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The challenge of generating and evolving real-life like synthetic test data without accessing real-world raw data -- a Systematic Review

arXiv:2602.06609v1 Announce Type: cross Abstract: Background: High-level system testing of applications that use data from e-Government services as input requires test data that is real-life-like but where the privacy of personal information is guaranteed. Applications with such strong requirement include information exchange between countries, medicine, banking, etc. This review aims to synthesize the current state-of-the-practice in this domain. Objectives: The objective of this Systematic Review is to identify existing approaches for creating and evolving synthetic test data without using real-life raw data. Methods: We followed well-known methodologies for conducting systematic literature reviews, including the ones from Kitchenham as well as guidelines for analysing the limitations of our review and its threats to validity. Results: A variety of methods and tools exist for creating privacy-preserving test data. Our search found 1,013 publications in IEEE Xplore, ACM Digital Library, and SCOPUS. We extracted data from 75 of those publications and identified 37 approaches that answer our research question partly. A common prerequisite for using these methods and tools is direct access to real-life data for data anonymization or synthetic test data generation. Nine existing synthetic test data generation approaches were identified that were closest to answering our research question. Nevertheless, further work would be needed to add the ability to evolve synthetic test data to the existing approaches. Conclusions: None of the publications really covered our requirements completely, only partially. Synthetic test data evolution is a field that has not received much attention from researchers but needs to be explored in Digital Government Solutions, especially since new legal regulations are being placed in force in many countries.
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Exploring AI-Augmented Sensemaking of Patient-Generated Health Data: A Mixed-Method Study with Healthcare Professionals in Cardiac Risk Reduction

arXiv:2602.05687v2 Announce Type: replace-cross Abstract: Individuals are increasingly generating substantial personal health and lifestyle data, e.g. through wearables and smartphones. While such data could transform preventative care, its integration into clinical practice is hindered by its scale, heterogeneity and the time pressure and data literacy of healthcare professionals (HCPs). We explore how large language models (LLMs) can support sensemaking of patient-generated health data (PGHD) with automated summaries and natural language data exploration. Using cardiovascular disease (CVD) risk reduction as a use case, 16 HCPs reviewed multimodal PGHD in a mixed-methods study with a prototype that integrated common charts, LLM-generated summaries, and a conversational interface. Findings show that AI summaries provided quick overviews that anchored exploration, while conversational interaction supported flexible analysis and bridged data-literacy gaps. However, HCPs raised concerns about transparency, privacy, and overreliance. We contribute empirical insights and sociotechnical design implications for integrating AI-driven summarization and conversation into clinical workflows to support PGHD sensemaking.
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Reliability of LLMs as medical assistants for the general public: a randomized preregistered study

Nature Medicine, Published online: 09 February 2026; doi:10.1038/s41591-025-04074-y

In a randomized controlled study involving 1,298 participants from a general sample, performance of humans when assisted by a large language model (LLM) was sensibly inferior to that of the LLM alone when assessing ten medical scenarios leading to disease identification and recommendations for treatment.
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Integrating liquid biopsies in non-small cell lung cancer diagnosis and management: opportunities and challenges

Expert Rev Anticancer Ther. 2026 Feb 15:1-12. doi: 10.1080/14737140.2026.2630026. Online ahead of print.

ABSTRACT

INTRODUCTION: Liquid biopsy has emerged as an important approach to capture tumor-derived material from blood and other body fluids, offering a minimally invasive window into cancer biology. In non - small cell lung cancer (NSCLC), it enables comprehensive molecular profiling that informs patient management, from guiding therapy choices to monitoring disease status and assessing minimal residual disease (MRD).

