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Background To establish and validate the utility of computed tomography (CT) radiomics for the prognosis of patients with non-small cell lung cancer (NSCLC). Materials and methods Overall, 215 patients with pathologic diagnosis of NSCLC were included, chest CT images and clinical data were collected before treatment, and follow-up was conducted to assess brain metastasis and survival. Radiomics characteristics were extracted from the chest CT lung window images of each patient, key characteristics were screened, the radiomics score (Radscore) was calculated, and radiomics, clinical, and combined models were constructed using clinically independent predictive factors. A nomogram was constructed based on the final joint model to visualize prediction results. Predictive efficacy was evaluated using the concordance index (C-index), and survival (Kaplan-Meier) and calibration curves were drawn to further evaluate predictive efficacy. Results The training set included 151 patients (43 with brain metastasis and 108 without brain metastasis) and 64 patients (18 with brain metastasis and 46 without). Multivariate analysis revealed that lymph node metastasis, lymphocyte percentage, and neuron-specific enolase (NSE) were independent predictors of brain metastasis in patients with NSCLC. The area under the curve (AUC) of the these models were 0.733, 0.836, and 0.849, respectively, in the training set and were 0.739, 0.779, and 0.816, respectively, in the validation set. Multivariate Cox regression analysis revealed that the number of brain metastases, distant metastases elsewhere, and C-reactive protein levels were independent predictors of postoperative survival in patients with brain metastases ( P  < 0.05). The calibration curve exhibited that the predicted values of the prognostic prediction model agreed well with the actual values. Conclusion The model based on CT radiomics characteristics can effectively predict NSCLC brain metastasis and its prognosis and provide guidance for individualized treatment of NSCLC patients.

Macrophages have been suggested to contribute to constructing a cancer stem cell (CSC) niche. However, whether and how macrophages regulate the activity of CSCs through juxtacrine signaling are poorly understood. Here we report LSECtin, a transmembrane protein highly expressed on tumor-associated macrophages (TAMs), enhances stemness of breast cancer cells (BCCs). We identified BTN3A3, a B7 family member with previously unknown functions as the receptor for LSECtin on BCCs responsible for stemness-promoting effect of LSECtin. In mice bearing human tumor xenografts, either macrophage-specific ablation of LSECtin or silencing of BTN3A3 in BCCs decreased CSC frequency and tumor growth. Admixture of LSECtin-positive macrophages increased the tumorigenic activity of BCCs dependent on BTN3A3. Disruption of the LSECtin-BTN3A3 axis with BTN3A3-Fc or anti-BTN3A3 mAb has a therapeutic effect on breast cancer. These findings define a juxtacrine signaling mechanism by which TAMs promote cancer stemness. Targeting this axis in the CSC niche may provide potential therapies to breast cancer.

Background An accurate preoperative assessment of alveolar bone morphology is essential to the success of dental implant surgery. Although Cone Beam Computed Tomography (CBCT) provides high-resolution volumetric imaging for this purpose, interpreting it requires substantial expertise and remains inherently subjective. Integrating artificial intelligence (AI), specifically three-dimensional convolutional neural networks (3D-CNNs), could automate and standardize CBCT interpretation. However, there has been no systematic development of AI-driven preoperative tools capable of objectively predicting the necessity of adjunctive procedures, such as guided bone regeneration or maxillary sinus elevation. Methods We retrospectively collect 285 CBCT datasets from a single institution from patients undergoing dental implant surgery. Then, we construct a 3D-CNN–based deep learning model to automatically predict the need for adjunctive surgical intervention prior to implant placement. To optimize the model’s performance, we design a four-stage optimization framework that incorporates multimodal data augmentation, learning rate decay scheduling, optimizer selection, and convolutional channel configuration. We comprehensively evaluate model performance using accuracy (ACC), area under the receiver operating characteristic curve (AUC), and F1-score across training, validation, and test sets. We employ Grad-CAM visualization to reveal spatial attention patterns and apply LASSO regression to extract key latent features from the model’s fully connected layers. These features are then used to create a quantitative nomogram to improve clinical interpretability. Results The optimized 3D-CNN achieves an accuracy of 0.81, an AUC of 0.79, and an F1-score of 0.82 on the validation and test sets, demonstrating strong discriminative and generalizability capabilities. Grad-CAM heatmaps shows that the model focuses on the edentulous ridge and the adjacent maxillary sinus regions, which are areas that align with expert clinical reasoning. LASSO regression identifies 14 high-contribution features for constructing an interpretable clinical nomogram (AUC = 0.855). Decision curve analysis indicates a positive net clinical benefit across multiple threshold ranges. Conclusions This study presents a 3D-CNN-based CBCT interpretation model that can objectively predict the need for bone augmentation procedures before implant surgery. Integrating multimodal data augmentation and standardized Hounsfield unit (HU) normalization significantly improve the model’s robustness and generalization. By combining deep learning with clinical decision-making processes, this study provides an interpretable, quantitative artificial intelligence (AI) framework for preoperative implant assessment. As the current model was developed, optimized, and tested on a single-center dataset, prospective multicenter external validation across diverse patient populations, varied CBCT acquisition protocols, and different clinical practice settings is essential to establish its generalizability and clinical utility before widespread deployment. This framework offers a feasible paradigm for future intelligent, standardized surgical planning in dental implantology.

