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Beyond Nodal Status: Interactions Between Molecular Subtype, Tumor Burden, and Survival in 12,225 Patients with Breast Cancer

Background Lymph node status and molecular subtype are among the most established prognostic factors in breast cancer. However, the extent to which their prognostic effects vary across different tumor size categories and clinical subgroups remains incompletely understood. We investigated the interplay between nodal status, molecular subtype, and tumor size in a large real world breast cancer cohort and developed a prognostic nomogram for individualized survival prediction. Methods A total of 12,225 women with invasive breast cancer from the Shiraz Breast Cancer Registry were analyzed. Patients were stratified according to tumor size, lymph node status, and molecular subtype. Overall survival (OS) and disease free survival (DFS) were evaluated using Kaplan Meier analyses and subgroup comparisons. Logistic regression was performed to identify predictors of lymph node involvement, while Cox regression was used to determine independent prognostic factors. A nomogram was subsequently developed and internally validated for prediction of 3-year and 5-year OS. Results Of 12,225 patients, 41.7% had lymph node positive disease. Across nearly all tumor size categories and molecular subtypes, nodal involvement was associated with significantly worse OS and DFS. Notably, the survival disadvantage associated with nodal positivity was more pronounced among patients with larger tumors and among those with HER2 positive and triple negative breast cancer (TNBC). Although TNBC demonstrated the lowest rate of lymph node involvement among molecular subtypes (adjusted OR 0.54, 95% CI 0.46-0.63), it appeared to show one of the largest survival gaps between node positive and node negative disease. In the overall cohort, survival outcomes generally ranked from best to worst as Luminal A, Luminal B, HER2 positive, and TNBC. However, survival differences among molecular subtypes were not consistently observed across all tumor size and nodal status subgroups. When significant differences were present, Luminal A and Luminal B tumors consistently showed superior outcomes compared with HER2 positive and TNBC tumors. Multivariable analysis identified lymph node status, tumor size, molecular subtype, lymphovascular invasion, tumor necrosis, type of surgery, radiotherapy, hormone therapy, and adjuvant chemotherapy as independent prognostic factors. A nomogram integrating clinicopathological and treatment variables demonstrated good predictive performance, with time dependent AUCs of 0.749 and 0.751 for 3 year and 5 year OS, respectively, and showed good calibration. Conclusions The prognostic impact of lymph node status is not uniform across breast cancer subgroups and appears particularly pronounced in larger tumors and biologically aggressive subtypes. Despite a lower likelihood of nodal involvement, TNBC showed substantial outcome deterioration when nodal metastasis was present. These findings highlight the importance of jointly considering nodal status, molecular subtype, and tumor burden in prognostic assessment.

A Deep Hypergraph Learning Model for Predicting Antimicrobial Combination Effects Across Bacterial Targets

Antimicrobial resistance (AMR) creates an urgent need for efficient strategies to identify effective antibacterial combinations. Combination therapy, including antimicrobial peptides (AMPs) paired with conventional antibiotics, is a promising approach, but exhaustive experimental screening across drug pairs and bacterial targets is impractical. This study introduces a hybrid GCN-based hypergraph neural network (HGNN) for predicting antimicrobial-agent combination outcomes against bacterial targets. Each antimicrobial-agent-antimicrobial-agent-bacterium triplet is represented as a ternary hyperedge, enabling the model to learn context-dependent interaction patterns. The framework integrates SMILES-derived molecular graph embeddings for antimicrobial agents, including conventional antibiotics and AMPs, with taxonomy-derived bacterial representations. The prediction task was formulated as a three-class classification problem: synergy, antagonism, and non-interaction. The non-interaction class included experimentally verified indifferent records and synthetic presumed non-interaction triplets generated by negative sampling. Model development used drug-pair-grouped splitting, five-fold grouped cross-validation within the training/validation partition, and final evaluation on a held-out test set. On the held-out three-class test set, the selected GCN-based HGNN achieved an accuracy of 0.83, weighted F1-score of 0.84, macro F1-score of 0.80, and ROC-AUC of 0.95. Per-class evaluation showed accuracies of 0.80 for synergy, 0.92 for antagonism, and 0.85 for non-interaction. Pair-type analysis showed strong performance across AMP-AMP, AMP-conventional antibiotic, and conventional antibiotic-conventional antibiotic combinations. These findings suggest that hypergraph-based representation learning can support computational prioritization of antimicrobial combinations for experimental follow-up. Further studies will be needed to improve model interpretability and to perform prospective validation of predicted synergistic combinations.

Charting the Future of Scholarly Knowledge with AI: A Community Perspective

arXiv:2509.02581v2 Announce Type: replace-cross Abstract: Despite the growing availability of tools designed to support scholarly knowledge extraction and organization, many researchers still rely on manual methods, sometimes due to unfamiliarity with existing technologies or limited access to domain-adapted solutions. Meanwhile, the rapid increase in scholarly publications across disciplines has made it increasingly difficult to stay current, further underscoring the need for scalable, AI-enabled approaches to structuring and synthesizing scholarly knowledge. Various research communities have begun addressing this challenge independently, developing tools and frameworks aimed at building reliable, dynamic, and queryable scholarly knowledge bases. However, limited interaction across these communities has hindered the exchange of methods, models, and best practices, slowing progress toward more integrated solutions. This manuscript identifies ways to foster cross-disciplinary dialogue, identify shared challenges, categorize new collaboration and shape future research directions in scholarly knowledge and organization.