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NFATC2::NUTM2 Fusion Defines a Novel Primary Pulmonary Epithelial Tumor With a Distinctive Immunophenotype

Am J Surg Pathol. 2026 Jun 1;50(6):695-704. doi: 10.1097/PAS.0000000000002533. Epub 2026 Mar 13.

ABSTRACT

With the application of molecular techniques in pathologic diagnosis, several novel primary pulmonary epithelial tumors have been continuously discovered and classified under the WHO classification of thoracic tumors. Recently, a pulmonary tumor with NFATC2 :: NUTM2B fusion was first documented, but the spectrum of NFATC2::NUTM2 fusion variants and their associated pathologic features remains incompletely characterized. Coincidentally, we also found and described 6 primary pulmonary tumors harboring recurrent NFATC2::NUTM2A/E fusions through integrated genomic analysis. These patients, including 4 females and 2 males, with a median age of 53 years, presented with incidentally detected peripheral lung nodules composed of monotonous epithelioid cells arranged in cords, nests, and trabeculae within a prominent desmoplastic stroma. All tumors exhibited a consistent immunophenotype: CK5/6+/GATA3+/calponin+/EMA+/DOG1 (perinuclear dot-like staining)/p63-. High-throughput chromosome conformation capture (Hi-C) analysis showed the structural variation of NFATC2::NUTM2E in all 6 cases, whereas RNA sequencing detected the fusion transcripts in 5 cases ( NFATC2::NUTM2A , n=2; NFATC2::NUTM2E , n=3). Ultrastructural examination of 1 case suggested epithelial differentiation. All patients remained disease-free after complete resection (median follow-up: 24 mo; range: 9 to 41 mo). These findings define a novel primary pulmonary tumor entity driven by NFATC2::NUTM2 fusions, and characterized by a distinctive immunophenotype, expanding the spectrum of NUTM2 -associated neoplasms. Our study underscores the utility of multiomics approaches for characterizing rare neoplasms and provides a diagnostic framework for this entity.

PMID:41821426 | DOI:10.1097/PAS.0000000000002533

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Targeting the OXNAD1-PTGS2 axis with resveratrol overcomes ferroptosis Inhibition and reverses 5-FU resistance in gastric cancer

Gastric Cancer. 2026 Mar 13. doi: 10.1007/s10120-026-01718-x. Online ahead of print.

ABSTRACT

BACKGROUND: 5-Fluorouracil (5-FU) remains a cornerstone of first-line chemotherapy for gastric cancer, yet the emergence of resistance severely compromises its clinical efficacy. Although ferroptosis suppression has been recognized as a pivotal mechanism of chemoresistance, the mitochondrial regulatory processes involved remain poorly understood.

METHODS: We integrated clinical specimen analysis, in vitro and in vivo functional assays, multi-omics profiling, and molecular docking to delineate the role of the mitochondrial oxidoreductase OXNAD1 in mediating 5-FU resistance in gastric cancer, and to assess the therapeutic potential of the natural polyphenol resveratrol as a chemosensitizing agent.

RESULTS: OXNAD1 was found to be significantly overexpressed in gastric cancer tissues and cell lines, correlating with unfavorable prognosis and enhanced 5-FU resistance. Mechanistically, OXNAD1 directly bound to and suppressed the ferroptosis driver PTGS2, thereby attenuating lipid peroxidation and mitochondrial damage, ultimately restraining ferroptosis and promoting drug resistance. Notably, resveratrol disrupted the OXNAD1-PTGS2 interaction by directly binding OXNAD1, reinstating ferroptotic activity, markedly enhancing the cytotoxic effect of 5-FU in resistant cells, and potentiating the antitumor efficacy of 5-FU in xenograft models.

CONCLUSION: The OXNAD1-PTGS2 axis constitutes a critical metabolic-cell death cross-regulatory pathway underlying 5-FU resistance in gastric cancer. Targeting this axis with resveratrol provides a promising combinatorial strategy to overcome chemoresistance.

PMID:41824193 | DOI:10.1007/s10120-026-01718-x

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Multi-Omics and Single-Cell Mendelian Randomization Reveal a Potential Role of VNN2 in Lung Adenocarcinoma in Resting Natural Killer Cells

World J Oncol. 2026 Mar 5;17(2):247-255. doi: 10.14740/wjon2689. eCollection 2026 Apr.

