Sanjay Jain

Harishwar Reddy Kasireddy, Patricio S. La Rosa, Akshita Gupta et al.

Histopathology foundation models (HFMs), pretrained on large-scale cancer datasets, have advanced computational pathology. However, their applicability to non-cancerous chronic kidney disease remains underexplored, despite coexistence of renal pathology with malignancies such as renal cell and urothelial carcinoma. We systematically evaluate 11 publicly available HFMs across 11 kidney-specific downstream tasks spanning multiple stains (PAS, H&E, PASM, and IHC), spatial scales (tile and slide-level), task types (classification, regression, and copy detection), and clinical objectives, including detection, diagnosis, and prognosis. Tile-level performance is assessed using repeated stratified group cross-validation, while slide-level tasks are evaluated using repeated nested stratified cross-validation. Statistical significance is examined using Friedman test followed by pairwise Wilcoxon signed-rank testing with Holm-Bonferroni correction and compact letter display visualization. To promote reproducibility, we release an open-source Python package, kidney-hfm-eval, available at https://pypi.org/project/kidney-hfm-eval/ , that reproduces the evaluation pipelines. Results show moderate to strong performance on tasks driven by coarse meso-scale renal morphology, including diagnostic classification and detection of prominent structural alterations. In contrast, performance consistently declines for tasks requiring fine-grained microstructural discrimination, complex biological phenotypes, or slide-level prognostic inference, largely independent of stain type. Overall, current HFMs appear to encode predominantly static meso-scale representations and may have limited capacity to capture subtle renal pathology or prognosis-related signals. Our results highlight the need for kidney-specific, multi-stain, and multimodal foundation models to support clinically reliable decision-making in nephrology.

Ziwei Xu, Sanjay Jain, Mohan Kankanhalli

Hallucination has been widely recognized to be a significant drawback for large language models (LLMs). There have been many works that attempt to reduce the extent of hallucination. These efforts have mostly been empirical so far, which cannot answer the fundamental question whether it can be completely eliminated. In this paper, we formalize the problem and show that it is impossible to eliminate hallucination in LLMs. Specifically, we define a formal world where hallucination is defined as inconsistencies between a computable LLM and a computable ground truth function. By employing results from learning theory, we show that LLMs cannot learn all the computable functions and will therefore inevitably hallucinate if used as general problem solvers. Since the formal world is a part of the real world which is much more complicated, hallucinations are also inevitable for real world LLMs. Furthermore, for real world LLMs constrained by provable time complexity, we describe the hallucination-prone tasks and empirically validate our claims. Finally, using the formal world framework, we discuss the possible mechanisms and efficacies of existing hallucination mitigators as well as the practical implications on the safe deployment of LLMs.

Sanjay Jain, Junqiang Peng, Frank Stephan et al.

Parity-SAT is the problem of determining whether a given CNF formula has an odd number of satisfying assignments. As a canonical $\oplus$P-complete problem, it represents a fundamental variant of the exact model counting problem (#SAT). Under the Strong Exponential Time Hypothesis (SETH), Parity-SAT admits no $O^*((2-\varepsilon)^n)$-time or $O^*((2-\varepsilon)^m)$-time algorithm for any constant $\varepsilon>0$, where $n$ and $m$ denote the numbers of variables and clauses, respectively. Thus, breaking the $2^n$ or $2^m$ barrier appears impossible in full generality. In this work, we revisit this barrier through structural restrictions and a refined exploitation of parity. We study Parity-$d$-occ-SAT, where each variable appears in at most $d$ clauses, and obtain three main results. First, we design {a randomized} $O^*(2^{m(1-1/O(d))})$-time algorithm, thereby breaking the $2^m$ barrier for every fixed $d$. Second, for the special case $d=2$, we develop a significantly sharper branching algorithm running in $O^*(1.1193^n)$ time or $O^*(1.3248^m)$ time. Third, leveraging the structural insights underlying the $d=2$ case, we obtain an $O^*(1.1052^L)$-time algorithm for general Parity-SAT, where $L$ denotes the formula length. All algorithms use only polynomial space. Notably, our running-time bounds are better than the best known bounds for the corresponding exact counting counterparts, highlighting a genuine algorithmic advantage of parity over counting. Conceptually, our results demonstrate that parity admits finer structural reductions and more efficient branching than exact model counting, and that bounded occurrence can be systematically leveraged to circumvent classical exponential barriers.

Katy Börner, Ellen M. Quardokus, Bruce W. Herr et al.

