Life

Background: Immunochemotherapy (ICT) is considered standard in regards to care for small-cell lung cancer (SCLC) in extensive stages, yet reliable biomarkers for treatment response remain elusive. While previous univariate analyses suggest specific peripheral lymphocyte subsets correlate with survival, the systemic immune response involves complex, multivariate interactions that require advanced analytical approaches. Methods: This paper analysed high-dimensional flow cytometry data from 32 patients with stage IV SCLC treated with carboplatin, etoposide, and atezolizumab. Peripheral blood was analysed at baseline (V0) and longitudinally during treatment. To identify potential early predictive biomarkers and mitigate sample attrition in later cycles, we focused on baseline and measurements after two cycles of ICT (V1). We employed a rigorous machine learning framework utilising nested cross-validation, bootstrapping, and permutation-based statistical testing to evaluate eleven different regression and survival models. Results: Under model-appropriate metrics, regressors did not generalise (R2 <0); conversely, censoring-aware Random Survival Forests (RSF) successfully extracted robust prognostic signatures. Baseline immune profiles (V0) achieved a concordance index (C-index) of 0.66 (p= 0.015), while dynamic changes from V0 to V1 ({triangleup}V) achieved a C-index of 0.65 (p= 0.022). Crucially, absolute values measured after two cycles of ICT (V1) yielded no significant signal (p= 0.445). Feature importance analysis confirmed the prognostic value of Th17 normalisation and identified Naive Regulatory T cells and Memory B cells as candidate components. Conclusion: Machine learning validation confirms a predictive signal in the peripheral immune profile of SCLC patients. Early dynamic shifts in the balance between regulatory and effector immune arms are associated with prognosis, contrasting with the lack of signal in absolute counts after two cycles of ICT. These findings establish a proof of concept for multivariate liquid biopsy immune profiling, warranting confirmation in larger cohorts and highlighting the necessity of integrating systemic and tumour-intrinsic data.

We present our Stage-1 Registered Report as a full clinical trial article with all methods in past tense and including mock results, table and figures for the primary analysis. To remind the reader that this Stage-1 article is written before data collection, we highlight in color that these mock results are only for illustrative purposes and will be replaced by the actual results in the Stage-2 Registered Report. Background In patients experiencing out-of-hospital cardiac arrest, optimization of oxygen delivery during cardiopulmonary resuscitation is a critical. Although both positive end-expiratory pressure (PEEP) and zero end-expiratory pressure (ZEEP) are employed during CPR, their respective impacts on clinically relevant outcomes is yet to be clearly established. Methods This investigator-initiated, pragmatic, registry-based, multicenter, triple-blind randomized controlled superiority trial evaluates whether applying 8 cm H2O PEEP during cardiopulmonary resuscitation improves outcomes compared with ZEEP in adults with non-traumatic, non-drowning out-of-hospital cardiac arrest. Pre-randomized CPR kits (1:1 PEEP vs. sham) were used by ambulance sites during manual ventilation throughout the resuscitation process. The primary analysis was conducted in the principal stratum of patients who received either a supraglottic airway or endotracheal tube. The primary outcome was neurological status at hospital discharge measured by a utility-weighted score on the modified Rankin Scale. Secondary outcomes included prehospital return of spontaneous circulation, 30-day survival, and 6-month quality of life. The primary safety outcome was clinically significant pneumothorax.

Background: Induced pluripotent stem cell-derived ventricular cardiomyocytes (iPSC-vCMs) hold great promise for replacing ventricular cardiomyocytes lost after myocardial infarction. However, their immature phenotype limits successful engraftment by increasing the risk of post-transplant arrhythmias. In contrast to the atmospheric O2 used during most iPSC-vCM differentiations, O2 levels inside the developing heart remain low, but very little is known on the effect on O2 on iPSC-vCM differentiation. Methods: We used a GMP compliant Quad Physoxia glovebox platform providing continuous stable specified O2 tensions during all processes to simulate the in vivo O2 conditions more closely with the aim of improving iPSC-vCM maturation. Results: We demonstrate by single cell RNA sequencing, and data integration with datasets for human cardiomyocytes from the different heart chambers as well as cell morphology-, ploidy-, and functional studies, that sustained 10% O2 throughout iPSC-CM differentiation promotes atrial- instead of ventricular iPSC-CM subtype specification. Conclusions: While this rejects our original hypothesis and forces some concerns to iPSC-vCM manufacturing by sphere technology, these unexpected data may serve as an attractive and easy approach to refine atrial iPSC-CM specification to benefit their exponentially growing diagnostic-, cytotoxic-, and regenerative use.