AREAS COVERED: Its main advantages over tissue biopsy lie in being noninvasive, capable of reflecting tumor heterogeneity and real-time biological changes. These strengths allow liquid biopsy to be applied at different clinical timepoints, including diagnosis, treatment decision-making, evaluation during therapy, detection of resistance, and surveillance for recurrence. Although circulating tumor DNA (ctDNA) remains the most established analyte, the scope is broadening to include circulating RNAs, circulating tumor cells, exosomes, DNA methylation signatures, and tumor-educated platelets, each providing complementary insights. A literature search of PubMed, EMBASE, and Web of Science was conducted without restrictions, supplemented by screening reference lists and major oncology conference abstracts.

EXPERT OPINION: While significant progress has been made integrating liquid biopsies in NSCLC, challenges persist, encompassing issues of standardization, cost, and clinical integration.

PMID:41656166 | DOI:10.1080/14737140.2026.2630026

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The Feasibility of Smartwatch Micro–Ecological Momentary Assessment for Tracking Eating Patterns of Malaysian Children and Adolescents in the South-East Asian Community Observatory Child Health Update 2020: Cross-Sectional Study

Background: Mobile phone ecological momentary assessment (EMA) methods are a well-established measure of eating and drinking behaviors, but compliance can be poor. Micro-EMA (μEMA), which collects information with a single tap response to brief questions on smartwatches, offers a novel application that may improve response rates. To our knowledge, there is no data evaluating μEMA to measure eating habits in children or in low-to-middle-income countries. Objective: In this study, we investigated the feasibility of micro-EMA to measure eating patterns in Malaysian children and adolescents. Methods: We invited 100 children and adolescents aged 7-18 years in Segamat, Malaysia, to participate in 2021-2022. Smartwatches were distributed to 83 children and adolescents who agreed to participate. Participants were asked to wear the smartwatch for 8 days and respond to 12 prompts per day, hourly, from 9AM to 8PM, asking for information on their meals, snacks, and drinks consumed. A questionnaire captured their experiences using the smartwatch and μEMA interface. Response rate (proportion of prompts responded to) assessed participants’ adherence. We explored associations between response rate with time of day, across days, age, and sex using multilevel binomial logistic regression modeling. Results: Eighty-two participants provided usable smartwatch data. The median number (IQR) of meals, drinks, and snacks per day was 2 (2-4), 3 (1-5), and 1 (0-2), respectively, on the first day of the study. The median response rate across the study was 68% (IQR 50-83). The response rate decreased across study days from 74% (68-78) on Day 1 to 40% (30-50) on Day 7 (odds ratio [OR] per study day 0.73, 95% CI 0.64-0.83). Response rate was lowest at the start of the day and highest between the hours of 12 PM and 2 PM. Female participants responded to more prompts than male participants (OR 1.72, 95% CI 1.03-2.86). There was no evidence of differential response by age (OR 0.73, 95% CI 0.41-1.28). Most participants (65%) rated their experience using the smartwatch positively, with 33% saying they were happy to participate in future studies using the smartwatch. For children that did not wear the smartwatch for the full study duration (n=22), discomfort was the most common complaint (41%). Conclusions: In this study of the feasibility of μEMA on smartwatches to measure eating in Malaysian children, we found the method was acceptable. However, response rates declined across study days, resulting in substantial missingness. Future studies (eg, through focus groups) should explore approaches to improving response to event prompts, trial alternative devices to increase children’s comfort, and evaluate revised protocols for reporting of intake events.
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EcDNA-borne structural variants drive oncogenic fusion transcript amplification

Extrachromosomal DNA (ecDNA) is a major source of oncogenic fusions across cancer types, generating tissue-specific fusion landscapes with diagnostic potential. EcDNA-borne PVT1 5′-end fusions stabilize partner RNAs and boost oncogene output.
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Phenome-wide analysis of copy number variants in 470,727 UK Biobank genomes