ABSTRACT

BACKGROUND: We aimed to evaluate the potential association between genetically predicted vanin-2 (VNN2) expression and lung adenocarcinoma (LUAD) risk, and to explore the immune cell subtype that may underlie this relationship.

METHODS: We integrated whole-blood expression quantitative trait loci (eQTL) data from eQTLGen, plasma protein quantitative trait loci (pQTL) data from deCODE, and LUAD genome-wide association study (GWAS) data from European-ancestry cohorts, together with differential expression analysis using GEPIA2, to identify candidate genes for subsequent single-cell eQTL (sc-eQTL) Mendelian randomization (MR) analysis. For the sc-eQTL analysis, VNN2-associated eQTLs from 14 immune cell types profiled in the OneK1K single-cell eQTL resource were tested for associations with LUAD risk.

RESULTS: Bulk-level MR analysis showed that genetically predicted increases in VNN2 expression and protein levels were significantly associated with a reduced risk of LUAD (eQTL-MR: odds ratio (OR) = 0.964, 95% confidence interval (95% CI), 0.934-0.995; P = 0.024; pQTL-MR: OR = 0.946, 95% CI, 0.921-0.970; P = 2.87 × 10-5). Transcriptomic analyses confirmed significant downregulation of VNN2 in LUAD tumors compared with normal lung tissues. sc-eQTL MR identified the strongest association in resting natural killer (rNK) cells (OR = 0.896, 95% CI, 0.829-0.967; P = 0.005).

CONCLUSIONS: Multi-omics and sc-eQTL MR analyses indicated that genetically predicted increases in VNN2 expression were associated with a reduced risk of LUAD, with the most pronounced effect observed in rNK cells. These findings suggest a potential cell type-specific role of VNN2 in LUAD susceptibility and warrant further studies to validate its biological relevance and clinical implications.

PMID:41822323 | PMC:PMC12978397 | DOI:10.14740/wjon2689

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NFATC2::NUTM2 Fusion Defines a Novel Primary Pulmonary Epithelial Tumor With a Distinctive Immunophenotype

Am J Surg Pathol. 2026 Mar 13. doi: 10.1097/PAS.0000000000002533. Online ahead of print.

ABSTRACT

With the application of molecular techniques in pathologic diagnosis, several novel primary pulmonary epithelial tumors have been continuously discovered and classified under the WHO classification of thoracic tumors. Recently, a pulmonary tumor with NFATC2::NUTM2B fusion was first documented, but the spectrum of NFATC2::NUTM2 fusion variants and their associated pathologic features remains incompletely characterized. Coincidentally, we also found and described 6 primary pulmonary tumors harboring recurrent NFATC2::NUTM2A/E fusions through integrated genomic analysis. These patients, including 4 females and 2 males, with a median age of 53 years, presented with incidentally detected peripheral lung nodules composed of monotonous epithelioid cells arranged in cords, nests, and trabeculae within a prominent desmoplastic stroma. All tumors exhibited a consistent immunophenotype: CK5/6+/GATA3+/calponin+/EMA+/DOG1 (perinuclear dot-like staining)/p63-. High-throughput chromosome conformation capture (Hi-C) analysis showed the structural variation of NFATC2::NUTM2E in all 6 cases, whereas RNA sequencing detected the fusion transcripts in 5 cases (NFATC2::NUTM2A, n=2; NFATC2::NUTM2E, n=3). Ultrastructural examination of 1 case suggested epithelial differentiation. All patients remained disease-free after complete resection (median follow-up: 24 mo; range: 9 to 41 mo). These findings define a novel primary pulmonary tumor entity driven by NFATC2::NUTM2 fusions, and characterized by a distinctive immunophenotype, expanding the spectrum of NUTM2-associated neoplasms. Our study underscores the utility of multiomics approaches for characterizing rare neoplasms and provides a diagnostic framework for this entity.