Cell motility is powered by the bacterial flagellar motor, a rotary nanomachine whose activity is dynamically modulated by external stimuli. In Magnetospirillum gryphiswaldense, magnetic and chemical inputs are thought to converge at the level of motility control, yet the mechanisms underlying chemotactic regulation remain poorly understood. Here, we seek to establish a quantitative reference-state of a model strain of magnetotactic bacteria through bacterial flagellar motor dynamics. To achieve this goal, magnetotaxis was kept as a natural factor by keeping the earth's magnetic field as the only source of magnetism. To avoid aerotaxis bias, oxygen gradients were removed by implementing two different constant oxygen conditions: environmental oxygen exposure, and limited oxygen exposure. Together, the tethered-cell bacterial flagellar rotational assay and the free-swimming assay in the absence of external stimuli presented in this paper establish a framework for investigating motor and cellular swimming adaptation to magnetic, aerotactic, and chemical signals. Under reference-state conditions, the bacterial flagellar motor showed a tendency to exhibit log-normal distributions for the time spent in each motor state: runs in different directions (counter-clockwise and clockwise), and pause. A semi-Markov reference-state model was developed to provide a quantitative description of bacterial flagellar motor dynamics. The model revealed that cell magnetic polarity modulates the transition pathways leading to the paused state, whereas oxygen, in the absence of a gradient, primarily regulates residence in each motility state.

A key scientific challenge is to develop a universal theory of life that integrates our biological knowledge with fundamental logical principles. We propose that a "five nodes" principle may govern the origin of life and consistently exist hierarchically within living systems. In our investigation, we explored autocatalytic chemical reaction networks (CRNs) as potential origins for methanotrophy and anoxygenic phototrophy, aiming to validate the "five nodes" principle in the emergence of autopoietic systems. Our research revealed the emergence of autocatalytic peptides and weakly reversible realizations within the MSA reaction network (composed of CH4, SO42-/SO32-, and NH4+) as well as in the light-Sammox (sulfurous reduction coupled to anaerobic ammonium oxidation)-driven CRN (composed of HCO3-, SO32-, and NH4+) under hydrothermal conditions. Furthermore, we identified the possible emergence of three main interdependent components essential for life within the two reaction networks: membrane compartments, peptide nucleic acids (PNA) backbones, and catalytic capacities for energy release reactions. Our findings suggest that non-equilibrium synergy of five bioessential elements (NESFBE) can facilitate proto-energy and material metabolism, thereby enabling diverse scenarios for lifes origin. Importantly, our discovery indicates linear constraints present in these CRNs that contributed to lifes inception, which is the mathematical foundation of the "five nodes" principle. Linear constraints determine both the emergence and self-disintegration of autopoietic systems. We infer a period five existence based on hierarchical structures found within autopoietic systems, and "period five indicates autopoiesis" could be one of universal theory of life.

AO_SCPLOWBSTRACTC_SCPLOWCellular automata and graph reaction-diffusion systems encode local spatial interactions in different mathematical forms. We develop a cochain-operator calculus for these two settings. Over a finite field Fq, every local rule on a finite neighborhood has a unique reduced polynomial representative. On an oriented line, the coboundary and endpoint maps recover the left and right shifts. Our main theorem shows that these operators, together with linear operations, constant cochains, and the degree-zero cup product, generate every finite-radius polynomial cellular automaton. Explicit formulas for Rules 30, 110, and 22 show how reflection-invariant linear coupling, directed transport, and nonlinear neighbor interactions enter the calculus. On a general graph, d*d is the unweighted combinatorial Laplacian and enters a graph reaction- diffusion recurrence. Over [R], the term - Dd*d with D [&ge;] 0 admits the usual diffusion interpretation; over Fq, the corresponding expression defines modular coupling without an intrinsic order. In the morphogenetic examples, we therefore distinguish pattern-generating dynamics from finite-state observation and use the Betti numbers of active induced subcomplexes to summarize observed patterns. This yields a common algebraic representation without identifying real-valued diffusion with finite-field dynamics.

