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176 papers

Skin Cancer Detection Using Preprocessed Vision Transformers: An Interpretability-Driven Approach

Ananya Atri · Aug 15, 2026

Abstract : Skin cancer is an issue affecting health all over the world, and proper diagnosis of the issue would lead to better patient outcomes. Deep Learning, in particular Convolutional Neural Networks (CNNs), has brought more objective and fast screening techniques. This paper assesses the diagnostic capability of Vision Transformers (ViT) with Explainable AI (XAI) on HAM10000 data (10,015 pigmented skin lesion images). The researchers used a critically important preprocessing pipeline comprising of morphology transformations to remove hair, image segmentation to identify regions of interest and data augmentation to overcome imbalanced classes. Five XAI techniques were used, namely, Grad-CAM, LIME, SHAP, Integrated Gradients and Saliency Maps to improve diagnostic transparency. The experiment outcomes revealed that ViT + Grad-CAM architecture was the best performer with a total accuracy of 96.6%. The model achieved 0.92 precision, 0.90 recall and 0.92 F1-score. Grad-CAM was especially useful in a clinical setting as it is fast to run and localizes classes accurately.

Skin CancerMedicineComputer VisionArtificial IntelligenceVision Transformer

Designing polymer-peptide conjugates to target dipeptide repeat aggregates implicated in amyotrophic lateral sclerosis.

Gray VP et al. · Jul 8, 2026

Toxic dipeptide repeats such as the aggregating glycine-alanine (GA) n peptide are implicated in the progression of amyotrophic lateral sclerosis (ALS), a lethal neuromuscular disease with an urgent need for new therapeutics. Here, we report polymer-peptide conjugates that prevent aggregation of (GA) 10 . Optical density measurements and transmission electron microscopy demonstrate that conjugates prevent aggregation when co-incubated with (GA) 10 and disperse pre-aggregated (GA) 10 . These results represent an important step toward a new generation of therapeutics for ALS and contribute to a growing body of literature demonstrating the potential of polymer-peptide conjugates as therapeutics.

Medicine

Bioorthogonal tuning of nanosurface opsonisation via click coupling of a complement fusion protein inhibitor.

Jacques S et al. · Jul 3, 2026

Complement opsonisation contributes to immune clearance of nanopharmaceuticals, but complement activation has some undesirable effects. Herein, we show that tethering the fusion complement receptor 2-complement receptor 1 (CR2-CR1) regulator to cross-linked iron oxide nanoworms via a PEG spacer and copper-free click chemistry overcomes complement opsonisation. Furthermore, CR2-CR1-conjugated nanoworms reduce complement opsonisation of unmodified nanoparticles.

Medicine

Ruminants Epidemiology, Spatial Clustering and Multivariate Risk Modelling of Cutaneous Leishmaniasis in District Bajaur, Pakistan.

Khan MA et al. · Jul 1, 2026

Background and objective Cutaneous leishmaniasis (CL) remains a significant public health concern in endemic regions of Pakistan, particularly in ecologically diverse and resource-limited areas. This study aimed to investigate the epidemiology, risk factors, lesion characteristics, seasonal trends and spatial distribution of CL in District Bajaur, Khyber Pakhtunkhwa, Pakistan. Methods A cross-sectional observational study was conducted in 2022, including clinically suspected and laboratory-confirmed CL cases from all nine tehsils of District Bajaur. Demographic information, lesion characteristics (site, type and number), season of presentation and regional distribution were collected using a structured questionnaire. Statistical analyses included univariate and multivariate logistic regression, multinomial regression, Poisson regression, stratified analyses and interaction modelling. Spatial clustering was evaluated using Z-scores, Moran's I statistics and GIS-based risk mapping. Results CL prevalence was significantly higher among males, younger individuals, unmarried participants and during the summer season. Lesions were predominantly located on exposed body parts, especially the hands and face, with dry lesions and single-lesion presentations being most common. Multivariate analysis identified male gender, younger age, unmarried status, summer season, dry lesion type and single lesions as independent risk factors. Stratified and interaction analyses indicated an elevated risk among young males during the summer. Spatial analysis revealed significant clustering of cases, with Khar, Loe Mamund and Salarzai identified as high-risk tehsils. A clinician-friendly risk scoring system was developed to estimate individual infection probability. Conclusion CL in District Bajaur is influenced by a complex interaction of demographic, clinical, seasonal and spatial factors. These findings emphasize the importance of targeted surveillance, vector control strategies and risk-based interventions to reduce disease burden in endemic regions.