Utidelone, a genetically engineered epothilone analogue, has shown promise as a potential treatment for breast cancer in phase 1 and 2 trials. The aim of this phase 3 trial was to compare the efficacy and safety of utidelone plus capecitabine versus capecitabine alone in patients with metastatic breast cancer. We did a multicentre, open-label, superiority, phase 3, randomised controlled trial in 26 hospitals in China. Eligible participants were female patients with metastatic breast cancer refractory to anthracycline and taxane chemotherapy regimens. We randomly assigned participants (2:1) using computer based randomisation and block sizes of 6 to a 21-day cycle of either utidelone (30 mg/m2 intravenously once per day on days 1–5) plus capecitabine (1000 mg/m2 orally twice per day on days 1–14), or capecitabine alone (1250 mg/m2 orally twice per day on days 1–14), until disease progression or unacceptable toxicity occurred. Patients, physicians, and assessors were not masked to treatment allocation; however, an independent radiology review committee used to additionally assess response was masked to allocation. The primary endpoint was centrally assessed (by an independent radiology review committee) progression-free survival, and analysed using the Kaplan-Meier product-limit method in the intention-to-treat population. Safety was assessed in all participants who received at least one dose of study drug. Follow-up is ongoing. This study is registered at ClinicalTrials.gov, number NCT02253459. Between Aug 8, 2014, and Dec 14, 2015, we enrolled and randomly assigned 270 patients to treatment with utidelone plus capecitabine, and 135 to capecitabine alone. Median follow-up for progression-free survival was 6·77 months (IQR 3·81–10·32) for the utidelone plus capecitabine group and 4·55 months (2·55–9·39) for the capecitabine alone group. Median progression-free survival by central review in the utidelone plus capecitabine group was 8·44 months (95% CI 7·95–9·92) compared with 4·27 months (3·22–5·68) in the capecitabine alone group; hazard ratio 0·46, 95% CI 0·36–0·59; p<0·0001. Peripheral neuropathy was the most common grade 3 adverse event in the utidelone plus capecitabine group (58 [22%] of 267 patients vs 1 [<1%] of 130 patients in the capecitabine alone group). Palmar-plantar erythrodysaesthesia was the most prominent grade 3 adverse event in the capacitabine alone group (in 10 [8%] of 130 patients) and was the next most frequent grade 3 event in the utidelone plus capecitabine group (in 18 [7%] of 267 patients). 16 serious adverse events were reported in the combination therapy group (diarrhoea was the most common, in three [1%] patients) and 14 serious adverse events were reported in the monotherapy group (the most common were diarrhoea, increased blood bilirubin, and anaemia, in two [2%] patients for each event). 155 patients died (99 in the combination therapy arm, 56 in the monotherapy arm). All deaths were related to disease progression except for one in each group (attributed to pericardial effusion in the combination therapy group and dyspnoea in the monotherapy group) that were considered possibly or probably treatment-related. Despite disease progression with previous chemotherapies, utidelone plus capecitabine was more efficacious compared with capecitabine alone for the outcome of progression-free survival, with mild toxicity except for peripheral sensory neuropathy, which was manageable. The findings from this study support the use of utidelone plus capecitabine as an effective option for patients with metastatic breast cancer. Beijing Biostar Technologies, Beijing, China.

Shale oil reservoirs in the Daanzhai section of central Sichuan are mainly developed in the Daer subsection, with a rich resource base and great exploration and development potential. However, the shale oil reservoir is characterized by shale and limestone interactions, poor physical properties, undeveloped fractures, and large differences in the fracture pressure of interactive reservoirs. Therefore, it is necessary to use temporary plugging and diverting fracturing technology to improve the complexity of fractures in reservoir reconstruction. To this end, an experimental device was innovatively established that takes into account the morphology of fractures and the permeability of reservoirs, and it can evaluate the temporary blocks and turns within third-level fractures in a reservoir. It can simulate third-level turning fractures under conditions involving 3–15 mm crack openings and different roughness values. Using this device and method, the combination and particle-size optimization experiments involving the temporary plugging agents used in the field were carried out, and the field tests were carried out in Well Long’an 1 and Well Ren’an 1 in the Sichuan Basin. The test results show that the pressure response after temporary plugging is obvious, which can significantly improve microseismic event points and increase the reservoir’s reconstruction volume. Compared with Well Nanchong 2H, the length in kilometers of the SRV after tackling key problems increases from 3918 × 104 m3 to 4578 × 104 m3, an increase of 17%. The average crack length increased from 265 m to 321 m, an increase of 21%, achieving a significant breakthrough in the “oil production gap”.