PMID:41821426 | DOI:10.1097/PAS.0000000000002533

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METTL16 enhances proteasome inhibitor resistance in multiple myeloma by inhibiting eIF2α-PERK interaction and promoting PSMB5 translation

Oncogene, Published online: 13 March 2026; doi:10.1038/s41388-026-03706-y

METTL16 enhances proteasome inhibitor resistance in multiple myeloma by inhibiting eIF2α-PERK interaction and promoting PSMB5 translation
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Integrating a Large Language Model to Streamline Nursing Handover Documentation Across Multiple Hospitals in Taiwan: Development and Implementation Study

Background: The global nursing shortage, exacerbated by heavy workloads and high turnover rates associated with the COVID-19 pandemic, continues to undermine care quality and nurse well-being. Although digital health technologies have enhanced coordination, improved communication, and reduced clinical errors in nursing practice, they have also increased nurses’ documentation burden. Advances in large language models (LLMs) and other generative artificial intelligence (GenAI) tools facilitate the generation of accurate reports from electronic medical records (EMRs), thereby streamlining documentation workflows, saving time, and reducing nurses’ workloads. Accordingly, integrating LLMs into electronic nursing documentation systems warrants further exploration. Objective: This study examines the integration of an LLM into an in-house nursing information system (NIS) implemented across 3 hospitals in Taiwan to reduce the time and effort required for nursing handover documentation and to preliminarily assess the operational and economic implications of GenAI-assisted workflows. Methods: A multidisciplinary team of nursing specialists and information technology experts at Taipei Medical University (TMU) restructured the organization’s existing nursing handover documentation process to facilitate interaction with the LLM. The team also developed prompt-based interfaces to automatically generate section-specific content for the nursing handover document. The LLM-integrated NIS was subsequently deployed across 3 hospitals in Taiwan: Taipei Medical University Hospital (TMUH), Wan Fang Hospital (WFH), and Shuang Ho Hospital (SHH). We then extracted and analyzed NIS log data to compare documentation times before and after LLM implementation, thereby quantifying time savings. Results: Integration of the LLM into nursing handover documentation was associated with shorter per-patient documentation time in routine clinical use across TMUH, WFH, and SHH. Based on preintegration NIS logs (September 2024), the average handover document completion time per patient ranged from 3.45 (SD 3.82) to 4.32 (SD 4.48) minutes across hospitals and shifts, providing a preliminary baseline for subsequent comparisons. In postintegration NIS logs (October-December 2024), the overall handover document completion time per patient (mean) was substantially lower, ranging from 1.17 (SD 1.86) to 2.54 (SD 2.82) minutes across hospitals and shifts. Using monthly patient volume to estimate time savings, 113-273, 160-314, and 198-391 hours were saved per month at TMUH, WFH, and SHH, respectively, corresponding to aggregate savings of 474-981 hours per month across hospitals during the study period. Conclusions: We integrated an LLM into an NIS to generate nursing handover documents without altering existing workflows. Across 3 hospitals within TMU’s health system, GenAI assistance was associated with shorter documentation time and a positive net labor value from October to December 2024. Prompts were constrained, and nurse verification was required to mitigate hallucinations. Future work will enhance logging to capture reliability and editing metrics, compare LLM-generated drafts with nurse-finalized notes to inform prompt refinement, and assess generalizability to other documentation workflows.
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The value of an integrated multi-omics model in the diagnosis of benign and malignant pulmonary nodules

Transl Cancer Res. 2026 Feb 28;15(2):127. doi: 10.21037/tcr-2025-664. Epub 2026 Feb 25.

ABSTRACT

BACKGROUND: In recent years, multi-omics models based on a variety of biomarkers have been continuously developed and increasingly applied in the field of oncology, especially in the early diagnosis of lung cancer. This study aimed to integrate computed tomography (CT) radiomics with seven lung cancer-associated autoantibodies (AABs) to develop multi-omics predictive models for pulmonary nodule (PN) characterization.

METHODS: This retrospective study enrolled 179 patients with PNs measuring from 5 to 30 mm in diameter who underwent thoracic surgery at Zhongda Hospital, Southeast University between January 2020 and December 2024. The patients were pathologically categorized into lung cancer (n=87) and non-lung cancer (n=92) groups, and then randomly allocated into training and test sets at a ratio of 7 to 3. Least absolute shrinkage and selection operator (LASSO) regression was used for feature screening to construct a clinical model based on five clinical characteristics. A radiomics prediction model was constructed based on the radiomics features identified after delineating the regions of interest and extracting the radiomics features; the rad-score for each patient was calculated to develop a multi-analytic comprehensive model by combining different markers. The diagnostic performances of the models were compared using the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value.

