New ADC Yields Encouraging Clinical Benefit in Platinum-Resistant Ovarian Cancer

Patients with advanced platinum-resistant ovarian cancer whose disease had progressed on standard therapy experienced clinical benefit when treated with the investigational antibody-drug conjugate (ADC) QLS5132.

This finding is according to results from a Phase I clinical trial presented at the American Association for Cancer Research (AACR) Annual Meeting 2026, held in San Diego.

Patients diagnosed with platinum-resistant ovarian cancer face both a poor prognosis and limited treatment options, explained Tao Zhu, MD, chief physician and vice president of Zhejiang Cancer Hospital in China, who presented the study.

Zhu and collaborators tested an investigational ADC, QLS5132, which targets the protein CLDN6. QLS5132 combines a CLDN6-targeting monoclonal antibody with a cytotoxic payload, topoisomerase-1 inhibitor, at a drug-to-antibody ratio of 8:1. CLDN6, Zhu said, makes an ideal target as a protein with very high expression on the surface of ovarian cancer cells and minimal cell-surface expression in healthy tissues.

“The primary purpose of this first-in-human study was to evaluate the safety, tolerability, and pharmacokinetic profile of QLS5132 in patients with platinum-resistant ovarian cancer and determine the recommended Phase II dose for future clinical development,” Zhu said. “Additionally, we aimed to assess preliminary antitumor activity to establish an early signal of clinical benefit in this heavily pretreated population with limited options.”

The Phase I, single-arm, dose-escalation trial enrolled 28 patients with a median age of 57.5 who had been diagnosed with advanced platinum-resistant ovarian cancer and who had experienced progression while on standard therapy. The research team administered QLS5132 as an intravenous infusion every three weeks at dose levels of 1.6 mg/kg, 3.2 mg/kg, 4.8 mg/kg, 5.6 mg/kg, and 6.4 mg/kg.

Treatment-related adverse events (TRAEs) occurred in 26 (92.9%) patients, with nausea, anorexia, anemia, and weakness occurring most frequently. Nine (32.1%) patients experienced TRAEs of grade 3 or higher, and of those grade ≥3 TRAEs, seven were instances of hematological toxicity. No TRAEs led to treatment discontinuation or death, and no patients experienced interstitial lung disease, ocular toxicity, or febrile neutropenia, Zhu said.

After a median follow-up of 2.2 months, nine patients had a partial response at various dose levels. Two of these partial responses occurred in patients who had no detectable CLDN6 expression.

Across all dose levels, 18 evaluable patients experienced an objective response rate of 50% and a disease control rate of 94.4%. When calculated for the 17 evaluable patients who had received dose levels ≥3.2 mg/kg, the objective response rate and disease control rate rose to 52.9% and 100%, respectively. These responses to QLS5132 occurred irrespective of patients’ CLDN6 expression levels at baseline.

“The most encouraging finding from our study was that QLS5132 demonstrated compelling antitumor activity in patients with platinum-resistant ovarian cancer, with an objective response rate exceeding 50%,” said Zhu. “Equally important, at the potential recommended Phase II dose, we observed a favorable safety profile with no reported cases of interstitial lung disease, ocular toxicity, oral mucositis, or febrile neutropenia.”

Zhu also noted that, though more research would be needed to confirm, preliminary data indicated antitumor activity from QLS5132 regardless of CLDN6 expression levels—which, he said, could expand its potential as a treatment option to a broad cohort of patients with platinum-resistant ovarian cancer.

Zhu acknowledged that further research would be needed to fully understand why QLS5132 can have anticancer effects in patients with undetectable CLDN6 tumoral expression. But he suggested the phenomenon may have a few explanations, including tumor heterogeneity, as well as a potent bystander effect resulting in antitumor efficacy even in cells with low or no CLDN6 expression.

“These findings support the advancement of QLS5132 into Phase III studies, with the goal of providing a much-needed new treatment option for these patients,” said Zhu.

Some limitations of this study include a small sample size and an exploratory single-arm design.

This study was funded by Qilu Pharmaceutical. Zhu discloses no conflicts of interest.

The post New ADC Yields Encouraging Clinical Benefit in Platinum-Resistant Ovarian Cancer appeared first on GEN – Genetic Engineering and Biotechnology News.

Novel KIR‑CAR T Approach Shows Early Activity Against Solid Tumors

CAR T cell therapies have revolutionized outcomes for certain blood cancers, yet their impact on solid tumors has lagged. The field has long wrestled with T cell exhaustion—a state in which engineered cells lose their potency and fail to sustain an anti‑tumor response.

At this year’s AACR annual meeting in San Diego, researchers from the Perelman School of Medicine at the University of Pennsylvania presented first‑in‑human Phase I data pointing to a possible solution. Their novel “KIR‑CAR” T cell therapy demonstrated a favorable safety profile and early signals of activity across multiple solid tumor types.