Acute myeloid leukemia (AML) is an aggressive blood cancer driven by genetic and epigenetic alterations that disrupt normal hematopoiesis. Among these, the histone H3-K27M mutation, originally identified in pediatric high-grade gliomas, reshapes gene repression programs by reducing global H3-K27 trimethylation. Although rare, H3-K27M mutations have been detected in preleukemic hematopoietic stem cells (HSCs) of AML patients, suggesting its role in early leukemogenesis and identifying it as a promising therapeutic target. Here, we investigated how H3-K27M alters hematopoiesis using a longitudinal xenotransplantation mouse model of human hematopoietic stem and progenitor cells carrying either wild-type H3 or H3-K27M. To quantify hematopoietic dynamics, we developed a collection of mathematical models representing alternative lineage hierarchies and fit them to our longitudinal experimental data. Using information criteria, we identified the model that best depicts blood dynamics in each condition. Our results show that H3-K27M promotes HSC proliferation and differentiation and erythroid commitment while reducing multipotent progenitor self-renewal potential and lymphoid commitment, ultimately increasing blood cell numbers despite impairing erythroid maturation. Mathematical modelling inferred the progenitor-level alterations, which were not readily evident from the blood cell count alone. H3-K27M also induced distinct kinetics in human HSC1 and HSC2 subpopulations that were not observed in wild-type H3 controls. Together, our results provide the first quantitative framework to reveal how H3-K27M influences the hematopoietic hierarchy roadmap and alters blood cell dynamics in preleukemia.

Hematopoietic stem cells (HSCs) give rise to all blood cell lineages and possess long-term self-renewal potential. HSCs undergo symmetric division for their expansion and asymmetric division to generate one HSCs and one progenitor cells which contribute to production of mature blood cells. The midbody is a structure which is formed in the center of the intercellular bridge during cytokinesis. However, the midbody is either asymmetrically inherited by one daughter cell or symmetrically released after cell division, whether these distinct patterns of midbody inheritance influence HSC fate remain poorly understood. In this study, we designed a fusion protein hmKO2 and MgcRacGAP which is a component of midbody. We then traced the midbody inheritance during cell division and the future cell fates of HSC daughters after division by time-lapse imaging. As a result, we found that the midbody release correlated with the delay of the time to the next division but not to the lineage potential of HSCs, indicating the possibility that midbody remnant plays some roles in cell cycle progression. HighlightHematopoietic stem cells exhibit a low frequency of midbody inheritance. Midbody inheritance does not affect the lineage potential of daughter cells. Midbody loss is associated with delayed entry into the next cell cycle.

Nutritional status and immune function have a significant impact on the prognosis of patients undergoing maintenance hemodialysis (MHD). Previous studies have shown that the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI) at the initiation of dialysis can be used to assess the prognosis of MHD. However, as the physical status of patients are usually unstable in the early stage of dialysis, we hypothesized that the nutritional status and immune function after a certain period of stable dialysis might be more closely related to the prognosis. This study conducted a retrospective analysis of patients who started MHD between January 1, 2019 and December 31, 2021. A total of 200 patients were included, with 66 patients succumbing during follow-up. Both initial PNI and initial GNRI exhibited a negative correlation with all-cause mortality (p=0.019 and p=0.046, respectively). After three months of MHD, both PNI and GNRI increased in most patients; however, only the PNI measured after three months was significantly associated with prognosis and higher PNI was associated with a better prognosis (p<0.001). Multivariate Cox regression analyses indicated that only PNI after three months of MHD was linked to prognosis (p=0.004). Kaplan-Meier curves demonstrated patients experiencing a decrease in PNI following three months of MHD had poorer prognoses compared to those whose PNI increased (p=0.004). Furthermore, the predictive value of PNI after three months of MHD was evident in both younger (<60 years old; p=0.024) and older (>60 years old; p=0.022) patient groups. Both the PNI and GNRI showed a downward trend before death, but only PNI had a significant decline (p=0.03, compared with PNI after three months of MHD). In conclusion, for patients undergoing MHD, the correlation between PNI and prognosis is closer than that of GNRI, and the PNI after three months of MHD is a statistically significant but moderate predictor of long-term outcomes.

