Communications medicine最新文献

{"title":"Canakinumab or emavusertib for anemia in lower-risk MDS: results of the CANFIRE and LUCAS phase 2, open-label, multicenter trials.","authors":"Anne Sophie Platzbecker, Katharina Zoldan, Dominic Brauer, Philipp Kiewe, Daniel Sasca, Katja Sockel, Thomas Illmer, Aristoteles Giagounidis, Daniel Nowak, Kathrin Rieger, Friederike Wortmann, Katharina Götze, Martin Schmidt-Hieber, Karin Mayer, Ursula Vehling-Kaiser, Rudolf Weide, Stefan Mahlmann, Jens Przybilla, Susanne Melzer, Michael Cross, Marie Schneider, Dirk Hasenclever, Klaus H Metzeler, Uwe Platzbecker","doi":"10.1038/s43856-026-01885-z","DOIUrl":"10.1038/s43856-026-01885-z","url":null,"abstract":"<p><strong>Background: </strong>Dysregulated innate immune signaling promotes inflammatory suppression of hematopoietic stem and progenitor cell function, contributing to ineffective erythropoiesis in myelodysplastic neoplasms (MDS). The phase 2, open-label CANFIRE and LUCAS trials aimed to determine the efficacy and safety of canakinumab or emavusertib, respectively, in patients with lower-risk MDS (LR-MDS) or myelodysplastic/myeloproliferative neoplasms (MDS/MPN).</p><p><strong>Methods: </strong>Patients in CANFIRE were refractory, intolerant to, or ineligible for erythropoiesis-stimulating agent (ESA) treatment and received canakinumab 200 mg subcutaneously every 21 days for up to eight cycles within the first six months of treatment. Patients in LUCAS were either refractory or intolerant to ESAs (cohort A) or ESA-naïve with serum erythropoietin levels >200 U/L (cohort B); all patients received emavusertib 200-300 mg orally twice daily for 21 days in up to four 28-day cycles. The primary endpoint for both trials was hematologic improvement-erythroid per International Working Group 2018 criteria at the end of the planned treatment period. CANFIRE was registered at ClinicalTrials.gov (NCT05237713; registered January 21, 2022). LUCAS was registered in the EU Clinical Trials Register (EudraCT 2020-003986-20; registered March 15, 2021) and at ClinicalTrials.gov (NCT05178342; registered November 2, 2021).</p><p><strong>Results: </strong>Here we show that of 11 patients enrolled in CANFIRE and 36 patients enrolled in LUCAS, no patients in either trial achieved the primary endpoint. Canakinumab treatment was well-tolerated, with no reported serious adverse events (SAEs) and no patients died in the CANFIRE trial. In the LUCAS trial, 15 patients reported SAEs, and four patients died. CANFIRE and LUCAS were terminated early due to inadequate patient recruitment and after a pre-planned interim futility analysis, respectively.</p><p><strong>Conclusions: </strong>Inhibition of IL-1β or IRAK4 signaling with canakinumab or emavusertib did not result in hematologic improvement in patients with LR-MDS.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984362","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":"MAKAAO, an open access resource linking human autoantibodies and autoimmune diseases.","authors":"Fabien Maury, Adrien Coulet, Maud de Dieuleveult","doi":"10.1038/s43856-026-01872-4","DOIUrl":"10.1038/s43856-026-01872-4","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972305","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":"Implications of the new US AI framework in medicine.","authors":"Antonis A Armoundas","doi":"10.1038/s43856-026-01910-1","DOIUrl":"10.1038/s43856-026-01910-1","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946309","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":"Resolution-dependent self-supervised transfer in chest radiograph classification.","authors":"Soroosh Tayebi Arasteh, Mina Shaigan, Christiane Kuhl, Jakob Nikolas Kather, Sven Nebelung, Daniel Truhn","doi":"10.1038/s43856-026-01897-9","DOIUrl":"10.1038/s43856-026-01897-9","url":null,"abstract":"<p><strong>Background: </strong>Self-supervised learning (SSL) has improved visual representation learning, but its value in chest radiography remains uncertain. DINOv3 extends earlier SSL models through Gram-anchored self-distillation and explicit high-resolution adaptation. Whether these changes improve transfer learning for chest radiograph classification has not been established.</p><p><strong>Methods: </strong>We benchmarked DINOv3 against DINOv2 and supervised ImageNet initialization across seven chest radiograph datasets comprising 816,183 radiographs from pediatric and adult cohorts. ViT-B/16 and ConvNeXt-B were evaluated under full fine-tuning at 224 × 224 and 512 × 512 pixels, with targeted 1024 × 1024 experiments on three cohorts. Additional analyses examined parameter-efficient adaptation, synthetic label corruption, external validation, frozen 7B features, and computational efficiency. The primary outcome was the mean area under the receiver operating characteristic curve across labels.