The investigational therapy, SynKIR-110, represents a departure from traditional CAR T designs. Rather than using a single-chain receptor, the therapy is modeled after natural killer (NK) cell receptors and uses a “multi-chain” architecture.

This design separates tumor recognition from activation, effectively creating an intrinsic “on-off” mechanism. The T cell remains in a resting state until it encounters its target, at which point the receptor components assemble to trigger an immune attack.

“The KIR-CAR design provides a natural ‘on-off’ mechanism, which helps avoid the problem of T cell exhaustion,” said Janos L. Tanyi, MD, PhD, principal investigator of the study. “The CAR turns on when it finds its target, kills it, and then rests, rather than constantly burning energy.”

This contrasts with conventional CAR T cells, which remain continuously active and can become depleted over time, limiting their effectiveness—particularly in the more complex microenvironment of solid tumors.

The Phase I dose-escalation trial enrolled nine patients with advanced, mesothelin-expressing cancers, including ovarian cancer, mesothelioma, and cholangiocarcinoma. These patients had limited treatment options, having received an average of four prior lines of therapy.

Although the primary goal of the study was to assess safety, early signs of efficacy were observed. Disease stabilization was reported in four patients, and one patient in the highest dose cohort achieved an ongoing partial response.

“These are cancer types that have never had an approved cell therapy,” Tanyi said. “We’re seeing good efficacy signals, even at low doses, and limited toxicity.”

The results suggest that the therapy may be able to generate meaningful anti-tumor responses even in heavily pretreated populations.

Safety has been another major barrier for CAR T therapies, particularly in solid tumors. However, the KIR-CAR approach appears to mitigate some of these concerns.

No dose-limiting toxicities were observed in the initial cohorts. Cytokine release syndrome (CRS), a common side effect of CAR T therapy, occurred in 33% of patients but was limited to low-grade events. Notably, there were no cases of immune effector cell-associated neurotoxicity syndrome (ICANS), a more severe complication sometimes seen with CAR T therapies.

The ability to limit toxicity while maintaining activity is a key step toward broader application of cell therapies in solid tumors.

SynKIR-110 targets mesothelin, a protein expressed on the surface of several solid tumors but largely absent from normal tissues. This makes it an attractive target for immunotherapy, particularly in cancers such as ovarian cancer and mesothelioma, where treatment options are limited.

The trial results indicate that the therapy’s activity is not confined to a single tumor type, raising the possibility of broader applicability across mesothelin-expressing cancers.

The findings come amid growing efforts to adapt CAR T technology for solid tumors. While the approach has revolutionized hematologic malignancies, solid tumors present additional challenges, including immunosuppressive microenvironments, physical barriers to T cell infiltration, and antigen heterogeneity.

Researchers are exploring multiple strategies to address these barriers, including improved targeting, combination therapies, and next-generation receptor designs such as KIR-CAR.

As noted by CAR T pioneer Carl June, MD, advancing cellular therapies into solid tumors remains a central goal for the field.

The Phase I study continues to enroll patients, aiming for a 42‑person cohort to define the maximum tolerated dose ahead of Phase II. Early readouts show that CAR T expansion rises with dose, a pattern that may translate into stronger anti‑tumor activity at higher levels.

While still preliminary, the findings highlight the potential of multi‑chain CAR designs to sustain activity without added toxicity. If confirmed, KIR‑CAR therapies could usher in a new generation of engineered immune cells that more closely mirror natural immune regulation.

For now, the data offer a promising sign that CAR T innovation may finally be gaining ground in solid tumors.

The post Novel KIR‑CAR T Approach Shows Early Activity Against Solid Tumors appeared first on GEN – Genetic Engineering and Biotechnology News.

Earliest Events of Lung Cancer Development Mapped

Researchers at Memorial Sloan Kettering (MSK) Cancer Center have identified the earliest cellular and molecular events that create the needed conditions for lung cancer cells to begin their growth into a tumor. The study, published in Nature, describes how cells with cancer-causing mutations initiate a coordinated chain of events to involve nearby fibroblasts and immune cells to create a microenvironment conducive to tumor growth at the very start of disease.

“We also found that this transformation of the local neighborhood is reversible, if caught early enough. This opens the door to new treatment and prevention strategies,” said senior author Joo-Hyeon Lee, PhD, an associate member in the developmental biology program at MSK.

The research focused on lung alveolar type II (AT2) stem cells that acquire mutations in the KRAS gene. Rather than simply proliferating, the mutant cells enter a regenerative-like state that resembles tissue repair. In this state, they produce amphiregulin (AREG), a signaling molecule that initiates communication with surrounding cells. AREG activates nearby fibroblasts through EGFR signaling, which prompts them to adopt a fibrotic, injury-like state which results in a remodeling of the extracellular matrix.

Within the microenvironment created, fibroblasts play a central role in shielding emerging tumor cells by producing a fibrous scaffold that supports tumor growth while also releasing signals that alter the activity of immune cells. Macrophages recruited to the site undergo reprogramming, shifting away from fighting the tumor toward phenotypes that suppress immune responses. Neutrophils and regulatory T cells are also recruited, further dampening anti-tumor immunity. This coordinated activity creates a protective niche in which the cells with the KRAS mutation can grow without being eliminated.