The National Institutes of Health's (NIH) Human Biomolecular Atlas Program (HuBMAP) aims to create a comprehensive high-resolution atlas of all the cells in the healthy human body. Multiple laboratories across the United States are collecting tissue specimens from different organs of donors who vary in sex, age, and body size. Integrating and harmonizing the data derived from these samples and 'mapping' them into a common three-dimensional (3D) space is a major challenge. The key to making this possible is a 'Common Coordinate Framework' (CCF), which provides a semantically annotated, 3D reference system for the entire body. The CCF enables contributors to HuBMAP to 'register' specimens and datasets within a common spatial reference system, and it supports a standardized way to query and 'explore' data in a spatially and semantically explicit manner. [...] This paper describes the construction and usage of a CCF for the human body and its reference implementation in HuBMAP. The CCF consists of (1) a CCF Clinical Ontology, which provides metadata about the specimen and donor (the 'who'); (2) a CCF Semantic Ontology, which describes 'what' part of the body a sample came from and details anatomical structures, cell types, and biomarkers (ASCT+B); and (3) a CCF Spatial Ontology, which indicates 'where' a tissue sample is located in a 3D coordinate system. An initial version of all three CCF ontologies has been implemented for the first HuBMAP Portal release. It was successfully used by Tissue Mapping Centers to semantically annotate and spatially register 48 kidney and spleen tissue blocks. The blocks can be queried and explored in their clinical, semantic, and spatial context via the CCF user interface in the HuBMAP Portal.

Rodney LaLonde, Ziyue Xu, Ismail Irmakci et al.

Our work expands the use of capsule networks to the task of object segmentation for the first time in the literature. This is made possible via the introduction of locally-constrained routing and transformation matrix sharing, which reduces the parameter/memory burden and allows for the segmentation of objects at large resolutions. To compensate for the loss of global information in constraining the routing, we propose the concept of "deconvolutional" capsules to create a deep encoder-decoder style network, called SegCaps. We extend the masked reconstruction regularization to the task of segmentation and perform thorough ablation experiments on each component of our method. The proposed convolutional-deconvolutional capsule network, SegCaps, shows state-of-the-art results while using a fraction of the parameters of popular segmentation networks. To validate our proposed method, we perform experiments segmenting pathological lungs from clinical and pre-clinical thoracic computed tomography (CT) scans and segmenting muscle and adipose (fat) tissue from magnetic resonance imaging (MRI) scans of human subjects' thighs. Notably, our experiments in lung segmentation represent the largest-scale study in pathological lung segmentation in the literature, where we conduct experiments across five extremely challenging datasets, containing both clinical and pre-clinical subjects, and nearly 2000 computed-tomography scans. Our newly developed segmentation platform outperforms other methods across all datasets while utilizing less than 5% of the parameters in the popular U-Net for biomedical image segmentation. Further, we demonstrate capsules' ability to generalize to unseen rotations/reflections on natural images.

Brandon Ginley, Kuang-Yu Jen, Avi Rosenberg et al.

Glomerulosclerosis, interstitial fibrosis, and tubular atrophy (IFTA) are histologic indicators of irrecoverable kidney injury. In standard clinical practice, the renal pathologist visually assesses, under the microscope, the percentage of sclerotic glomeruli and the percentage of renal cortical involvement by IFTA. Estimation of IFTA is a subjective process due to a varied spectrum and definition of morphological manifestations. Modern artificial intelligence and computer vision algorithms have the ability to reduce inter-observer variability through rigorous quantitation. In this work, we apply convolutional neural networks for the segmentation of glomerulosclerosis and IFTA in periodic acid-Schiff stained renal biopsies. The convolutional network approach achieves high performance in intra-institutional holdout data, and achieves moderate performance in inter-intuitional holdout data, which the network had never seen in training. The convolutional approach demonstrated interesting properties, such as learning to predict regions better than the provided ground truth as well as developing its own conceptualization of segmental sclerosis. Subsequent estimations of IFTA and glomerulosclerosis percentages showed high correlation with ground truth.

Brendon Lutnick, Brandon Ginley, Darshana Govind et al.

Neural networks promise to bring robust, quantitative analysis to medical fields, but adoption is limited by the technicalities of training these networks. To address this translation gap between medical researchers and neural networks in the field of pathology, we have created an intuitive interface which utilizes the commonly used whole slide image (WSI) viewer, Aperio ImageScope (Leica Biosystems Imaging, Inc.), for the annotation and display of neural network predictions on WSIs. Leveraging this, we propose the use of a human-in-the-loop strategy to reduce the burden of WSI annotation. We track network performance improvements as a function of iteration and quantify the use of this pipeline for the segmentation of renal histologic findings on WSIs. More specifically, we present network performance when applied to segmentation of renal micro compartments, and demonstrate multi-class segmentation in human and mouse renal tissue slides. Finally, to show the adaptability of this technique to other medical imaging fields, we demonstrate its ability to iteratively segment human prostate glands from radiology imaging data.

Sanjay Jain, Prateek Saxena, Frank Stephan et al.

The present paper introduces a practical protocol for provably secure, outsourced computation. Our protocol minimizes overhead for verification by requiring solutions to withstand an interactive game between a prover and challenger. For optimization problems, the best or nearly best of all submitted solutions is expected to be accepted by this approach. Financial incentives and deposits are used in order to overcome the problem of fake participants.