (IMB) model could be beneficial for HIV prevention among men who have sex with men in resource-limited settings. Methods: Participants were recruited in Nanning, China, between April 2023 and April 2024. Eligible participants were randomly assigned to either the social media intervention group or the routine HIV prevention services control group. Participants in the intervention group received a 3-month social media intervention, which included completing video-based tasks. Baseline surveys were conducted, followed by follow-up surveys every 3 months, for a total of 2 follow-ups. Outcomes included HIV testing uptake, high-risk behavior, AIDS-related knowledge, safe sex self-efficacy, and attitude. Results: A total of 180 eligible men who have sex with men were enrolled (90 per group). Follow-up rates were 97.8% (88/90) and 95.5% (86/90) for the intervention and control groups, respectively. At the follow-ups, the intervention group demonstrated significantly higher uptake of HIV testing, a lower proportion of participants reporting high-risk sexual behaviors, and higher condom use self-efficacy compared to the control group (all
  • ✇MIT Technology Review
  • Desalination plants in the Middle East are increasingly vulnerable Casey Crownhart
    MIT Technology Review Explains: Let our writers untangle the complex, messy world of technology to help you understand what’s coming next. You can read more from the series here. As the conflict in Iran has escalated, a crucial resource is under fire: the desalination technology that supplies water across much of the region. In early March, Iran’s foreign minister accused the US of attacking a desalination plant on Qeshm Island in the Strait of Hormuz and disrupting the water supply to
     

Desalination plants in the Middle East are increasingly vulnerable

7 April 2026 at 22:54

MIT Technology Review Explains: Let our writers untangle the complex, messy world of technology to help you understand what’s coming next. You can read more from the series here.

As the conflict in Iran has escalated, a crucial resource is under fire: the desalination technology that supplies water across much of the region.

In early March, Iran’s foreign minister accused the US of attacking a desalination plant on Qeshm Island in the Strait of Hormuz and disrupting the water supply to nearly 30 villages. (The US denied responsibility.) In the weeks since, both Bahrain and Kuwait have reported damage to desalination plants and blamed Iran, though Iran also denied responsibility.

In late March, President Donald Trump threatened the destruction of “possibly all desalinization plants” in Iran if the Strait of Hormuz was not reopened. Since then, he’s escalated his threats against Iran, warning of plans to attack other crucial civilian infrastructure like power plants and bridges.

Countries in the Middle East, particularly the Gulf states, rely on the technology to turn salt water into fresh water for farming, industry, and—crucially—drinking. The mounting attacks and threats to date highlight just how vital the industry is to the region—a situation made even more precarious by rising temperatures and extreme weather driven by climate change.

Right now, 83% of the Middle East is under extremely high water stress, says Liz Saccoccia, a water security associate at the World Resources Institute. Future projections suggest that’s going to increase to about 100% by 2050, she adds: “This is a continuing trend, and it’s getting worse, not better.”

Here’s a look at desalination technology in the Middle East and what wartime threats to the critical infrastructure could mean for people in the region. 

A vital resource

Desalination technology has helped provide water supplies in the Middle East since the early 20th century and became widespread in the 1960s and 1970s.

There are two major categories of desalination plants. Thermal plants use heat to evaporate water, leaving salt and other impurities behind. The vapor can then be condensed into usable fresh water. The alternative is membrane-based technology like reverse osmosis, which pushes water through membranes that have tiny pores—so small that salt can’t get through.

Early desalination plants in the Middle East were the first type, burning fossil fuels to evaporate water, leaving the salt behind. This technique is incredibly energy-intensive, and over time, processes that rely on filters became the dominant choice.

Membrane technologies have made up essentially all new desalination capacity in recent years; the last major thermal plant built in the Gulf came online in 2018. Many reverse osmosis plants still rely on fossil fuels, but they’re more efficient. Since then, membrane technologies have added more than 15 million cubic meters of daily capacity—enough to supply water to millions of people.