Valproic acid/sodium valproate (VPA) is a widely prescribed anticonvulsant and has also been used against certain tumor cells. It is a potent modulator of gene expression. Its ability to induce apoptosis has been well documented in HeLa cells. However, another form of cell death - mitotic catastrophe - has not yet been explored in VPA-treated HeLa cells. Here, we investigated the effects of VPA treatment on mitotic catastrophe characteristics, including morphological features and their frequencies, fluorescence intensity signals of caspase-2 and p53, and the expression and abundance of DNMT1 and DNMT3B. An increased frequency of mitotic catastrophe was observed not only morphologically, but also through enhanced induction of caspase-2, involvement of p53, at least under more drastic VPA treatment, but without a decrease in DNMT1 or DNMT3B levels. Additionally, enhancement of mitotic catastrophe coincided with a reduction in mitotic chromosome abnormalities. Increased DNMT3B expression following VPA action, may be favored by previously reported chromatin decondensation induced by this drug. Enhanced CpG methylation of specific DNA sites could thus be promoted. In conclusion, VPA was shown to trigger metabolic pathways linked to different forms of cell death in HeLa cells, supporting its oncosuppressive potential.

A fraction of patients treated with radiotherapy are known to be more sensitive to ionizing radiations. Skin fibroblasts from such radiosensitive individuals exhibit a higher cellular toxicity after irradiation and a delay in DNA repair. Deciphering the molecular mechanisms underlying these cellular defects is thus of major importance. We previously observed that the transcription factor NFATc2 is expressed at a reduced level in fibroblasts from radiosensitive patients. The present work aimed to elucidate the role of NFATc2 in the regulation of DNA repair, particularly the repair of radiation-induced double-strand breaks. We demonstrate an interaction of NFATc2 with the NHEJ repair protein Ku80 and observe that the NFATc2 RHD domain is necessary and sufficient for this interaction. Moreover, we show that NFATc2-Ku80 complexes are not colocalized to DNA double-strand breaks sites suggesting an involvement upstream of the DNA repair pathway. The silencing of NFATc2 impairs the NHEJ repair activities by delaying Ku70-Ku80 interaction in the early steps of this pathway. Finally, stable over-expression of NFATc2 in patients fibroblasts partially rescues their defective DNA repair phenotype, especially in the most radiosensitive cells. Altogether, our data reveal that NFATc2 is a regulator of DNA repair in skin fibroblasts and therefore a potential modulator of cellular radiosensitivity.

Human deep-space missions face bone-kidney risks that cannot be extrapolated from six-month ISS data. We built a 12-state Ca-bone-urine-stone mechanistic ODE model and jointly calibrated its 11 physiological parameters on eight ISS targets by Bayesian identification (M0 base = 19-D; M1 extension adds a GCR-bone coupling term for parsimony testing only), then propagated the M0 posterior to four environments (ISS, Lunar subsurface, Lunar surface, Mars). Lumbar-lower BMD loss increases with mission duration and partial-gravity unloading (ISS 180 d -4.83% -> Mars 730 d -12.15%; 2^3 factorial: duration 82.9%, gravity 12.5%, GCR main effect ~ 0), whereas stone rate follows the opposite gradient (ISS 16.1 vs Mars 13.1 per 1000 person-years), reflecting weakened partial-gravity bone resorption alongside residual urinary chemistry changes. The dominant pathway thus shifts from bone-centric on the ISS to kidney-centric on Mars, where residual urinary-chemistry changes-not bone resorption-drive stone risk. The direct GCR-bone coupling term is unidentifiable at current ISS doses (DeltaWAIC = +0.0076 +/- 0.126 SE), so M0 is retained as the main inference model. Bisphosphonates provide >=84% BMD protection but leave a urinary-chemistry residual, so bisphosphonate monotherapy would underestimate Mars stone risk; potassium-magnesium-citrate combinations (RRR_RSS 51%) should therefore be added to deep-space countermeasures. A Lunar-surface 365-day mission is the earliest environment on the NASA roadmap to cross a composite RED threshold. That profile differs from the regolith-shielded 180-day case in both cumulative GCR (~69x) and duration (2x), so a shielding-specific effect cannot be isolated here; forcing the GCR coupling terms to zero leaves all four composite tiers unchanged (0/4, Supp S24), and the shielded 180-day profile is YELLOW rather than GREEN. Independent hold-out validation (Culliton 2025 60-day HDT-bedrest RCT, n=8 control arm of n=24 total) supports the M0 posterior predictive distribution on the lumbar-BMD sub-scope.