Nature, Published online: 04 February 2026; doi:10.1038/s41586-025-10087-x

A multiancestry phenome-wide analysis of copy number variants in the UK Biobank genomes increases power to detect genetic associations with complex traits across human populations.
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Trustworthy Blockchain-based Federated Learning for Electronic Health Records: Securing Participant Identity with Decentralized Identifiers and Verifiable Credentials

arXiv:2602.02629v1 Announce Type: cross Abstract: The digitization of healthcare has generated massive volumes of Electronic Health Records (EHRs), offering unprecedented opportunities for training Artificial Intelligence (AI) models. However, stringent privacy regulations such as GDPR and HIPAA have created data silos that prevent centralized training. Federated Learning (FL) has emerged as a promising solution that enables collaborative model training without sharing raw patient data. Despite its potential, FL remains vulnerable to poisoning and Sybil attacks, in which malicious participants corrupt the global model or infiltrate the network using fake identities. While recent approaches integrate Blockchain technology for auditability, they predominantly rely on probabilistic reputation systems rather than robust cryptographic identity verification. This paper proposes a Trustworthy Blockchain-based Federated Learning (TBFL) framework integrating Self-Sovereign Identity (SSI) standards. By leveraging Decentralized Identifiers (DIDs) and Verifiable Credentials (VCs), our architecture ensures only authenticated healthcare entities contribute to the global model. Through comprehensive evaluation using the MIMIC-IV dataset, we demonstrate that anchoring trust in cryptographic identity verification rather than behavioral patterns significantly mitigates security risks while maintaining clinical utility. Our results show the framework successfully neutralizes 100% of Sybil attacks, achieves robust predictive performance (AUC = 0.954, Recall = 0.890), and introduces negligible computational overhead (
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Digital intervention <i>mylovia</i> improves sexual functioning in women with sexual dysfunction in randomized controlled trial

npj Digital Medicine, Published online: 03 February 2026; doi:10.1038/s41746-026-02385-z

Digital intervention mylovia improves sexual functioning in women with sexual dysfunction in randomized controlled trial
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Barriers to Digital Health Adoption in Older Adults: Scoping Review Informed by Innovation Resistance Theory

Background: The transformation of digital health technologies has reshaped how healthcare is delivered, particularly in primary care. However, despite the advantages of these innovations, older adults remain among the most resistant users. Traditional technology adoption models may not fully capture the complexity of this reluctance, which is shaped not only by usability challenges but also by emotional, psychological, and identity-related concerns. Innovation Resistance Theory (IRT) offers a complementary framework focused on understanding barriers to adoption rather than solely on facilitators. Objective: To map and synthesize evidence on older adults’ resistance to digital health technologies in primary care through the lens of IRT, and to examine how empirically observed resistance factors align with, extend, or refine IRT’s functional and psychological barriers. Methods: A scoping review combined with concept-driven thematic synthesis was conducted. Empirical studies published between 2014 and 2025 were identified through systematic searches across five databases: PubMed, CINAHL, Ovid Medline, Web of Science, and Scopus. Inclusion criteria focused on studies examining barriers or resistance to digital health use among older adults aged 60 and above in primary care settings. The search was guided by terms related to “older adults”, “digital health”, “eHealth”, “telemedicine”, and “technology resistance”. After screening and reviewing the full texts, data were extracted into a structured matrix, and findings were organized according to the five dimensions of the IRT: usage, value, risk, tradition, and image barriers. Results: Of 4,976 identified records, seventeen studies met the inclusion criteria. Functional barriers included usability challenges, interface complexity, and age-related impairments. Psychological resistance was frequently linked to emotional discomfort, symbolic misalignment, and concerns about the loss of relational care. Value and risk concerns included distrust in diagnostics accuracy, concerns regarding privacy and data security, and skepticism about care quality. Traditional preferences for face-to-face interactions and generational digital divides further reinforced image-based resistance. A key finding was the interaction between barriers, where low self-efficacy and technology anxiety create feedback loops that reinforce avoidance behaviors. Conclusions: Resistance to digital health among older adults is not simply a lack of adoption but a complex, emotionally grounded process involving functional, psychological, and identity-based barriers. Interventions must go beyond technical usability to rebuild emotional trust, preserve the relational aspects of care, and align digital solutions with the values and expectations of older adults. Innovation Resistance Theory offers a comprehensive framework for understanding these multifaceted dynamics and serves as a valuable guide for policy development, user-centered design, and future research Clinical Trial: None
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Integrative proteogenomics maps multifactorial aetiology, progression and therapeutic vulnerabilities in gastric cancer

Gut. 2026 Jan 30:gutjnl-2025-337247. doi: 10.1136/gutjnl-2025-337247. Online ahead of print.