Capacity has expanded quickly in recent years; between 2006 and 2024, countries across the Middle East collectively spent over $50 billion building and upgrading desalination facilities, and nearly that much operating them.

Today, there are nearly 5,000 desalination plants operational across the Middle East.

And looking ahead, growth is continuing. Between 2024 and 2028, daily capacity is expected to grow from about 29 million cubic meters to 41 million cubic meters.

Uneven vulnerabilities

Some countries rely on the technology more than others. Iran, for example, uses desalination for about 3% of its municipal fresh water. The country has access to groundwater and some surface water, including rivers, though these resources are being stretched thin by agriculture and extreme drought.

Other nations in the region, particularly the Gulf countries (Bahrain, Qatar, Kuwait, the United Arab Emirates, Saudi Arabia, and Oman), have much more limited water resources and rely heavily on desalination. Across these six nations, all but the UAE get more than half their drinking water from desalination, and for Bahrain, Qatar, and Kuwait the figure is more than 90%.

“The Gulf countries are much, much more vulnerable to attacks on their desalination plants than Iran is,” says David Michel, a senior associate in the global food and water security program at the Center for Strategic and International Studies.

There are thousands of desalination facilities across the region, so the system wouldn’t collapse if a small number were taken offline, Michel says. However, in recent years there’s been a trend toward larger, more centralized plants.

The average desalination plant is about 10 times larger than it was 15 years ago, according to data from the International Energy Agency. The largest desalination plants today can produce 1 million cubic meters of water daily, enough for hundreds of thousands of people. Taking one or more of these massive facilities offline could have a significant effect on the system, Michel says.

Escalating threats

Desalination facilities are quite linear, meaning there are multiple steps and pieces of equipment that work in sequence—and the failure of a component in that chain can take an entire facility down. Attacks on water inlets, transportation networks, and power supplies can also disrupt the system, Michel says. 

During the Gulf War in 1991, Iraqi forces pumped oil into the gulf, contaminating the water and shutting down desalination plants in Kuwait. 

The facilities are also generally located close to other targets in this conflict. Desalination is incredibly energy intensive, so about three-quarters of facilities in the region are next to power plants. Trump has repeatedly threatened power plants in Iran. In response, Iran’s military has said that if civilian targets are hit, the country will respond with strikes that are “much more devastating and widespread.” Other governments and organizations, including the United Nations, the European Union, and the Red Cross, have broadly condemned threats to infrastructure as illegal. 

But war isn’t the only danger facing these plants, even if it is the most immediate. Some studies have suggested that global warming could strengthen cyclones in the region, and these extreme weather events could force shutdowns or damage equipment.

Water pollution could also cause shutdowns. Oil spills, whether accidental or intentional, as in the case of the Gulf War, can  wreak havoc. And in 2009, a red algae bloom closed desalination plants in Oman and the United Arab Emirates for weeks. The algae fouled membranes and blocked the plants from being able to take water in from the Persian Gulf and the Gulf of Oman.

Desalination facilities could become more resilient to threats in the future, and they may need to as their importance continues to grow. 

There’s increasing interest in running desalination facilities at least partially on solar power, which could help reduce dependence on the oil that powers most facilities today. The Hassyan seawater desalination project in the UAE, currently under construction, would be the largest reverse osmosis plant in the world to operate solely with renewable energy. 

Another way to increase resilience is for countries to build up more strategic water storage to meet demand. Qatar recently issued new policies that aim to improve management and storage of desalinated water, for example. Countries could also work together to invest in shared infrastructure and policies that help strengthen the water supply through the region. 

Preparedness, resilience, and cooperation will be key for the Middle East broadly as critical infrastructure, including the water supply, is increasingly under threat. 

“The longer the conflict goes on, the more likely we’ll see significant water infrastructure damage,” says Ginger Matchett, an assistant director at the Atlantic Council. “What worries me is that after this war ends, some of the lessons will show how water can be weaponized more strategically than previously imagined.” 