BACKGROUND: Peripheral artery disease (PAD) can lead to amputation in advanced cases, making cell therapy using human induced pluripotent stem cells (hiPSCs) a promising therapeutic option. hiPSC-derived endothelial cells (hiPSC-ECs) have shown favorable effects in treating experimental ischemic cardiovascular disease. An autologous approach for PAD patients is preferable to avoid immunological reactions. However, it is yet unknown whether hiPSCs and hiPSC-ECs derived from PAD patients have similar characteristics and potency compared to those derived from non-PAD donors. Therefore, we explored whether there are significant differences in the characteristics and potency of hiPSCs and hiPSC-ECs between non-PAD donors and PAD patients. METHODS: We generated hiPSCs from the blood of non-PAD donors and patients with PAD. We determined the pluripotency of hiPSCs using qRT-PCR, flow cytometry, immunostaining, RNA-seq, and teratoma formation assay. The genetic stability of hiPSCs was confirmed by G-banding karyotyping. We then differentiated hiPSCs into endothelial cells (ECs) in a clinically compatible manner. We compared the characteristics and therapeutic potency of hiPSC-ECs derived from non-PAD and PAD groups using qRT-PCR, flow cytometry, immunostaining, and RNA-seq. In vitro endothelial functions were determined by nitric oxide (NO) production and capillary network formation. Therapeutic potency and incorporation of engrafted hiPSC-ECs were evaluated in a hindlimb ischemia model. RESULTS: We successfully generated hiPSCs from the blood of seven non-PAD donors and eight PAD patients. Both non-PAD and PAD-derived hiPSCs exhibited similar expression levels of pluripotency markers. All hiPSCs, regardless of the group, formed teratomas and showed normal karyotypes. RNA-seq analyses revealed similar gene expression profiles between the groups. hiPSC-ECs derived from both non-PAD and PAD donors exhibited similar expression levels of EC markers at both the gene and protein levels. RNA-seq analyses showed no significant overall differences in gene expression profiles between the groups. Functional analyses demonstrated similar endothelial characteristics and function in hiPSC-ECs from both groups. Both groups showed similar perfusion recovery, limb salvage, and vessel-forming capacity. Engrafted hiPSC-ECs from both groups also exhibited similar angiogenic and vessel-forming capabilities. CONCLUSIONS: Our study demonstrated no significant differences in hiPSCs and hiPSC-ECs derived from non-PAD donors and PAD patients in terms of molecular and cell biological characteristics, therapeutic effects, and vessel-forming capability. Our study indicates that hiPSCs and hiPSC-ECs derived from PAD patients can serve as a novel platform for autologous cell therapy.

Plant-derived immunomodulators are of immense therapeutic interest, of which sesquiterpene lactones (SLs) are a promising source. Artemisinin and Parthenolide are two structurally related SLs that are known to inhibit NF-{kappa}B. However, whether this mechanism produces comparable immunomodulatory outcomes has not been directly examined. In this study, we compared the effects of Artemisinin and Parthenolide across different in vitro and in vivo inflammatory contexts: T-cell activation, macrophage activation, and Salmonella Typhimurium infection. Parthenolide inhibited mouse T-cell activation more effectively than Artemisinin in terms of cell cycling, IL-2 production, and induction of activation markers, CD69 and CD44. In addition, Parthenolide suppressed production of LPS-induced nitrite and pro-inflammatory cytokines in primary thioglycolate (TG)-elicited macrophages as well as RAW 264.7 cells. It also reduced ROS production across all tested conditions. In contrast, Artemisinin exhibited comparatively modest effects, although it increased IL-6 in LPS-activated RAW 264.7 cells. Neither compound reduced bacterial burden in an in vitro model of S. Typhimurium infection; however, Parthenolide, but not Artemisinin, lowered TNF- amounts. Together, these findings demonstrate that Parthenolide is a broader and more consistent immunomodulator than Artemisinin. These observations led us to investigate the effects of Parthenolide in an in vivo model of mice orally fed with S. Typhimurium. Parthenolide-treated mice showed higher survival accompanied with lower sera amounts of IL-6 and TNF-, indicating that its protective effects operate by limiting host immunopathology. The implications of these observations on the use of compounds that lower host inflammatory responses during infections are discussed.

