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Don't Retrain, Just Reuse: Recovering Dual-Target Molecules from Single-Target Diffusion Models

arXiv:2605.25681v1 Announce Type: cross Abstract: Designing a single molecule that modulates two targets is a promising strategy for polypharmacology, but it remains substantially harder than standard single-target generation because one candidate must satisfy two binding requirements while preserving drug-likeness and synthesizability. Existing dual-target generative methods typically introduce dual-target capability by either retraining the generator or intervening in the diffusion process during sampling. The former can be costly and difficult to stabilize when dual-target supervision is sparse, while the latter may be sensitive to denoising-time target balancing and competing update directions. These limitations motivate a generator-preserving alternative that keeps the pretrained prior intact: can dual-target candidates instead be recovered from the input space of a frozen single-target diffusion model, without modifying its parameters or denoising dynamics? We formulate this task as a constrained multi-objective optimization problem and propose REUSE, a hierarchical evolutionary input-space search framework that combines pair-conditioned exploration with structured multi-stage selection to enforce dual-target affinity, chemical quality, and diversity. Experiments show that, compared with methods that modify the diffusion process, REUSE consistently improves dual-target affinity and balance, achieving a 20.9-percentage-point gain in Dual High Affinity over the strongest prior baseline while maintaining competitive molecular quality.

DeepEN: A Deep Reinforcement Learning Framework for Personalized Enteral Nutrition in Critical Care

arXiv:2510.08350v3 Announce Type: replace-cross Abstract: Objective: Enteral nutrition (EN) delivery in the ICU remains suboptimal due to limited personalization and uncertainty regarding appropriate calorie, protein, and fluid targets under dynamic metabolic demands. We introduce DeepEN, a reinforcement learning (RL) framework for personalized EN optimization using electronic health record data. Methods: DeepEN was trained on over 11,000 ICU patients from MIMIC-IV to generate 4-hourly, patient-specific caloric, protein, and fluid targets. The state representation incorporated demographics, comorbidities, vital signs, laboratory values, and recent interventions. A physiologically aligned reward framework balanced biomarker stability with long-term survival. Policy learning employed a dueling double deep Q-network with Conservative Q-Learning regularization to enable safe offline training. Results: DeepEN achieved the highest estimated policy value ($V^\pi = 9.48$) and the lowest calibrated mortality (18.8 +/- 1.0%), representing a 4.0 percentage-point absolute reduction compared with clinician practice (22.8%). The policy also demonstrated superior metabolic stability, achieving the highest proportion of glucose, phosphate, and sodium values within target range. Furthermore, deviation from the DeepEN policy was independently associated with increased mortality and biomarker instability, whereas deviation from a random policy showed no such association. Interpretability analyses further indicated that recommendations were conditioned on physiologically relevant markers of organ function and metabolic status rather than static dosing heuristics. Conclusion: DeepEN demonstrates the feasibility of conservative offline RL for safe, individualized EN optimization, highlighting the potential of data-driven personalization to complement guideline-based approaches in critical care.

Characterization of dysbiosis patterns in gut microbiota of digestive system cancers: an umbrella review

14 May 2026 at 18:00

Front Microbiol. 2026 Apr 28;17:1782471. doi: 10.3389/fmicb.2026.1782471. eCollection 2026.

ABSTRACT

Digestive system cancers (DSCs) represent a substantial global health burden. In recent years, the role of gut microbiota in the DSCs has garnered considerable attention, but its change pattern during tumor progression and the specific mechanisms are still not fully understood. We conducted a comprehensive systematic review to characterize patterns of gut microbiota dysbiosis across different DSC types and assess their clinical significance. We systematically searched four English and three Chinese databases up to January 2025 to identify systematic reviews focused on the dynamic characteristics of the gut microbiota during gastrointestinal tumorigenesis. Microbiota biodiversity and taxonomic composition were extracted to identify specific signatures associated with DSCs. The ROBIS tool was used to evaluate the methodological quality of the included studies. Ultimately, 59 studies involving six distinct DSC types were included. Data synthesis and comparison revealed distinct microbiota profiles across DSCs. At the phylum level, Bacillota was decreased in esophageal cancer (EC) and pancreatic ductal adenocarcinoma (PDAC), Pseudomonadota was augmented in EC but exhibited divergent trajectories in colorectal cancer (CRC) and PDAC. Genus-level analyses revealed Veillonella enrichment in EC and PDAC, and Fusobacterium outgrowth in EC, gastric cancer (GC) and CRC. Parvimonas and Streptococcus showed a concordant ascending trend in GC and CRC. Prevotella was overrepresented in EC and GC. This synthesis delineates a qualitative landscape of gut microbiota imbalances associated with various DSCs, highlighting the potential for these microbial shifts to serve as markers for early detection and targeted therapy. Multiomics integration and prospective cohort studies should be prioritized to accelerate clinical translation.

PMID:42131199 | PMC:PMC13161176 | DOI:10.3389/fmicb.2026.1782471

FDX1 as a predictive biomarker and therapeutic target for lymph node metastasis in gastric cancer

Clin Exp Med. 2026 May 10. doi: 10.1007/s10238-026-02160-0. Online ahead of print.

ABSTRACT

The prognostic values of cuproptosis-related genes (CRGs) in gastric cancer with lymph node metastasis (GCLM), especially in the tumor immune microenvironment (TIME), remain unclear. We analyzed the expression, mutation, immunity, drug sensitivity, and prognostic value of CRGs in GCLM using TCGA and GEO cohorts. Consensus clustering was performed to identify CRG subtypes, with differences characterized by multi-omics analysis. A CRG-based prognostic risk score and immune score were constructed for individualized assessment, and the role of CRGs was validated through in vitro and in vivo experiments. Consensus clustering revealed that CRGs were significantly enriched in biological processes related to mitosis and energy metabolism, as well as in immune-related and cancer-associated pathways. Four distinct CRG subtypes were identified, showing marked differences in expression profiles, prognosis, genetic alterations, TIME, and chemotherapeutic drug sensitivity. We developed an exploratory CRG-based prognostic risk score for preliminary individualized assessment, and the functional relevance of CRGs in GCLM was further validated through in vitro experiments. Among these, FDX1, LIAS, DLAT, MTF1, and GLS were identified as key determinants of overall survival in patients with GCLM, with FDX1 emerging as a potential independent prognostic factor. Notably, upregulation of FDX1 significantly suppressed lymph node metastasis of gastric cancer cells in a mouse popliteal lymph node metastasis model. Our data uncovers FDX1 might be a potential favorable prognostic factors in GCLM patients. These findings may improve our understanding of CRGs in GCLM and provide new in-sights for assessing prognosis and developing more effective treatment strategies.

PMID:42107026 | DOI:10.1007/s10238-026-02160-0

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