Changes in Workplace Productivity and Estimated Cost Savings During Internet-Based Cognitive Behavioral Therapy in the Irish National Health Service: Naturalistic, Repeated-Measures, Retrospective Survey Study

Background: Depression and anxiety can significantly impact workplace productivity, for instance, by increasing absenteeism and presenteeism. This loss of productivity leads to diminished workplace economic outcomes. Internet-based cognitive behavioral therapy (iCBT) has emerged as a cost-effective intervention within workplace settings that improves workplace productivity loss due to depression and anxiety, but more generalizable evidence beyond the workplace, such as in a national health service setting, is lacking. Objective: This naturalistic, repeated-measures, retrospective study investigated the impact of iCBT on work productivity metrics using nationally representative data from patients enrolled in the Irish national health service (ie, the Health Service Executive). Methods: We analyzed repeated measures retrospective data from 7125 employed patients enrolled in iCBT at the Health Service Executive between March 2023 and May 2024. The Work Productivity and Activity Impairment questionnaire was used to measure absenteeism, presenteeism, overall productivity loss, and activity impairment. Secondary outcomes included depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). Patients were primarily 25 to 64 years old (n=5578, 78%), female (n=4956, 70%), and met clinical scoring criteria on the Patient Health Questionnaire-9 or Generalized Anxiety Disorder-7 (n=4774, 67%). Missing data were handled using multiple imputation. We used mixed-effects models to assess pre-post treatment changes in outcomes and then utilized Irish national salary estimates from 2022 to derive cost savings (in 2022 € values; €1=approximately US $1.05) based on productivity improvement during use of the iCBT program. Results: From baseline to follow-up, absenteeism reduced by 6.85% (

WNT7A correlates with immunosuppression and predicts adverse prognosis in lung adenocarcinoma: Potential implication of the NF-kappaB/CCL2 Axis

Cytokine. 2026 Apr 6;202:157144. doi: 10.1016/j.cyto.2026.157144. Online ahead of print.

ABSTRACT

BACKGROUND: The remodeling of the tumor immune microenvironment (TME) is a pivotal determinant of therapeutic efficacy and clinical outcome in Lung Adenocarcinoma (LUAD). While WNT signaling is a known oncogenic driver, the specific immunomodulatory role of WNT7A and its potential crosstalk with inflammatory pathways in LUAD remain to be fully elucidated. We sought to define the prognostic value of WNT7A and explore the molecular mechanisms by which it may foster an immunosuppressive TME.

METHODS: We performed a multi-omics analysis utilizing the TCGA-LUAD cohort (N = 508) and validated findings in an independent external cohort (GSE30219, N = 293). The prognostic significance of WNT7A was evaluated using Kaplan-Meier and multivariate Cox regression analyses. TME composition was dissected via ssGSEA, focusing on myeloid-derived suppressor cell (MDSC) infiltration. Mechanistic pathways were identified using Gene Set Enrichment Analysis (GSEA) and gene co-expression networks.

RESULTS: High WNT7A expression was identified as a significant predictor of poor Overall Survival (OS) in the TCGA cohort (P < 0.05) and validated in the external cohort (P < 0.05). Multivariate analysis confirmed WNT7A as an independent prognostic risk factor (HR = 1.085, P = 0.036). Immunologically, WNT7A expression was positively correlated with MDSC infiltration (R = 0.43, P < 0.001), suggesting a shift towards an immune-tolerant phenotype. Mechanistically, GSEA revealed a robust activation of inflammatory signaling in the high-WNT7A group. Specifically, the TNFA Signaling via NF-κB pathway was significantly enriched(NES = 2.52, P < 0.001). Consistent with this pathway activation, WNT7A showed a statistically significant positive correlation with CCL2 (P < 0.001), a critical chemokine for MDSC recruitment, implicating the NF-κB/CCL2 axis in this process.