RESULTS: The multi-omics model demonstrated superior diagnostic accuracy with an AUC of 0.902 [95% confidence interval (CI): 0.817-0.986], accuracy of 82.4%, sensitivity of 88.5%, and specificity of 80.0%, outperforming the clinical (AUC =0.848; 95% CI: 0.777-0.919) and radiomics (AUC =0.854; 95% CI: 0.786-0.922) models. Notably, the radiomics model exhibited high sensitivity (96.6%) but poor specificity (63.6%), while the multi-omics model resolved this trade-off via the synergistic integration of clinical-radiomic-biomarker features, achieving significant improvements in the PPV (81.5% vs. 72.7%) compared to the clinical model.

CONCLUSIONS: Integrating CT radiomics with seven lung cancer-AABs established a robust multi-omics framework for PN diagnosis. Compared to the standalone clinical or radiomics models, this comprehensive model demonstrated superior diagnostic performance.

PMID:41815158 | PMC:PMC12971553 | DOI:10.21037/tcr-2025-664

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Author Correction: Gut stem cell necroptosis by genome instability triggers bowel inflammation

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10302-3

Author Correction: Gut stem cell necroptosis by genome instability triggers bowel inflammation
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Immune evasive DNA donors and recombinases license kilobase-scale writing

Nature, Published online: 11 March 2026; doi:10.1038/s41586-026-10241-z

INSTALL overcomes fundamental challenges for DNA delivery and integration methods by synergizing immune-stealth nucleic acids with recombinases to enable kilobase-scale integration strategies without viral vectors.
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Clinical development of cancer vaccines

Nature Medicine, Published online: 11 March 2026; doi:10.1038/s41591-026-04241-9

This Review highlights insights from recent clinical trials and discusses critical factors for optimizing cancer vaccines, with a focus on proxies for vaccine efficacy, neoantigen selection, modular platforms and early intervention.
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Large Language Model for Discrete Optimization Problems: Evaluation and Step-by-step Reasoning

arXiv:2603.07733v1 Announce Type: new Abstract: This work investigated the capabilities of different models, including the Llama-3 series of models and CHATGPT, with different forms of expression in solving discrete optimization problems by testing natural language datasets. In contrast to formal datasets with a limited scope of parameters, our dataset included a variety of problem types in discrete optimization problems and featured a wide range of parameter magnitudes, including instances with large parameter sets, integrated with augmented data. It aimed to (1) provide an overview of LLMs' ability in large-scale problems, (2) offer suggestions to those who want to solve discrete optimization problems automatically, and (3) regard the performance as a benchmark for future research. These datasets included original, expanded and augmented datasets. Among these three datasets, the original and augmented ones aimed for evaluation while the expanded one may help finetune a new model. In the experiment, comparisons were made between strong and week models, CoT methods and No-CoT methods on various datasets. The result showed that stronger model performed better reasonably. Contrary to general agreement, it also showed that CoT technique was not always effective regarding the capability of models and disordered datasets improved performance of models on easy to-understand problems, even though they were sometimes with high variance, a manifestation of instability. Therefore, for those who seek to enhance the automatic resolution of discrete optimization problems, it is recommended to consult the results, including the line charts presented in the Appendix, as well as the conclusions drawn in this study for relevant suggestions.
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Investigating the Effect of Hospital Infection Control Informatization on Optimizing Microbiological Specimen Submission Before Antibiotic Therapy: Failure Mode and Effects Analysis