ABSTRACT

BACKGROUND: Gastric cancer, with disproportionately higher incidence in East Asia, arises from complex host-microbiome-environment interactions beyond Helicobacter pylori (HP) infection. However, the molecular architecture linking environmental carcinogens, microbial succession and host response remains unclear.

OBJECTIVE: To delineate multifactorial aetiologies and clinically actionable subtypes/biomarkers of gastric cancer through integrative proteogenomic, microbial and environmental exposure profiling.

DESIGN: We established a multiomics atlas of paired tumour, adjacent mucosa tissues and blood from 154 treatment-naïve Taiwanese patients, integrating whole-exome sequencing, RNA-seq, proteome and phosphoproteome profiling with carcinogen signatures, HP status, microbiome composition and refined anatomical mapping. Cell-based functional assays tested carcinogen effects. Microbial subtype was assessed in an independent cohort.

RESULTS: A polycyclic-aromatic-hydrocarbon signature, dibenz[a,h]acridine, emerged as a high-risk exposure promoting invasion, immune suppression and poor survival, significantly exceeding nitrosamine-linked risk in this cohort. Multilayer integration defined three initiation ecologies: HP-driven inflammatory, non-HP microbiome-enriched immune-silent and HP-free microbially depleted states. Among HP-negative tumours, a Streptococcus-enriched subtype associated with tight-junction (CLDN18.2/ZO-1/OCLN) disruption and epithelial-mesenchymal transition, whereas a subset of clinically aggressive cases retained CLDN18.2-high epithelial-stable subtype for therapeutic accessibility. An independent cohort revealed gastric juice-derived Streptococcus anginosus abundance inversely correlated with tight-junction proteins. Anatomical mapping reveals location-specific, sex-specific, subtype-specific oncogenic networks and kinase activity, including CDK4 activation in clinical biomarker-negative tumours. Decision-tree models combining exposure and proteome-immune states refined recurrence and survival prediction beyond stage.

CONCLUSION: This proteogenomic framework defines exposure-informed and microbiome-informed gastric cancer subtypes, providing a molecular schema for patient stratification, prevention and actionable therapeutic vulnerabilities.

PMID:41617485 | DOI:10.1136/gutjnl-2025-337247

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Liquid biopsy biomarkers for accurate detection of malignant pulmonary nodules: a meta-analytic approach

Discov Oncol. 2026 Jan 29;17(1):178. doi: 10.1007/s12672-025-03646-1.

ABSTRACT

Pulmonary nodules are a common radiological finding that can be classified as either benign or Malignant, with significant clinical implications. The early detection of malignant nodules is critically important for improving the prognosis of lung cancer, which remains the leading cause of cancer-related mortality worldwide. Traditional imaging techniques have Limitations in accurately classifying pulmonary nodules. Liquid biopsy, a minimally invasive method that evaluates circulating components in the Blood, presents promising diagnostic potential in this context. This study aims to evaluate the diagnostic capacity of multiple liquid biopsy biomarkers for early and accurate differentiation between benign and Malignant pulmonary nodules. Accordingly, we conducted a comprehensive study involving a meta-analysis, selecting 16 eligible studies that utilised liquid biopsy to assess various circulating biomarkers in the diagnostic yield. The most significant results were linked to circulating free DNA (cfDNA). However, other components, including circulating tumour cells (CTCs), microRNAs/pfeRNAs, extracellular vesicles (EVs), serological markers, and imaging techniques, also provided valuable information. Similarly, integrating multi-omics data with machine learning models has been shown to enhance the ability to differentiate between benign and malignant pulmonary nodules, thereby supporting early diagnosis and improved management for patients with lung cancer.