CONCLUSION: WNT7A serves as a prognostic biomarker linked to immune evasion in LUAD, potentially by modulating the NF-κB/CCL2/MDSC axis. This study identifies WNT7A as a potential therapeutic target to remodel the immune microenvironment, providing a rationale for future investigations into WNT-targeted strategies to improve immunotherapy efficacy.

PMID:41946008 | DOI:10.1016/j.cyto.2026.157144

Iron Physiology and Its Impact on Atopic Diseases: An EAACI Taskforce Report

Allergy. 2026 Apr 6. doi: 10.1111/all.70325. Online ahead of print.

ABSTRACT

Iron is essential for oxygen transport, energy metabolism, and immune regulation. Yet iron deficiency is the most common micronutrient disorder across all age groups, affecting nearly one quarter of the global population. Iron deficiency triggers nutritional immunity, a host defense mechanism that withholds and redistributes iron, contributing to increased morbidity and mortality. This review outlines normal iron physiology, distribution and absorption pathways and on the consequences of deficiency across body compartments, with particular attention to type 2-driven diseases. Beyond anemia, insufficient iron availability disrupts immune homeostasis by promoting type 2 inflammation, elevating IgE, and activating mast cells and eosinophils. Regulatory macrophages, the central hub of iron cycling, adopt an inflammatory, iron-sequestering state that reinforces malabsorption and redistribution. Epidemiology studies show higher iron-deficiency risk in allergic individuals; low maternal iron or early-life iron predisposes to eczema, wheeze, and asthma, while food-allergen elimination (notably cow's milk) further worsens anemia risk. Clinical evidence indicates that restoring iron status through diet, supplementation, or fortification lowers IgE levels, improves lung function, and alleviates symptoms of rhinitis, urticaria, and asthma. Iron may therefore represent a modifiable determinant of allergic disease development and severity. Integrating iron assessment and nutritional care into allergy management may reduce disease burden and slow the progression of allergic march.

PMID:41943501 | DOI:10.1111/all.70325

WNT7A correlates with immunosuppression and predicts adverse prognosis in lung adenocarcinoma: Potential implication of the NF-kappaB/CCL2 Axis

Cytokine. 2026 Apr 6;202:157144. doi: 10.1016/j.cyto.2026.157144. Online ahead of print.

ABSTRACT

BACKGROUND: The remodeling of the tumor immune microenvironment (TME) is a pivotal determinant of therapeutic efficacy and clinical outcome in Lung Adenocarcinoma (LUAD). While WNT signaling is a known oncogenic driver, the specific immunomodulatory role of WNT7A and its potential crosstalk with inflammatory pathways in LUAD remain to be fully elucidated. We sought to define the prognostic value of WNT7A and explore the molecular mechanisms by which it may foster an immunosuppressive TME.

METHODS: We performed a multi-omics analysis utilizing the TCGA-LUAD cohort (N = 508) and validated findings in an independent external cohort (GSE30219, N = 293). The prognostic significance of WNT7A was evaluated using Kaplan-Meier and multivariate Cox regression analyses. TME composition was dissected via ssGSEA, focusing on myeloid-derived suppressor cell (MDSC) infiltration. Mechanistic pathways were identified using Gene Set Enrichment Analysis (GSEA) and gene co-expression networks.

RESULTS: High WNT7A expression was identified as a significant predictor of poor Overall Survival (OS) in the TCGA cohort (P < 0.05) and validated in the external cohort (P < 0.05). Multivariate analysis confirmed WNT7A as an independent prognostic risk factor (HR = 1.085, P = 0.036). Immunologically, WNT7A expression was positively correlated with MDSC infiltration (R = 0.43, P < 0.001), suggesting a shift towards an immune-tolerant phenotype. Mechanistically, GSEA revealed a robust activation of inflammatory signaling in the high-WNT7A group. Specifically, the TNFA Signaling via NF-κB pathway was significantly enriched(NES = 2.52, P < 0.001). Consistent with this pathway activation, WNT7A showed a statistically significant positive correlation with CCL2 (P < 0.001), a critical chemokine for MDSC recruitment, implicating the NF-κB/CCL2 axis in this process.