Background: Antimicrobial resistance (AMR) poses a critical global health threat, with inappropriate antibiotic use being a major driver. Timely microbiological specimen submission before initiating antibiotic therapy is a cornerstone of antimicrobial stewardship (AMS), enabling pathogen-directed therapy and reducing unnecessary broad-spectrum exposure. However, suboptimal compliance remains common due to workflow interruptions, technological barriers, and behavioral factors. Failure Mode and Effects Analysis (FMEA), a proactive risk-assessment method widely used in health care quality improvement, provides a systematic framework to identify process vulnerabilities and prioritize corrective actions. Despite its increasing application, few studies have integrated FMEA with hospital informatization to optimize microbiological specimen submission workflows in routine AMS practice. Objective: This study aimed to systematically identify workflow risks affecting preantibiotic microbiological specimen submission and to design, implement, and evaluate informatization-enabled interventions using an FMEA-based framework. Methods: FMEA was conducted at a tertiary hospital in China. A multidisciplinary team identified potential failure modes across 4 domains: health information systems, personnel, administration, and external support. Risk Priority Numbers (RPNs) and Action Priority (AP) indices were calculated for each failure mode. Targeted interventions were implemented, including dual-verification barcode scanning, artificial intelligence-driven clinical decision support alerts, EHR-integrated training modules, and automated compliance dashboards. Pre- and postintervention specimen submission rates (January 2024-December 2024) were analyzed using the Mann-Kendall trend test. Results: The top 5 failure modes included PDA barcode scanning failures (RPN=175), inadequate clinical decision support (RPN=140), insufficient clinician awareness (RPN=56), suboptimal oversight mechanisms, and patient-related barriers. Postintervention, significant upward trends were observed in overall specimen submission rates (
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Deconstructing Multimodal Mathematical Reasoning: Towards a Unified Perception-Alignment-Reasoning Paradigm

arXiv:2603.08291v1 Announce Type: new Abstract: Multimodal Mathematical Reasoning (MMR) has recently attracted increasing attention for its capability to solve mathematical problems that involve both textual and visual modalities. However, current models still face significant challenges in real-world visual math tasks. They often misinterpret diagrams, fail to align mathematical symbols with visual evidence, and produce inconsistent reasoning steps. Moreover, existing evaluations mainly focus on checking final answers rather than verifying the correctness or executability of each intermediate step. To address these limitations, a growing body of recent research addresses these issues by integrating structured perception, explicit alignment, and verifiable reasoning within unified frameworks. To establish a clear roadmap for understanding and comparing different MMR approaches, we systematically study them around four fundamental questions: (1) What to extract from multimodal inputs, (2) How to represent and align textual and visual information, (3) How to perform the reasoning, and (4) How to evaluate the correctness of the overall reasoning process. Finally, we discuss open challenges and offer perspectives on promising directions for future research.
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CoCo: Code as CoT for Text-to-Image Preview and Rare Concept Generation

arXiv:2603.08652v1 Announce Type: new Abstract: Recent advancements in Unified Multimodal Models (UMMs) have significantly advanced text-to-image (T2I) generation, particularly through the integration of Chain-of-Thought (CoT) reasoning. However, existing CoT-based T2I methods largely rely on abstract natural-language planning, which lacks the precision required for complex spatial layouts, structured visual elements, and dense textual content. In this work, we propose CoCo (Code-as-CoT), a code-driven reasoning framework that represents the reasoning process as executable code, enabling explicit and verifiable intermediate planning for image generation. Given a text prompt, CoCo first generates executable code that specifies the structural layout of the scene, which is then executed in a sandboxed environment to render a deterministic draft image. The model subsequently refines this draft through fine-grained image editing to produce the final high-fidelity result. To support this training paradigm, we construct CoCo-10K, a curated dataset containing structured draft-final image pairs designed to teach both structured draft construction and corrective visual refinement. Empirical evaluations on StructT2IBench, OneIG-Bench, and LongText-Bench show that CoCo achieves improvements of +68.83%, +54.8%, and +41.23% over direct generation, while also outperforming other generation methods empowered by CoT. These results demonstrate that executable code is an effective and reliable reasoning paradigm for precise, controllable, and structured text-to-image generation. The code is available at: https://github.com/micky-li-hd/CoCo
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A Robust Incomplete Multimodal Low-Rank Adaptation Approach for Emotion Recognition