Medicine

The Effect of Dopaminergic Medication on Impulse Control and Compulsive Behaviour: A Translational Perspective.

Wolfschlag M et al. · Jul 1, 2026

Dopaminergic medication used in disorders like Parkinson's disease (PD) and restless legs syndrome can cause impulsive-compulsive behaviour (ICB), often with strong negative effects on patients' quality of life. This narrative review presents translational evidence on iatrogenic ICB, taking findings from epidemiological, clinical, neuroimaging and preclinical studies into consideration. Epidemiological and clinical studies find dopamine agonists with high D2/3-selectivity to be most strongly linked to ICB. Their effect on ICB has often been shown to be dose-dependent, but the impact of combining different dopaminergic drugs or applying extended-release formulations is less clear. Intervention studies support tapering or replacing dopamine agonists for ICB reduction, whereas no efficacious pharmacotherapy has been identified for ICB treatment specifically. Adequate animal models for mimicking different types of ICB are available, and point, in line with human neuroimaging studies, towards an involvement of striatum and prefrontal cortex in iatrogenic ICB. Overall, complementary research designs have led to profound evidence regarding the occurrence of ICB in PD and establishing methods transferable to other, less-studied patient populations. A combined approach integrating insights from human studies and animal models could contribute to developing dopaminergic drugs with lower ICB risk but also specific pharmacotherapies for impulsivity or compulsivity in the future.

Medicine

Physical Adaptations to High-Intensity Multimodal Training in Recreationally Active Adults: A Randomised Control Trial.

Sharp T et al. · Jul 1, 2026

High-intensity multimodal training (HIMT), combines aerobic and resistance exercise within a single session, offering a time-efficient training mode. However, the efficacy of HIMT for physical adaptations compared to other combined training models (e.g., inter-session concurrent training [ISCT]) remains unclear. This two-arm parallel randomised controlled trial examined the physical adaptations of 7 weeks of HIMT compared to a matched active control (ISCT) in recreationally active adults. The HIMT group completed 4 × 45-min sessions/week integrating aerobic and resistance exercises. The ISCT group completed 2 × 45-min resistance sessions/week and 2 × 45-min aerobic sessions/week. Training intensity was prescribed at ≥ 7 RPE (CR-10) with weekly volume and exercise selection matched across groups. Maximal strength, aerobic capacity, anthropometry and body composition were assessed pre and post-intervention. Both HIMT (n = 38) and ISCT (n = 37) demonstrated small improvements in upper- and lower-body strength, peak oxygen uptake and maximum work rate (p < 0.05). Trivial but significant improvements were also observed in fat mass, body fat percentage, lean mass, waist circumference and waist-to-hip ratio (p < 0.05). A modest group × time interaction favoured ISCT for reducing body fat percentage (b = -0.628, 95% CI [-1.21 to -0.046], p = 0.035 and d = -0.082). Seven weeks of HIMT and ISCT improved muscular strength, aerobic fitness and body composition. Separating high-intensity aerobic and resistance sessions across days may offer a small advantage for reducing relative body fat. Longer interventions may be needed for greater adaptations. TRIAL REGISTRATION: ETH24-9364, ACTRN12624000556549, Protocol: available on the Open Science Framework.

Medicine

Connection after correction: Parent-child relationships following early cardiac surgery.