CONCLUSION: WNT7A serves as a prognostic biomarker linked to immune evasion in LUAD, potentially by modulating the NF-κB/CCL2/MDSC axis. This study identifies WNT7A as a potential therapeutic target to remodel the immune microenvironment, providing a rationale for future investigations into WNT-targeted strategies to improve immunotherapy efficacy.

PMID:41946008 | DOI:10.1016/j.cyto.2026.157144

IC3-Evolve: Proof-/Witness-Gated Offline LLM-Driven Heuristic Evolution for IC3 Hardware Model Checking

arXiv:2604.03232v1 Announce Type: new Abstract: IC3, also known as property-directed reachability (PDR), is a commonly-used algorithm for hardware safety model checking. It checks if a state transition system complies with a given safety property. IC3 either returns UNSAFE (indicating property violation) with a counterexample trace, or SAFE with a checkable inductive invariant as the proof to safety. In practice, the performance of IC3 is dominated by a large web of interacting heuristics and implementation choices, making manual tuning costly, brittle, and hard to reproduce. This paper presents IC3-Evolve, an automated offline code-evolution framework that utilizes an LLM to propose small, slot-restricted and auditable patches to an IC3 implementation. Crucially, every candidate patch is admitted only through proof- /witness-gated validation: SAFE runs must emit a certificate that is independently checked, and UNSAFE runs must emit a replayable counterexample trace, preventing unsound edits from being deployed. Since the LLM is used only offline, the deployed artifact is a standalone evolved checker with zero ML/LLM inference overhead and no runtime model dependency. We evolve on the public hardware model checking competition (HWMCC) benchmark and evaluate the generalizability on unseen public and industrial model checking benchmarks, showing that IC3-Evolve can reliably discover practical heuristic improvements under strict correctness gates.

Position: Science of AI Evaluation Requires Item-level Benchmark Data

arXiv:2604.03244v1 Announce Type: new Abstract: AI evaluations have become the primary evidence for deploying generative AI systems across high-stakes domains. However, current evaluation paradigms often exhibit systemic validity failures. These issues, ranging from unjustified design choices to misaligned metrics, remain intractable without a principled framework for gathering validity evidence and conducting granular diagnostic analysis. In this position paper, we argue that item-level AI benchmark data is essential for establishing a rigorous science of AI evaluation. Item-level analysis enables fine-grained diagnostics and principled validation of benchmarks. We substantiate this position by dissecting current validity failures and revisiting evaluation paradigms across computer science and psychometrics. Through illustrative analyses of item properties and latent constructs, we demonstrate the unique insights afforded by item-level data. To catalyze community-wide adoption, we introduce OpenEval, a growing repository of item-level benchmark data designed supporting evidence-centered AI evaluation.

VERT: Reliable LLM Judges for Radiology Report Evaluation

arXiv:2604.03376v1 Announce Type: new Abstract: Current literature on radiology report evaluation has focused primarily on designing LLM-based metrics and fine-tuning small models for chest X-rays. However, it remains unclear whether these approaches are robust when applied to reports from other modalities and anatomies. Which model and prompt configurations are best suited to serve as LLM judges for radiology evaluation? We conduct a thorough correlation analysis between expert and LLM-based ratings. We compare three existing LLM-as-a-judge metrics (RadFact, GREEN, and FineRadScore) alongside VERT, our proposed LLM-based metric, using open- and closed-source models (reasoning and non-reasoning) of different sizes across two expert-annotated datasets, RadEval and RaTE-Eval, spanning multiple modalities and anatomies. We further evaluate few-shot approaches, ensembling, and parameter-efficient fine-tuning using RaTE-Eval. To better understand metric behavior, we perform a systematic error detection and categorization study to assess alignment of these metrics against expert judgments and identify areas of lower and higher agreement. Our results show that VERT improves correlation with radiologist judgments by up to 11.7% relative to GREEN. Furthermore, fine-tuning Qwen3 30B yield gains of up to 25% using only 1,300 training samples. The fine-tuned model also reduces inference time up to 37.2 times. These findings highlight the effectiveness of LLM-based judges and demonstrate that reliable evaluation can be achieved with lightweight adaptation.