PMID:41612093 | PMC:PMC12855667 | DOI:10.1007/s12672-025-03646-1

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Products, Performance, and Technological Development of Ambulatory Oxygen Therapy Devices: Scoping Review

Background: Ambulatory oxygen therapy is prescribed for patients with chronic lung diseases who experience exertional hypoxemia. However, available devices may not adequately meet user requirements, and their performance characteristics are heterogeneous. Objective: This study aims to identify devices available for delivery of ambulatory oxygen therapy, the technologies that they use to generate oxygen, the performance characteristics of each device, and the development status. Methods: We used medical and engineering databases to identify peer-reviewed papers (eg, MEDLINE, IEEE). Gray literature was used to identify additional descriptions of ambulatory oxygen devices in military medicine, space exploration, or patents. The last search was conducted in September 2025. Documents that described a device that can deliver oxygen in an ambulatory context (defined as weighing less than 10 kg) and were written in English were included. Search results were screened for inclusion by 2 independent reviewers. Data were synthesized by descriptively mapping the performance of each product, the technology used, and the development status of emerging technologies. Results: From 9702 records identified, a total of 166 met eligibility criteria (106 scientific publications and 60 gray literature). We identified 33 portable oxygen concentrators (POCs; 29 commercially available), 10 oxygen cylinders, and 6 portable liquid oxygen (LOX) devices. The POC products showed a trade-off between portability and oxygen delivery capacity (maximum flow rate ranging from 2.0 to 6.0 L/min; device weight ranging from 1.0 to 9.1 kg). Pressure swing adsorption with zeolite was the most common oxygen generation technology in POCs on the market. The mean maximum continuous operating time of POCs was 3.8 hours. Two prototype POCs (maximum flow rate of 4-6 L/min and device weight of 8-9 kg) were developed for space exploration using modified adsorbents. LOX devices were the lightest and had the longest continuous operating time. Innovations in delivery included the downsizing of a POC by using nanozeolite as an adsorbent and pulse oximeter oxygen saturation (SpO2)–targeted automatic titration of oxygen delivery based on the user’s SpO2. Conclusions: This scoping review is the first study to integrate medical, engineering, and gray literature on ambulatory oxygen devices and their development. Although prior literature has narratively explained the products and technologies, no previous research has systematically investigated them. This review showed that POCs available to consumers may not meet the needs of patients in terms of flow rate, portability, and operating time. LOX devices offered superior performance but are limited by high costs. Limitations of this review include the difficulty of comparing product performance across oxygen delivery settings and that the records were largely obtained from English-language sources. Innovation in ambulatory oxygen technology has been limited over the past decade, highlighting urgent need for research and development of new lightweight devices with higher oxygen delivery. Clinical Trial: OSF Registries 10.17605/OSF.IO/QS7FX; https://osf.io/qs7fx
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OpenAI and Anthropic Introduce Healthcare-Focused AI Platforms

OpenAI and Anthropic have announced new healthcare-oriented AI offerings that extend their models beyond general conversational use and into regulated clinical and life sciences environments. Both releases emphasize technical integration, interoperability, and governance, reflecting a shift toward AI systems designed to operate directly within existing healthcare infrastructure.