The unicellular algae cell cycle can be divided into several phases, including the commitment point (CP), a point-of-no-return where the cell decides to divide, presumably based on reaching a critical cell size. Light plays a crucial role in the fitness of photosynthetic algal cells, affecting both CP timing and the number of daughter cells produced. So far, only few genes involved in CP have been described, and the presumed sizer and its signal(s) remain unidentified. Using synchronized cells and varying light intensities as a proxy, we explored the effects of light intensity in Chlamydomonas reinhardtii and observed both physiological and transcriptional changes occurring before and after CP under low light (LL) (100 {micro}mol m-{superscript 2} s-{superscript 1}) and optimal light (OL) (500 {micro}mol m-{superscript 2} s-{superscript 1}) conditions. Although CP was delayed by approximately 6 hours in LL, resulting in smaller mother cells and fewer daughter cells, the cells divided at the same time in both conditions. Overall, nucleic acid, protein, and energy reserve levels were lower in LL, with almost no starch produced. RNA-seq analysis identified several core genes shared between both conditions, with 201 genes expressed only in pre-CP1, 161 genes specific to post-CP1, and 582 shared across different phases. In LL, RNA-seq analysis showed an increase in differentially expressed genes (DEGs) in pre-CP1 compared to post-CP1, with an emphasis on photosynthesis, RNA metabolism, and organelle production before commitment, and cell division-related pathways (microtubules, DNA recombination) after CP1. In OL, the number of DEGs increased in post-CP1 by approximately 41% compared to pre-CP1, with a strong emphasis on protein production throughout the cell cycle.

Background Despite numerous randomized controlled trials (RCTs) and systematic reviews (SRs), current sepsis guidelines continue to issue only weak recommendations for corticosteroids. We examined the clinical scope, underlying study pools, and mortality conclusions of SRs evaluating corticosteroids for sepsis. Methods We conducted a meta-research study of SRs on corticosteroids in sepsis (2015 to 2025), extracting SR characteristics, mortality results, and included RCTs. Study-pool overlap was assessed using an SRxRCT inclusion matrix, Jaccard similarity (J), and hierarchical clustering. SRs and RCTs were classified according to standardized Population, Intervention, Comparison, Outcome (PICO) profiles. We explored discordance in short-term mortality conclusions among clinically comparable SRs and potential associations with study-pool composition, target populations, and methodological characteristics. Results Forty-two SRs including 121 unique RCTs were identified. More than half of pairwise SR comparisons shared no RCTs, and only three pairs showed high overlap (J>0.8). SRs addressing similar intervention and target population profiles frequently relied on different study pools. Among 38 SRs with short-term mortality meta-analyses, 15 (39%) reported benefit and 23 (61%) no evidence of effect. Discordance occurred exclusively among SRs evaluating broad, non-specific corticosteroid strategies; conclusions were consistent for hydrocortisone plus fludrocortisone (benefit) and hydrocortisone, ascorbic acid, and thiamine (no evidence of effect). SRs including sepsis +/- shock populations more frequently reported benefit than those restricted to septic shock (62% vs 22%), although estimates were imprecise. No single methodological or clinical factor consistently explained discordance. Conclusions SRs addressing apparently similar clinical questions frequently synthesized different underlying evidence bases and reported discordant conclusions. Guideline developers should therefore consider not only methodological quality and reported PICO, but also whether the RCTs included in an SR adequately represent the intended clinical question. Clinically coherent evidence syntheses may improve the interpretability of pooled treatment effects and support more targeted corticosteroid therapy in sepsis.

It is essential to experimentally evaluate antiviral efficacy predicted by molecular docking and related in silico approaches, which this study achieves for three bisphosphonates (alendronate, minodronate, zoledronate) and treprostinil, identified as potential antiviral therapies in our previous work. These investigational compounds had no detectable cytotoxicity at concentrations up to 25M in Vero E6 cells but also failed to show any antiviral effect against the PQ.8.1 isolate of SARS-CoV-2, when compared to control drugs (ensitrelvir, nirmatrelvir, and remdesivir). It appears that for bisphosphonates, any protective effect is likely due to other virus- or host-mediated mechanisms of action. This study demonstrates the importance of iterating between theoretical hypotheses and experiments to elucidate underlying mechanisms at play.

