Communications medicine最新文献

{"title":"Timing and intraindividual variability of daytime napping and Alzheimer's disease in older adults.","authors":"Chenlu Gao, Xi Zheng, Ruixue Cai, Lei Yu, Julie A Schneider, Aron S Buchman, David A Bennett, Yue Leng, Agustin Ibáñez, Lei Gao, Kun Hu, Peng Li","doi":"10.1038/s43856-025-00936-1","DOIUrl":"10.1038/s43856-025-00936-1","url":null,"abstract":"<p><strong>Background: </strong>Excessive daytime napping has been associated with neurodegeneration in older adults, but prior research has focused on nap duration and frequency. Emerging frameworks emphasize the multidimensionality of sleep, but it remains unknown whether other dimensions of napping (e.g., timing, variability) are linked to neurodegeneration. To address this gap, we investigated the associations of daytime nap timing and intraindividual variability of nap duration with incident Alzheimer's dementia and Alzheimer's disease pathology.</p><p><strong>Methods: </strong>We analyzed data from 936 older adults (age range: 56-99; 77% female) in the Rush Memory and Aging Project to examine incident Alzheimer's dementia and from 320 deceased participants (age range at death: 71-105; 70% female) to examine Alzheimer's pathology. The proportions of morning (9-11am) and early afternoon naps (1-3 pm) and the intraindividual variability of nap duration were assessed using actigraphy. Participants completed neurological assessments at baseline and annually for up to 17 years. In deceased participants, amyloid β and neurofibrillary tangles were examined.</p><p><strong>Results: </strong>Here we show that more morning naps are linked to a higher risk of Alzheimer's dementia, whereas more early afternoon naps are linked to reduced amyloid β levels. Higher intraindividual variability of nap duration is shown to be associated with increased amyloid β and neurofibrillary tangles.</p><p><strong>Conclusions: </strong>Our findings suggest that specific timing patterns and irregularities in daytime napping are linked to Alzheimer's disease risk and pathology. Multi-dimensional assessments of nap behaviors may aid in risk stratification for neurocognitive impairment and offer a potential target for interventions aimed at promoting healthy cognitive aging.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"219"},"PeriodicalIF":5.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNA-15a-5p mediates abdominal aortic aneurysm progression and serves as a potential diagnostic and prognostic circulating biomarker.","authors":"Greg Winski, Ekaterina Chernogubova, Albert Busch, Suzanne M Eken, Hong Jin, Moritz Lindquist Liljeqvist, Tooba Khan, Alexandra Bäcklund, Valentina Paloschi, Joy Roy, Rebecka Hultgren, Christine Brostjan, Gert J de Borst, Joost P G Sluijter, Nadja Sachs, Hans-Henning Eckstein, Reinier A Boon, Joshua M Spin, Philip S Tsao, Folkert W Asselbergs, Lars Maegdefessel","doi":"10.1038/s43856-025-00892-w","DOIUrl":"10.1038/s43856-025-00892-w","url":null,"abstract":"<p><strong>Background: </strong>MicroRNAs are post transcriptional modulators of gene expression. We explored the diagnostic and prognostic value of circulating microRNAs in abdominal aortic aneurysm (AAA) disease, for which currently no established circulating biomarker is available.</p><p><strong>Methods: </strong>We profiled the expression of 754 human microRNAs in plasma from 187 patients with AAA and 190 matched non-diseased controls. To validate, we used two additional AAA patient cohorts, looking at circulating and aortic tissue-derived microRNA expression, and their correlation to AAA disease phenotype, as well as two murine AAA models.</p><p><strong>Results: </strong>We show that among 12 differentially expressed microRNAs, miR-15a and -659 are the most significantly up-regulated in AAA, whereas miR-1183 and -192 are the most significantly down-regulated. miR-15a is upregulated AAA patient tissues, and in plasma from two murine AAA models. In patients from three different cohorts, miR-15a expression levels in plasma, serum and aortic tunica media are significantly correlated with AAA diameter. Through modulation of miR-15a in human aortic smooth muscle cells, we identify several potential target genes of miR-15a known to be down-regulated in human AAA, suggesting its potential involvement in AAA pathology. Inhibition of miR-15a in vivo demonstrates a significant inhibition of murine aortic diameter growth at day 7.</p><p><strong>Conclusions: </strong>Our findings suggest that miR-15a is a potential biomarker of AAA. Through in vivo studies and based on its target profile, we show that miR-15a is involved in AAA pathogenesis and could help treatment, but also assist in risk-stratification of AAA patients and identify candidates for early AAA repair.