By Robert Krzaczyński
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High-Fidelity Longitudinal Patient Simulation Using Real-World Data

arXiv:2601.17310v1 Announce Type: new Abstract: Simulation is a powerful tool for exploring uncertainty. Its potential in clinical medicine is transformative and includes personalized treatment planning and virtual clinical trials. However, simulating patient trajectories is challenging because of complex biological and sociocultural influences. Here, we show that real-world clinical records can be leveraged to empirically model patient timelines. We developed a generative simulator model that takes a patient's history as input and synthesizes fine-grained, realistic future trajectories. The model was pretrained on more than 200 million clinical records. It produced high-fidelity future timelines, closely matching event occurrence rates, laboratory test results, and temporal dynamics in real patient future data. It also accurately estimated future event probabilities, with observed-to-expected ratios consistently near 1.0 across diverse outcomes and time horizons. Our results reveal the untapped value of real-world data in electronic health records and introduce a scalable framework for in silico modeling of clinical care.
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Decentralized Multi-Agent Swarms for Autonomous Grid Security in Industrial IoT: A Consensus-based Approach

arXiv:2601.17303v1 Announce Type: cross Abstract: As Industrial Internet of Things (IIoT) environments expand to include tens of thousands of connected devices. The centralization of security monitoring architectures creates serious latency issues that savvy attackers can exploit to compromise an entire manufacturing ecosystem. This paper outlines a new, decentralized multi-agent swarm (DMAS) architecture that includes autonomous artificial intelligence (AI) agents at each edge gateway, functioning as a distributed digital "immune system" for IIoT networks. Instead of using a traditional static firewall approach, the DMAS agents communicate via a lightweight peer-to-peer protocol to cooperatively detect anomalous behavior across the IIoT network without sending data to a cloud infrastructure. The authors also outline a consensus-based threat validation (CVT) process in which agents vote on the threat level of an identified threat, enabling instant quarantine of a compromised node or nodes. The authors conducted experiments on a testbed that simulated an innovative factory environment with 2000 IIoT devices and found that the DMAS demonstrated sub-millisecond response times (average of 0.85ms), 97.3% accuracy in detecting malicious activity under high load, and 87% accuracy in detecting zero-day attacks. All significantly higher than baseline values for both centralized and edge computing. Additionally, the proposed architecture can prevent real-time cascading failures in industrial control systems and reduce network bandwidth use by 89% compared to cloud-based solutions.
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Coronary Artery Segmentation and Vessel-Type Classification in X-Ray Angiography

arXiv:2601.17429v1 Announce Type: cross Abstract: X-ray coronary angiography (XCA) is the clinical reference standard for assessing coronary artery disease, yet quantitative analysis is limited by the difficulty of robust vessel segmentation in routine data. Low contrast, motion, foreshortening, overlap, and catheter confounding degrade segmentation and contribute to domain shift across centers. Reliable segmentation, together with vessel-type labeling, enables vessel-specific coronary analytics and downstream measurements that depend on anatomical localization. From 670 cine sequences (407 subjects), we select a best frame near peak opacification using a low-intensity histogram criterion and apply joint super-resolution and enhancement. We benchmark classical Meijering, Frangi, and Sato vesselness filters under per-image oracle tuning, a single global mean setting, and per-image parameter prediction via Support Vector Regression (SVR). Neural baselines include U-Net, FPN, and a Swin Transformer, trained with coronary-only and merged coronary+catheter supervision. A second stage assigns vessel identity (LAD, LCX, RCA). External evaluation uses the public DCA1 cohort. SVR per-image tuning improves Dice over global means for all classical filters (e.g., Frangi: 0.759 vs. 0.741). Among deep models, FPN attains 0.914+/-0.007 Dice (coronary-only), and merged coronary+catheter labels further improve to 0.931+/-0.006. On DCA1 as a strict external test, Dice drops to 0.798 (coronary-only) and 0.814 (merged), while light in-domain fine-tuning recovers to 0.881+/-0.014 and 0.882+/-0.015. Vessel-type labeling achieves 98.5% accuracy (Dice 0.844) for RCA, 95.4% (0.786) for LAD, and 96.2% (0.794) for LCX. Learned per-image tuning strengthens classical pipelines, while high-resolution FPN models and merged-label supervision improve stability and external transfer with modest adaptation.
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