There are few studies focus on post-neoadjuvant treatment in hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-)/lymph node-positive (LN+) breast cancer, a multi-center, open-label, randomized, controlled phase III trial was conducted to evaluate pathological response-guided non-cross-resistant adjuvant chemotherapy in patients with HR+/HER2-/LN+ breast cancer who were non-responsive to primary chemotherapy. Patients received four cycles of non-cross-resistant adjuvant chemotherapy plus endocrine therapy (ET), or ET alone. Forty patients responsive to neoadjuvant chemotherapy and with Miller and Payne G4 or G5 and LN- status were assigned to the observation group. Distant disease-free survival was the primary endpoint. The final intention-to-treat analysis comprised 379 patients. After a median follow-up period of 72.4 months, the 5-year distant disease-free survival was 92% and 90% in the chemotherapy plus ET and ET-alone groups, respectively. Comparatively, the observation group showed a trend towards better distant disease-free survival. For patients non-responsive to neoadjuvant chemotherapy, adjuvant non-cross-resistant chemotherapy did not significantly improve distant disease-free survival compared to ET alone.

Breast cancer is the most common malignant tumor among women globally. In 2022, there were approximately 357,161 new cases and 74,986 deaths from breast cancer among Chinese females. Of the new cases of breast cancer each year, about 5%–10% of patients have distant metastasis at the time of diagnosis. Of the early‐stage patients, 20%–30% of cases eventually develop into advanced breast cancer (ABC). Although ABC is currently difficult to cure, we can alleviate the clinical symptoms of patients, improve their quality of life, and further prolong their survival time by applying new therapeutic drugs and optimizing treatment models to achieve the purpose of long‐term survival with tumors. To better guide clinical practice, the Chinese expert group, based on the latest research progress in breast cancer, has analyzed, discussed, and updated the relevant research data on the basis of the “Guidelines for clinical diagnosis and treatment of advanced breast cancer in China (2022 edition)” to formulate the “Guidelines for clinical diagnosis and treatment of advanced breast cancer in China (2024 edition).” The updated guidelines incorporate new evidence generated by high‐quality evidence‐based medicine, new concepts in molecular pathological detection, new treatment strategies, new progress in precision medicine, and adverse events of new therapeutic drugs. At the same time, the updated guidelines emphasize multidisciplinary collaboration and pay attention to patient‐reported outcomes. The “Guidelines for clinical diagnosis and treatment of advanced breast cancer in China (2024 edition)” aim to provide clinicians with recommendations for the diagnosis and treatment of ABC in China, thereby improving patient outcomes and quality of life. Practice Guideline Registration: Practice Guideline Registration for Transparency (PREPARE‐2024CN1136). “The core objective of this guideline is to personalize the management of advanced breast cancer through molecular subtyping, optimizing the balance between survival and quality of life. We integrate recent evidence‐based advances and underscore the essential roles of multidisciplinary collaboration and management of patient‐reported outcomes (PROs).“

Monolayer transition metal dichalcogenides are recently emerged 2D electronic systems with various novel properties, such as spin-valley locking, circular dichroism, valley Hall effects, Ising superconductivity. The reduced dimensionality and large effective masses further produce unconventional many-body interaction effects. Although recent hole transport measurements in WSe\\(_2\\) indicate strong interactions in the valence bands, many-body interaction effects, particularly in the conduction bands, remain elusive to date. Here, for the first time, we perform transport measurements up to a magnetic field of \\(29\\)T to study the massive Dirac electron Landau levels (LL) in layer-polarized MoS\\(_2\\) samples with mobilities of \\(22000\\)cm\\(^2\\)/(V\\(\\)s) at \\(1.5\\)K and densities of \\(10^12\\)cm\\(^-2\\). With decreasing the density, we observe LL crossing induced valley ferrimagnet-to-ferromagnet transitions, as a result of the interaction enhancement of the g-factor from \\(5.64\\) to \\(21.82\\). Near integer ratios of Zeeman-to-cyclotron energies, we discover LL anticrossings due to the formation of quantum Hall Ising ferromagnets, the valley polarizations of which appear to be reversible by tuning the density or an in-plane magnetic field. Our results provide compelling evidence for many-body interaction effects in the conduction bands of monolayer MoS\\(_2\\) and establish a fertile ground for exploring strongly correlated phenomena of massive Dirac electrons.