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"218"},"PeriodicalIF":5.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood predictors of suffering in adulthood across 22 countries.","authors":"Richard G Cowden, Zhuo Job Chen, Renae Wilkinson, Dorota Weziak-Bialowolska, Thomas Breedlove, Craig Gundersen, Koichiro Shiba, R Noah Padgett, Byron R Johnson, Tyler J VanderWeele","doi":"10.1038/s43856-025-00913-8","DOIUrl":"10.1038/s43856-025-00913-8","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that suffering may degrade health and well-being. However, further research is needed to identify potential targets for addressing population-level suffering.</p><p><strong>Methods: </strong>This cross-sectional study used nationally representative data from 22 countries in Wave 1 of the Global Flourishing Study (N = 202,898) to explore associations of 13 individual characteristics and retrospectively recalled childhood factors with suffering in adulthood. We conducted a modified Poisson regression by country in which suffering was regressed on all candidate predictors. Random effects meta-analyses were used to aggregate results for the 11 predictors that were common across all countries.</p><p><strong>Results: </strong>Our meta-analytic results suggest that a combination of risk and protective factors during childhood may be associated with suffering in adulthood. Individuals whose parents were married (versus divorced) at age 12, had a very good/somewhat good paternal relationship (versus very bad/somewhat bad) when growing up, had excellent health (versus good) when growing up, and who reported their family lived comfortably (versus got by) financially when growing up are less likely to experience suffering in adulthood, whereas those who were abused during childhood (versus not), felt like an outsider in their family when growing up (versus not), attended religious services 1-3 times a month (versus never) around age 12, and are female (versus male) have a higher likelihood of suffering in adulthood. Associations are somewhat heterogeneous across the countries.</p><p><strong>Conclusions: </strong>Childhood experiences, influences, and conditions may impact experiences of suffering in adulthood. Targeted early-life interventions could mitigate the burden of suffering later in life.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"217"},"PeriodicalIF":5.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suppression of NRAS-mutant melanoma growth with NRAS-targeting Antisense Oligonucleotide treatment reveals therapeutically relevant kinase co-dependencies.","authors":"Valentin Feichtenschlager, Yixuan James Zheng, Tiange Qu, Dasha Hohlova, Ciara Callanan, Linan Chen, Christopher Chen, Wilson Ho, Albert Lee, Yeonjoo Hwang, Arowyn Courtright, Thy Nguyen, Olivia Marsicovetere, Denise P Muñoz, Klemens Rappersberger, Jean-Philippe Coppe, Susana Ortiz-Urda","doi":"10.1038/s43856-025-00932-5","DOIUrl":"10.1038/s43856-025-00932-5","url":null,"abstract":"<p><strong>Background: </strong>Melanoma is an aggressive form of skin cancer, and patients with NRAS-mutant melanoma face limited treatment options due to the lack of direct NRAS inhibitors. This study explores the utilization of antisense oligonucleotides (ASOs) to directly target NRAS-mRNA for therapeutic approaches.</p><p><strong>Methods: </strong>We designed and tested NRAS-mRNA-targeting ASOs. Experiments in melanoma cell lines and mouse models assessed effects on cell survival, apoptosis, and tumor growth. A kinase activity profiling platform identified therapeutically exploitable pathways influenced by NRAS suppression.</p><p><strong>Results: </strong>Our research suggests that ASOs do not need to target the mutated NRAS segment to be effective. ASOs designed for the non-mutated NRAS sequence eliminate NRAS-dependent melanoma cells while sparing NRAS wild-type cells. They act independently of subcellular target localization, reduce NRAS-mRNA levels, inhibit MAPK signaling, induce apoptosis, and suppress melanoma growth in vitro and in vivo. Outcomes of high-throughput kinase activity mapping (HT-KAM) indicate a significant dependency between NRAS-mRNA expression and the activity of MEK1, FGFR2, and CDK4 kinases. Co-targeting these kinases enhances the antiproliferative effect of NRAS ASOs, showing synergy.