A large share of late-stage clinical trial failures reflects not the underlying biology of the target but the composition of the enrolled population: trials recruit patients in whom the drug cannot work. Methods that identify likely responders before treatment therefore address a failure mode that better target selection alone cannot. We applied interpretable machine learning to gene-expression data from a treatment-response cohort in lupus nephritis (GSE224705; 21,914 genes across 319 samples) covering four regimens: mycophenolate mofetil (MMF), azathioprine (AZA), hydroxychloroquine (HC) and standard of care (SOC). We independently reconstructed the expression matrix and metadata, rebuilt the treatment-specific cohorts, and derived compact multi-gene programs that separate responders from non-responders within each treated population. Two results follow. First, discriminative performance is strongly graded by regimen. Com pact programs of five to ten genes achieved patient-level AUROC of 0.847 (MMF) and 0.866 (AZA), but only 0.718 (HC) and 0.623 (SOC); the SOC programs performed close to chance (MCC 0.119, balanced accuracy 0.555). A regimen in which response is not transcriptionally discriminable is an actionable finding for trial design rather than a null result. Second, the programs proved considerably more stable than the differential-expression lists that generated them: reconstructed counts of significant genes differed markedly from the published analysis (222 vs. 46 for MMF; 4,455 vs. 157 for AZA; 6 vs. 24 for HC; 5 vs. 11 for SOC), yet the dominant biology and the predictive performance were preserved. Programs were also non-redundant: re moving a single gene (TUBB2A) from the MMF program reduced AUROC by approximately 0.17. At the pathway level, 13 cross-treatment enrichment relationships remained significant after adjustment, indicating that response landscapes are treatment-specific yet coupled. Patient-generalisable programs of this kind offer a concrete near-term route to enrichment style trial design, identifying before enrolment which patients a given therapy suits. Our results also caution that the number of differentially expressed genes is a poor proxy for the strength or stability of a response signal.

Objective A diversity of approaches and cohorts have been published in research literature for suicide risk estimation, leading to some uncertainty around which factors and conditions are most strongly contributing to risk. Methods exist for weighting estimates by propensity score, removing simplifying the interpretation of model effects. Few studies have explored the use of these tools to assess when the effect of certain factors is uncertain or inconsistent. Method A mix of 1,001,737 suicide decedents and living patients were evaluated for suicide risk, relying on a subset of commonly identified factors: demographics, psychiatric conditions, substance use disorders, and social needs. Care utilization patterns were then assessed controlling for these factors in a hospital care setting. Four methods were considered for controlling multivariate confounding of odds predicting death by suicide: multivariate logistic regression, 1-to-1 sample matching, inverse propensity weighting (IPTW), and entropy balancing (EBAL). Results Test statistics showed suicide decedents were much more likely to have various psychiatric and substance use diagnoses, social needs and more likely to heightened care utilization across sampling intervals. Greater utilization was found close to date of death. Effect sizes after IPTW and EBAL weighting were also generally greater than would have been documented by regression alone. Conclusions Propensity weighting is a useful alternative to exploring nuanced effects, especially when the direction and strength of an association differ from traditional statistics. By weighting, the overall imbalance of cases remains consistent and effect terms might reflect more nuanced associations than regression or sample matching alone.

Exposure to chemical cues released by predator or pathogen can evoke anxiety or fear responses in prey/host animals such as fight, flight or freeze both at behavioral and molecular levels. Freezing is a fundamental anxiety response when fighting or fleeing arent feasible. Despite the potential relevance of freezing as a stress-coping mechanism, its behavioral and molecular underpinnings are not understood yet. At molecular level danger cues are perceived by chemosensory receptors expressed in sensory neurons which may further regulate the animals behavioral responses(Ye et al., 2024){Citation}. 2-nonanone (2-NA) is one of the principal volatile organic compounds secreted by many pathogenic bacteria infecting Caenorhabditis elegans as well as humans and may signal danger to worms. Here, we show that olfactory exposure to threat-associated cue 2-NA induces a reversible fear-like freezing response characterized by immobility and halted feeding in C. elegans. With the application of in silico and behavioral approaches we showed that 2-NA is one of the ligands for an olfactory G-protein Coupled Receptor (GPCR) STR-211 and RNAi knockdown of the receptor leads to a defect in 2-NA induced avoidance behavior in worms. We next discovered that STR-211 is required for immediate behavioral changes in C. elegans during freezing response against 2-NA. The study proposes an environment relevant animal model to mimic human anxiety and fear-like behavior, along with the identification of one of the olfactory GPCRs mediating this behavior. The model may help in understanding the neuromolecular basis of freezing response in human anxiety, contributing towards treatment of mental health disorders.