Clancy TA et al. · Jul 1, 2026

Early cardiac surgery for congenital heart disease (CHD) may have enduring effects on the parent-child emotional connection and a child's capacity for regulation. This study explored emotional availability in parent-child interaction following early cardiac surgery in relation to emotional and behavioral regulation in children and identified early predictors. Participants were 23 preschool-aged children with CHD and their parents from a longitudinal cohort assessed at infancy (post-surgery) and preschool age in Australia. Dyadic interaction was assessed using the Emotional Availability Scales (EA), and parents reported on child's emotional and behavioral regulation. Predictors included infant social-emotional functioning, parental attachment feelings and traumatic stress, hospitalization length, timing of diagnosis and duration of contact at birth. Over 50% of dyads demonstrated emotional availability, however 30% were classified as complicated and 12% detached. Greater parental sensitivity was associated with less externalizing behavior. Longer hospitalization was associated with lower child involvement and greater parental intrusiveness. Contact at birth was associated with greater emotional availability and more optimal parental structuring at preschool. Findings highlight the enduring impact of early medical adversity on emotional availability in CHD and illuminate effects on both child and parent. Future research should explore targeted interventions that buffer relational disruptions in medically vulnerable dyads.

Medicine

Pregnancy and kidney transplantation: optimized clinical and obstetric management to reduce maternal and perinatal complications.

Santos ACM et al. · Jul 1, 2026

Objective Review the literature to provide guidance on the appropriate clinical and obstetric management of pregnant women with kidney transplants to reduce maternal and perinatal complications. Methods The PubMed and SciELO databases, which evaluated pregnancy and kidney transplantation, were searched, focusing on clinical and obstetric management. Other variables of interest were preconception counseling, fertility, the safety of immunosuppressants, maternal complications, perinatal complications, graft worsening during pregnancy, and postpartum guidance. Results A total of 354 articles were identified, of which 76 were included in the analysis. Studies suggest that attempts to conceive should begin at least one year after kidney transplantation in the absence of graft rejection, with stable renal function (creatinine Conclusion Pregnancy in kidney transplant recipients is challenging due to maternal and perinatal risks. However, the present review demonstrates that clinical and obstetric management by an experienced multidisciplinary team contributes to better maternal and perinatal outcomes in pregnancies among kidney transplant recipients.

Medicine

Indicators of maternal anxiety, stress, and depression and developmental outcomes in preterm children: A systematic review.

Silva BBRD et al. · Jul 1, 2026

The study was conducted in Brazil and aimed to systematically review empirical research examining the association between maternal indicators of anxiety, stress, and depression and the developmental outcomes of preterm children. A literature search was conducted across PubMed, Web of Science, PsycINFO, EMBASE, Scopus, LILACS, and SciELO. Sixteen studies were analyzed. The systematic review revealed a significant association between maternal anxiety, depression, and stress indicators and poorer developmental outcomes for children born prematurely. This association was observed whether it was considered a single indicator of maternal mental health or a combination of two or more indicators. The systematic review affirms the impact of maternal mental health on the development of preterm children in early childhood.

Medicine

A Prospective Evaluation of Glucagon Stimulation Test Safety in Adults With Chronic Moderate-to-Severe Traumatic Brain Injury.

Snyder C et al. · Jul 1, 2026

Introduction Growth hormone deficiency (GHD) is a common and clinically significant consequence of moderate-to-severe traumatic brain injury (msTBI). The glucagon stimulation test (GST) is widely used to assess growth hormone deficiency; however, the safety of GST has not been systematically evaluated in adults with chronic msTBI. Methods This prospective study enrolled 138 adults aged 18-65 years with chronic msTBI (≥ 1-year post-injury) from a single academic Brain Injury Center neuroendocrine registry. All participants underwent standardized GST with systematic symptom assessment at baseline and serial intervals over 240 min. Adverse events and symptoms were graded by severity using predefined clinical criteria, and participants were analysed by GHD status and by presence of any adverse event. Results GST was well tolerated, with no serious adverse events, test terminations, or prolonged sequelae. The most common adverse effect was nausea (30.4%), with vomiting in 9.4% of participants; antiemetics were required in 16.7% of cases. Female sex was significantly associated with nausea (p Conclusions In adults with chronic msTBI, the glucagon stimulation test demonstrates a favourable safety profile with transient, non-severe adverse effects and no serious neurological or metabolic complications. These findings support GST as a safe and practical method for evaluating growth hormone deficiency in this population.

Medicine