</p><p><strong>Conclusions: </strong>These findings highlight antisense oligonucleotides as a promising therapeutic approach for NRAS-mutant melanoma. By effectively blocking NRAS-mRNA, this strategy overcomes challenges posed by the absence of a direct small molecule inhibitor for NRAS, and may offer new treatment options for patients.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"216"},"PeriodicalIF":5.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulation of cardiac fatty acid or glucose oxidation to treat heart failure in preclinical models: a systematic review and meta-analysis.","authors":"Tom Fischer, Christina Schenkl, Estelle Heyne, Peter Schlattmann, Torsten Doenst, P Christian Schulze, T Dung Nguyen","doi":"10.1038/s43856-025-00924-5","DOIUrl":"10.1038/s43856-025-00924-5","url":null,"abstract":"<p><strong>Background: </strong>Current expert opinion on cardiac metabolism in heart failure (HF) suggests that inhibiting cardiac fatty acid oxidation (FAO) or stimulating cardiac glucose oxidation (GO) can improve heart function. However, systematic evidence is lacking, and contradictory data exist. Therefore, we conducted a comprehensive meta-analysis to assess the effects of modulating myocardial GO or FAO on heart function.</p><p><strong>Methods: </strong>We screened MEDLINE via Ovid, Scopus, and Web of Science until March 02, 2024 for interventional studies reporting significant changes in cardiac GO or FAO in established animal models of HF, such as ischemia-reperfusion, pressure overload, rapid pacing, and diabetic cardiomyopathy. We employed multivariate analysis (four-level random-effects model) to enclose all measures of heart function. Additionally, we used meta-regression to explore heterogeneity and contour-enhanced funnel plots to assess publication bias. The protocol is registered on PROSPERO (CRD42023456359).</p><p><strong>Results: </strong>Of a total of 10,628 studies screened, 103 studies are included. Multivariate meta-analysis reveals that enhancing cardiac GO considerably restores cardiac function (Hedges' g = 1.03; 95% CI: 0.79-1.26; p < 0.001). Interestingly, interventions associated with reduced myocardial FAO show neutral effects (Hedges' g = 0.24; 95% CI: -0.57-1.05; p = 0.557), while those augmenting myocardial FAO markedly improve function (Hedges' g = 1.17; 95% CI: 0.58-1.76; p < 0.001).</p><p><strong>Conclusions: </strong>Our data underscore the role of cardiac metabolism in treating HF. Specifically, these results suggest that stimulating either myocardial FAO or GO may considerably improve cardiac function. Furthermore, these results question the current notion that inhibition of cardiac FAO is protective.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"213"},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dogs fed raw meat-based diets are vectors of drug-resistant Salmonella infection in humans.","authors":"Isabelle Bernaquez, Jeannot Dumaresq, Isabelle Picard, Colette Gaulin, Réjean Dion, Kim Weaver, Matthew Walker, Ashley Kearney, Amrita Bharat, Judith Fafard, Sadjia Bekal","doi":"10.1038/s43856-025-00919-2","DOIUrl":"10.1038/s43856-025-00919-2","url":null,"abstract":"<p><strong>Background: </strong>Salmonella enterica serovar 4,[5],12:i:- (S. 4,[5],12:i:-), the monophasic variant of Typhimurium, is among the most prevalent surface antigen subtypes and most frequent carriers of multidrug-resistance in Salmonella worldwide, therefore becoming a prominent public health threat.</p><p><strong>Methods: </strong>Genomic surveillance data analysis, in addition to human case and animal health investigations and food inspections from Quebec, Canada were conducted to identify the source of an emerging S. 4,[5],12:i:- cluster from 2021-2023. We performed antimicrobial susceptibility testing, whole genome sequencing, phylogeny and comparative genomic analyses to characterize this local strain.</p><p><strong>Results: </strong>We show that a cluster of 41 S. 4,[5],12:i:- emerged in Quebec, Canada, after acquiring a self-conjugative IncHI2A plasmid encoding extensive drug-resistance (mph(A), bla_CTX-M-55, qnrS1) and potential reduced biocide susceptibility via efflux pump regulators (ramAp, marR), metal resistance (terZABCDE, copG) and oxidative stress responses (umuDC, dsbC), among other mechanisms. Genomic epidemiology identifies 20 human cases, 16 veal calves, 3 dogs, one piglet, one moose, and 4 raw meat-based diet isolates belonging to this cluster. Infants are mainly (50%) affected, and dogs fed raw meat-based diets are the major source identified, followed by exposure to cattle. Retrospective genomic analyses demonstrates its association to USA porcine and shared plasmid pool among many food-producing animals, but indicated different niches for different plasmid subtypes.