</p><p><strong>Results: </strong>In adult cohorts, DINOv3 did not consistently outperform DINOv2 at 224 × 224 pixels, but became the strongest initialization at 512 × 512 pixels, especially with ConvNeXt-B. Gains were greatest for small focal and boundary-dependent abnormalities, whereas large-structure findings changed little. The pediatric cohort showed no significant benefit from DINOv3, higher resolution, or backbone choice. Scaling to 1024 × 1024 rarely improved performance and markedly increased computational cost. ConvNeXt-B remained superior to ViT-B/16 under both full and parameter-efficient adaptation. External validation preserved the 512 × 512 DINOv3 advantage, whereas synthetic label corruption showed that this benefit should not be interpreted simply as superior noise robustness. Frozen DINOv3-7B features underperformed relative to fully adapted 86 to 89M-parameter backbones.</p><p><strong>Conclusions: </strong>For adult chest radiograph classification, DINOv3 provides its most reliable benefit at 512 × 512 pixels, particularly with ConvNeXt-B. Fully adapted mid-sized models at 512 × 512 pixels provided the best performance-cost trade-off in our benchmark.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922057","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":"Publisher Correction: Networked SIRS model with Kalman filter state estimation for epidemic monitoring in Europe.","authors":"Atte Aalto, Daniele Proverbio, Giulia Giordano, Alexander Skupin, Jorge Gonçalves","doi":"10.1038/s43856-026-01893-z","DOIUrl":"10.1038/s43856-026-01893-z","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907734","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":"Applying a systemic approach that extends beyond the brain to Alzheimer's disease pathogenesis.","authors":"Payam Barnaghi, Antigone Fogel, Chloe Walsh, Ramin Nilforooshan, Valeria Ricotti, Thomas Voit","doi":"10.1038/s43856-026-01831-z","DOIUrl":"10.1038/s43856-026-01831-z","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889312","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":"K_V7 channel activation inhibits human and murine myometrium contractility and delays delivery in a mouse model of preterm birth.","authors":"Yosef T Mansour, Hiten D Mistry, Evonne C Chin-Smith, Mariola K Zaleska, Deanna C Sekulich, Jennifer L Herington, Jeff Reese, Rima Patel, Philip I Aaronson, Donna M Slater, Sarah K England, Iain A Greenwood, Mark R Johnson, Paul D Taylor, Rachel M Tribe","doi":"10.1038/s43856-026-01861-7","DOIUrl":"10.1038/s43856-026-01861-7","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous preterm birth, defined as delivery before 37 weeks of gestation, remains a global cause of neonatal illness and death, yet treatments for preterm labor remain limited. We hypothesized that K_V7 channels in the uterus (myometrium), could be a therapeutic target for preventing or treating preterm labor. The aim was to characterize K_V7 channel subtypes in human myometrium present after labor onset, and to use a preterm birth mouse model to provide proof-of-principal evidence that activating these channels in vivo can delay preterm delivery.</p><p><strong>Methods: </strong>This experimental study integrated studies of human myometrial tissue (term and preterm pregnancies, n = 159 across experiments), with a RU486-induced preterm birth mouse model (C57BL/6 J, n = 6-9 per experimental group), and ex vivo fetal ductus arteriosus preparations (CD-1 mice, n = 10 per group). Molecular and protein profiling, isometric tension recordings, and functional pharmacology were used to characterize K_V7 mediated regulation of human and mouse uterine contractility. In vivo dosing studies in mice assessed the effects of K_V7 activators (retigabine and ML213) on delivery timing (n = 6-9).</p><p><strong>Results: </strong>We show that K_V7 channels and ancillary units (KCNE1-5), are expressed in pregnant human myometrium, prior to and after the onset of labor. KCNQ4 and KCNE4 transcripts are also present in myometrium taken at preterm gestations ( ± labor). K_V7.2-5 activators markedly reduce spontaneous contractions in human and mouse myometrium in vitro and significantly delay preterm birth in vivo with limited impact on fetal ductus arteriosus function.</p><p><strong>Conclusions: </strong>These findings support K_V7 activation as a promising approach to suppress uterine contractility and hence delay preterm birth, highlighting a potential new direction for either drug repurposing or therapeutic development.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889365","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":"Visual prompt engineering for multimodal and irregularly sampled medical data.","authors":"Malte Tölle, Mohamad Scharaf, Samantha Fischer, Christoph Reich, Silav Zeid, Christoph Dieterich, Benjamin Meder, Norbert Frey, Philipp Wild, Sandy Engelhardt","doi":"10.1038/s43856-026-01817-x","DOIUrl":"10.1038/s43856-026-01817-x","url":null,"abstract":"<p><strong>Background: </strong>A patient undergoes multiple examinations in each hospital stay, where each provides different facets of the health status. These assessments include temporal data with varying sampling rates, discrete single-point measurements, therapeutic interventions such as medication administration, and images. While physicians are able to process and integrate diverse modalities intuitively, neural networks need specific modeling for each modality complicating the training procedure.