arXiv:2507.11202v1 Announce Type: cross Abstract: Multimodal Emotion Recognition (MER) often encounters incomplete multimodality in practical applications due to sensor failures or privacy protection requirements. While existing methods attempt to address various incomplete multimodal scenarios by balancing the training of each modality combination through additional gradients, these approaches face a critical limitation: training gradients from different modality combinations conflict with each other, ultimately degrading the performance of the final prediction model. In this paper, we propose a unimodal decoupled dynamic low-rank adaptation method based on modality combinations, named MCULoRA, which is a novel framework for the parameter-efficient training of incomplete multimodal learning models. MCULoRA consists of two key modules, modality combination aware low-rank adaptation (MCLA) and dynamic parameter fine-tuning (DPFT). The MCLA module effectively decouples the shared information from the distinct characteristics of individual modality combinations. The DPFT module adjusts the training ratio of modality combinations based on the separability of each modality's representation space, optimizing the learning efficiency across different modality combinations. Our extensive experimental evaluation in multiple benchmark datasets demonstrates that MCULoRA substantially outperforms previous incomplete multimodal learning approaches in downstream task accuracy.
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Annealed Co-Generation: Disentangling Variables via Progressive Pairwise Modeling

arXiv:2603.06615v1 Announce Type: cross Abstract: For multivariate co-generation in scientific applications, we advocate pairwise block rather than joint modeling of all variables. This design mitigates the computational burden and data imbalance. To this end, we propose an Annealed Co-Generation (ACG) framework that replaces high-dimensional diffusion modeling with a low-dimensional diffusion model, which enables multivariate co-generation by composing pairwise variable generations. We first train an unconditional diffusion model over causal variables that are disentangled into pairs. At inference time, we recover the joint distribution by coupling these pairwise models through shared common variables, enabling coherent multivariate generation without any additional training. By employing a three-stage annealing process-Consensus, Heating, and Cooling-our method enforces consistency across shared common variables and progressively constrains each pairwise data distribution to lie on a learnable manifold, while maintaining high likelihood within each pair. We demonstrate the framework's flexibility and efficacy on two distinct scientific tasks: flow-field completion and antibody generation. All datasets and code will be made publicly available upon publication.
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Evo: Autoregressive-Diffusion Large Language Models with Evolving Balance

arXiv:2603.06617v1 Announce Type: cross Abstract: We introduce \textbf{Evo}, a duality latent trajectory model that bridges autoregressive (AR) and diffusion-based language generation within a continuous evolutionary generative framework. Rather than treating AR decoding and diffusion generation as separate paradigms, Evo reconceptualizes text generation as a latent flow: each token is associated with a vector-valued embedding that evolves over a progression variable $t_i \in [0, 1]$, indicating its semantic maturity. Low $t_i$ values correspond to confident AR-like refinement, while high values invoke diffusion-style planning, allowing the model to adaptively balance AR and diffusion based on uncertainty. Theoretically, we show that both AR and diffusion models emerge as discretizations of a shared probability flow, and we derive Evo's training objective from a unified variational ELBO. The model is implemented as a time-conditioned Transformer governed by a shared vector field, trained end-to-end to jointly infer latent codes and their progression times. During decoding, Evo performs efficient, semantics-aware refinement, achieving high-quality outputs without sacrificing speed. Empirically, Evo 8B achieves state-of-the-art or highly competitive results on 15 diverse benchmarks, including reasoning (GSM8K, ARC-C), code generation (HumanEval, MBPP), and general language understanding, while maintaining fast inference speed. Our results demonstrate that Evo delivers a new paradigm for LLM design with strong generation quality, robust symbolic reasoning, and decoding efficiency.
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ObjChangeVR: Object State Change Reasoning from Continuous Egocentric Views in VR Environments

arXiv:2603.06648v1 Announce Type: cross Abstract: Recent advances in multimodal large language models (MLLMs) offer a promising approach for natural language-based scene change queries in virtual reality (VR). Prior work on applying MLLMs for object state understanding has focused on egocentric videos that capture the camera wearer's interactions with objects. However, object state changes may occur in the background without direct user interaction, lacking explicit motion cues and making them difficult to detect. Moreover, no benchmark exists for evaluating this challenging scenario. To address these challenges, we introduce ObjChangeVR-Dataset, specifically for benchmarking the question-answering task of object state change. We also propose ObjChangeVR, a framework that combines viewpoint-aware and temporal-based retrieval to identify relevant frames, along with cross-view reasoning that reconciles inconsistent evidence from multiple viewpoints. Extensive experiments demonstrate that ObjChangeVR significantly outperforms baseline approaches across multiple MLLMs.
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