</p><p><strong>Conclusions: </strong>This study highlights the threat of S. 4,[5],12:i:- ST34 and its raw pet food-based transmission to vulnerable human populations, where impacted veal farms and asymptomatic dogs can act as disease carriers with limited treatment options and possible environmental persistence.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"214"},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a scoring system to evaluate and clinically manage postoperative acute infarction complications in moyamoya disease.","authors":"Ziqi Liu, Xiaokuan Hao, Shihao He, Cunxin Tan, Yeru Wang, Kaiyu Shan, Xilong Wang, Zhenyu Zhou, Ming Lv, Ding Ma, Tao Yu, Qinglin Liu, Yunqi Jiao, Yu Wang, Haogeng Sun, Dongxu Yang, Jun Liu, Hao Chen, Jinxi Zhao, Xin Lou, Qiang Guo, Hua Guo, Yongbo Yang, Jun Pu, Bing Li, Yi Liu, Yujie Fan, Dong Zhang, Ning Ma, Li Li, Ran Duan, Rong Wang","doi":"10.1038/s43856-025-00937-0","DOIUrl":"10.1038/s43856-025-00937-0","url":null,"abstract":"<p><strong>Background: </strong>Revascularization is the most widely used treatment for moyamoya disease (MMD) but is associated with relatively high incidence of ischaemic complications in adult patients. At present, the guidelines in various countries do not include effective recommendations regarding postoperative complications, and a simple, practical and reliable scoring system is needed for rapid clinical evaluation and decision-making.</p><p><strong>Methods: </strong>In this prognostic study, we developed a prediction model based on a single-centre cohort and validated it in a multicentre external prospective cohort. All patients were followed for at least 30 days to confirm whether postoperative acute cerebral infarction occurred.</p><p><strong>Results: </strong>Among 2992 patients, 1980 patients are included in the derivation cohort, and 1012 patients compose the external validation cohort. Postoperative acute cerebral infarction occurs in 131 patients (6.62%) in the derivation cohort and 91 patients (8.99%) in the external validation cohort. Six risk factors are ultimately included in the development of the scoring system (CAMPIS). In the internal validation cohort, the Matthews correlation coefficient (MCC) and the concordance index (C-index) are 0.690 (0.681-0.698) and 0.956 (0.955-0.956), respectively. In the external validation cohort, the MCC and C-index are 0.762 (0.761-0.764) and 0.972 (0.971-0.973), respectively. In the derivation and validation cohorts, the postoperative infarction rates are 0.96% and 0.53%, 25.95% and 48.68%, and 84.71% and 89.47%, respectively, in the low-risk group, the medium-risk group, and the high-risk group.</p><p><strong>Conclusions: </strong>CAMPIS is a reliable and practical tool that can be used to facilitate decision-making and avoid potentially harmful interventions, serving as an effective complement to the existing guidelines in the assessment and control of postoperative ischaemic complications.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"215"},"PeriodicalIF":5.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Projecting future fluid intake of Chinese children in a warming world.","authors":"Sui Zhu, Guanhao He, Na Zhang, Yingying Jin, Zhongguo Huang, Shasha Han, Bingxiao Li, Zhiqiang Lin, Fengrui Jing, Fangfang Zeng, Yanhui Gao, Tao Liu, Xiaofeng Liang, Guansheng Ma, Wenjun Ma","doi":"10.1038/s43856-025-00929-0","DOIUrl":"10.1038/s43856-025-00929-0","url":null,"abstract":"<p><strong>Background: </strong>Adequate water intake is essential for maintaining health, particularly in children and adolescents. In the context of global warming, the likelihood of experiencing more frequent and intense heatwaves increases, posing a serious threat to regions already grappling with water scarcity. Therefore, we aim to explore the exposure-response relationship between ambient temperature and daily total fluid intake (TFI) among Chinese children and adolescents and to forecast their fluid consumption patterns up to the year 2099 in China, considering different climate change scenarios.</p><p><strong>Methods: </strong>Utilizing data from a 2011 cross-sectional survey of 3713 students (51.98% female) aged 7 to 18 in Beijing, Shanghai, and Guangzhou, this study employs generalized linear mixed models to analyze the association between temperature and fluid intake. Projections of future fluid consumption are made under the Shared Socioeconomic Pathways (SSP) 126, SSP370, and SSP585 scenarios, reflecting a range of possible climate futures.