</p><p><strong>Methods: </strong>We demonstrate that this complexity can be significantly reduced by visualizing all information as images along with unstructured text and subsequently training a conventional vision-text transformer. Our approach, Vision Transformer for irregular sampled Multi-modal Measurements (ViTiMM), simplifies data preprocessing and modeling by unifying clinical measurements, medications, X-ray images, and electrocardiography scans into a single visual representation.</p><p><strong>Results: </strong>ViTiMM outperforms current state-of-the-art methods in predicting in-hospital mortality, phenotyping, and decompensation on two datasets, the MIMIC-IV and COVID Data for Shared Learning (CDSL) dataset.</p><p><strong>Conclusions: </strong>We hope our work inspires advancements in multi-modal medical AI by reducing the training complexity to (visual) prompt engineering, thus lowering entry barriers and enabling no-code solutions for training. The source code is publicly available at https://github.com/Cardio-AI/ViTiMM .</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876487","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":"Eating jetlag based on meal timing discrepancies and risk of cardiovascular disease using the prospective cohort NutriNet-Santé.","authors":"Xuân Le Folcalvez, Elena Obeid, Anna Palomar-Cros, Léopold K Fezeu, Laurent Bourhis, Alice Bellicha, Sandrine Péneau, Valérie Deschamps, Mélanie Deschasaux-Tanguy, Mathilde Touvier, Serge Hercberg, Chantal Julia, Emmanuelle Kesse-Guyot, Valentina A Andreeva, Camille Lassale, Alexandra Montagner, Hervé Guillou, David Jacobi, Bernard Srour","doi":"10.1038/s43856-026-01758-5","DOIUrl":"10.1038/s43856-026-01758-5","url":null,"abstract":"<p><strong>Background: </strong>Eating jetlag is an emerging concept defined as meal timing regularity between free and work days. We evaluated the association between eating jetlag and the risk of cardiovascular disease in a French cohort.</p><p><strong>Methods: </strong>Data of 104,806 participants (79% women, mean age=42.7 years (SD 14.6)) were collected from the NutriNet-Santé prospective cohort (2009-2023). Cardiovascular disease was self-reported and validated against medical records. Eating jetlag intensity was calculated using times of first and last caloric intakes in repeated 24-hour dietary records (5.8 (SD 3.2) records on average)), as the absolute difference between weekends and weekdays, and its associations with cardiovascular disease risk were assessed through multi-adjusted Cox models. Eating jetlag direction was assessed using 3 categories: \"Advance\", \"Maintenance\", \"Delay\", in weekends compared to weekdays.</p><p><strong>Results: </strong>During a median follow-up of 8.1 years, eating jetlag was associated, in male participants, with higher cardiovascular disease (HR = 1.14 [1.05-1.23]) and coronary heart disease (HR = 1.21 [1.11-1.33]) risks. In males, participants in the \"Advance\" group had higher risks of cardiovascular and coronary heart diseases (HR = 1.44 [1.08-1.93], and HR = 1.68 [1.19-2.39], respectively) compared to those in the \"Maintenance\" group; while those in the \"Delay\" group had a higher coronary heart disease risk (HR = 1.36 [1.05-1.77]).</p><p><strong>Conclusion: </strong>Our results suggest a role for meal timing regularity between weekends and weekdays in CVD etiology, independently of sleep duration and diet quality, specifically in males. If confirmed in other studies, meal timing regularity could be a strategy to mitigate cardiovascular disease risk.</p><p><strong>Trial registration: </strong>NCT03335644.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876517","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":"Progress and challenges in expanding access to clinical trials in pancreatic cancer.","authors":"Sue S Thang, Dan Croagh, Sumitra Ananda, Andrew J Metz, Prasad Cooray, Ashleigh R Poh","doi":"10.1038/s43856-026-01869-z","DOIUrl":"10.1038/s43856-026-01869-z","url":null,"abstract":"<p><p>Clinical trials are essential for developing new cancer treatments and improving patient care. However, participation remains low across oncology and is particularly challenging for people with pancreatic cancer, who often experience rapid disease progression, limited treatment options, and short timeframes for trial enrolment. In this Review, we examine the factors that limit clinical trial participation in pancreatic cancer, including patient identification and referral, eligibility assessment, molecular testing, and trial delivery. We discuss how restrictive eligibility criteria, inconsistent integration of trial processes into routine care, variability in molecular testing, and logistical barriers reduce opportunities for participation. We also consider practical strategies to improve access, including earlier and more systematic trial identification, broader clinical eligibility criteria, timely molecular testing, more flexible trial designs, and decentralised models of care. Improving participation will require coordinated changes across clinical pathways, trial design, and healthcare systems to ensure that trial availability translates into equitable patient access.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857934","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}