TABQAWORLD: Optimizing Multimodal Reasoning for Multi-Turn Table Question Answering

arXiv:2604.03393v1 Announce Type: new Abstract: Multimodal reasoning has emerged as a powerful framework for enhancing reasoning capabilities of reasoning models. While multi-turn table reasoning methods have improved reasoning accuracy through tool use and reward modeling, they rely on fixed text serialization for table state readouts. This introduces representation errors in table encoding that significantly accumulate over multiple turns. Such accumulation is alleviated by tabular grounding methods in the expense of inference compute and cost, rendering real world deployment impractical. To address this, we introduce TABQAWORLD, a table reasoning framework that jointly optimizes tabular action through representation and estimation. For representation, TABQAWORLD employs an action-conditioned multimodal selection policy, which dynamically switches between visual and textual representations to maximize table state readout reliability. For estimation, TABQAWORLD optimizes stepwise reasoning trajectory through table metadata including dimension, data types and key values, safely planning trajectory and compressing low-complexity actions to reduce conversation turns and latency. Designed as a training-free framework, empirical evaluations show that TABQAWORLD achieves state-of-the-art performance with 4.87% accuracy improvements over baselines, with 5.42% accuracy gain and 33.35% inference latency reduction over static settings, establishing a new standard for reliable and efficient table reasoning.

Large Language Models Align with the Human Brain during Creative Thinking

arXiv:2604.03480v1 Announce Type: new Abstract: Creative thinking is a fundamental aspect of human cognition, and divergent thinking-the capacity to generate novel and varied ideas-is widely regarded as its core generative engine. Large language models (LLMs) have recently demonstrated impressive performance on divergent thinking tests and prior work has shown that models with higher task performance tend to be more aligned to human brain activity. However, existing brain-LLM alignment studies have focused on passive, non-creative tasks. Here, we explore brain alignment during creative thinking using fMRI data from 170 participants performing the Alternate Uses Task (AUT). We extract representations from LLMs varying in size (270M-72B) and measure alignment to brain responses via Representational Similarity Analysis (RSA), targeting the creativity-related default mode and frontoparietal networks. We find that brain-LLM alignment scales with model size (default mode network only) and idea originality (both networks), with effects strongest early in the creative process. We further show that post-training objectives shape alignment in functionally selective ways: a creativity-optimized \texttt{Llama-3.1-8B-Instruct} preserves alignment with high-creativity neural responses while reducing alignment with low-creativity ones; a human behavior fine-tuned model elevates alignment with both; and a reasoning-trained variant shows the opposite pattern, suggesting chain-of-thought training steers representations away from creative neural geometry toward analytical processing. These results demonstrate that post-training objectives selectively reshape LLM representations relative to the neural geometry of human creative thought.

Beyond Predefined Schemas: TRACE-KG for Context-Enriched Knowledge Graphs from Complex Documents

arXiv:2604.03496v1 Announce Type: new Abstract: Knowledge graph construction typically relies either on predefined ontologies or on schema-free extraction. Ontology-driven pipelines enforce consistent typing but require costly schema design and maintenance, whereas schema-free methods often produce fragmented graphs with weak global organization, especially in long technical documents with dense, context-dependent information. We propose TRACE-KG (Text-dRiven schemA for Context-Enriched Knowledge Graphs), a multimodal framework that jointly constructs a context-enriched knowledge graph and an induced schema without assuming a predefined ontology. TRACE-KG captures conditional relations through structured qualifiers and organizes entities and relations using a data-driven schema that serves as a reusable semantic scaffold while preserving full traceability to the source evidence. Experiments show that TRACE-KG produces structurally coherent, traceable knowledge graphs and offers a practical alternative to both ontology-driven and schema-free construction pipelines.
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