</p><p><strong>Results: </strong>Our results show a nearly linear relationship between temperature and fluid consumption. For every 1 °C increase, average daily TFI rises by 24 mL (95% CI: 21-27 mL), and plain water intake (PWI) increases by 12 mL (95% CI: 9-14 mL). The daily TFI ranges from 961 mL at 17 °C to 1298 mL at 31 °C. Future projections under different SSP scenarios indicate a substantial increase in fluid intake by the year 2099.</p><p><strong>Conclusions: </strong>These findings reveal a positive association between ambient temperature and fluid intake with projected increases in hydration needs under future warming scenarios. They highlight important public health implications in the context of climate change and emphasize the need for updated hydration guidelines to protect child health in a warming world.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"211"},"PeriodicalIF":5.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific prostate segmentation in kilovoltage images for radiation therapy intrafraction monitoring via deep learning.","authors":"Adam Mylonas, Zeyao Li, Marco Mueller, Jeremy T Booth, Ryan Brown, Mark Gardner, Andrew Kneebone, Thomas Eade, Paul J Keall, Doan Trang Nguyen","doi":"10.1038/s43856-025-00935-2","DOIUrl":"10.1038/s43856-025-00935-2","url":null,"abstract":"<p><strong>Background: </strong>During radiation therapy, the natural movement of organs can lead to underdosing the cancer and overdosing the healthy tissue, compromising treatment efficacy. Real-time image-guided adaptive radiation therapy can track the tumour and account for the motion. Typically, fiducial markers are implanted as a surrogate for the tumour position due to the low radiographic contrast of soft tissues in kilovoltage (kV) images. A segmentation approach that does not require markers would eliminate the costs, delays, and risks associated with marker implantation.</p><p><strong>Methods: </strong>We trained patient-specific conditional Generative Adversarial Networks for prostate segmentation in kV images. The networks were trained using synthetic kV images generated from each patient's own imaging and planning data, which are available prior to the commencement of treatment. We validated the networks on two treatment fractions from 30 patients using multi-centre data from two clinical trials.</p><p><strong>Results: </strong>Here, we present a large-scale proof-of-principle study of x-ray-based markerless prostate segmentation for globally available cancer therapy systems. Our results demonstrate the feasibility of a deep learning approach using kV images to track prostate motion across the entire treatment arc for 30 patients with prostate cancer. The mean absolute deviation is 1.4 and 1.6 mm in the anterior-posterior/lateral and superior-inferior directions, respectively.</p><p><strong>Conclusions: </strong>Markerless segmentation via deep learning may enable real-time image guidance on conventional cancer therapy systems without requiring implanted markers or additional hardware, thereby expanding access to real-time adaptive radiation therapy.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"212"},"PeriodicalIF":5.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying outbreak risk factors through case-controls comparisons.","authors":"Nina H Fefferman, Michael J Blum, Lydia Bourouiba, Nathaniel L Gibson, Qiang He, Debra L Miller, Monica Papeș, Dana K Pasquale, Connor Verheyen, Sadie J Ryan","doi":"10.1038/s43856-025-00916-5","DOIUrl":"10.1038/s43856-025-00916-5","url":null,"abstract":"<p><p>Outbreaks are typically investigated using approaches that aim to identify place- and context-dependent causative factors. As the focus is on understanding the basis of a specific outbreak, the resulting narratives are rarely suitable for forecasting risk or developing generalizable predictive and preventative measures. This Perspective article proposes applying a case-control framework as an outbreak epidemiological study design to promote evidence-based decision-making for prevention and response to outbreaks. The approach involves identifying counterfactuals, with case-control comparisons drawn to test hypotheses about conditions that manifest outbreaks. First, a framework is described for iterative multidisciplinary interrogation to elucidate and identify minimally sufficient sets of factors that lead to disease outbreaks. Next, example case-control comparison frameworks are discussed, centered on pathogen(s), influential contributor(s), or landscape(s), illustrated with examples focused on pathogen transmission.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"5 1","pages":"210"},"PeriodicalIF":5.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}