“These reciprocal interactions establish a self-sustaining epithelial–stromal–immune circuit that generates a tumor-permissive niche before malignant outgrowth,” the researches wrote. This loop reinforces itself: mutant cells sustain fibroblast activation, fibroblasts reshape immune responses, and immune cells further support tumor-promoting conditions.

The study builds on prior research in the Lee lab into lung injury and repair, which showed that normal regenerative programs involve temporary activation of stem cells and fibroblasts. In cancer, however, this process becomes dysregulated. Mutant cells remain locked in a regenerative state, continuously signaling to their environment. Earlier work by the same group had identified these regenerative states as a feature of early tumorigenesis.

To identify the mechanisms involved, the MSK first used mouse models of lung cancer carrying KRAS mutations. Through lineage tracing and single-cell analyses, they tracked individual cells to map how interactions with fibroblasts and immune cells evolved over time. They then used tissue samples from patients with early-stage lung adenocarcinoma and found returned the same result of cancer cells producing high levels of AREG and adjacent fibrotic fibroblasts.

Importantly, the team demonstrated that disrupting this communication network can prevent tumor formation. Blocking AREG signaling with an EGFR inhibitor kept fibroblasts and immune cells in their normal states and significantly impaired tumor development. Similarly, removing the AREG gene from mutant cells prevented the formation of the tumor-supportive niche. Even after early lesions had formed, inhibiting KRAS activity reversed many of the changes that had already occurred in the microenvironment.

The implications of this research to influence for cancer care are substantial. The identification of early signaling events and microenvironmental changes suggests new biomarkers for detecting lung cancer before it becomes advanced. High levels of AREG or evidence of fibroblast activation could indicate the presence of precancerous lesions, which could be particularly important for screening those at high risk of developing cancer, such as long-term smokers.

The findings also suggest there could be the development of new therapeutics aimed at preventing cancer development as opposed to treating it once it is established. By targeting the AREG–EGFR signaling axis or disrupting fibroblast activation, clinicians may be able to block tumor development at its earliest stages. Because the team showed these processes can be reversed, there is a window for intervention before the disease becomes resistant to treatment.

“The reversibility of these preneoplastic circuits defines a therapeutic window before progression to treatment-resistant disease,” the researchers wrote.

Next steps for the team include validating biomarkers in clinical populations, refining organoid models to study patient-specific tumor development, and testing preventive therapies that target these newly identified early signaling pathways.

The post Earliest Events of Lung Cancer Development Mapped appeared first on Inside Precision Medicine.

The Download: introducing the Nature issue

This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.

Introducing: the Nature issue

When we talk about “nature,” we usually mean something untouched by humans. But little of that world exists today. 

From microplastics in rainforest wildlife to artificial light in the Arctic Ocean, human influence now reaches every corner of Earth. In this context, what even is nature? And should we employ technology to try to make the world more “natural”?  

In our new Nature issue, MIT Technology Review grapples with these questions. We investigate birds that can’t sing, wolves that aren’t wolves, and grass that isn’t grass. We look for the meaning of life under Arctic ice, within ourselves, and in the far future on a distant world, courtesy of new fiction by the renowned author Jeff VanderMeer. 

Together, these stories examine how technology has altered our planet—and how it might be used to repair it. Subscribe now to read the full print issue.

What’s next for large language models?

After ChatGPT launched in late 2022, the OpenAI chatbot became an everyday everything app for hundreds of millions of people. It led to LLMs being heralded as the new future. The entire tech industry was consumed by the inferno, with companies racing to spin up rival products.

But what’s the next big thing after LLMs? More LLMs—but better. Let’s call them LLMs+. Find out how they’re set to become cheaper, more efficient, and more powerful.

—Will Douglas Heaven

LLMs+ is on our list of the 10 Things That Matter in AI Right Now, MIT Technology Review’s guide to what’s really worth your attention in the busy, buzzy world of AI. We’ll be unpacking one item from the list each day here in The Download, so stay tuned.

Will fusion power get cheap? Don’t count on it.

Fusion power could provide a steady, zero-emissions source of electricity in the future—if companies can get plants built and running. But a new study published in Nature Energy suggests that even if that future arrives, it might not come cheap.

The research team aimed to improve predictions of fusion’s future price by estimating the technology’s experience rate—the percentage by which its cost declines every time capacity doubles. Their findings offer new clues on the technology’s path to deployment. Read the full story.

—Casey Crownhart

This story is from The Spark, our weekly climate newsletter. Sign up to receive it in your inbox every Wednesday.

The must-reads

I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.

1 Trump signaled he’s open to reversing the Anthropic ban
What that really means in practice remains to be seen. (Reuters $)
+ Anthropic says there’s no “kill switch” for its AI. (Axios)
+ “Humans in the loop” in AI warfare is an illusion. (MIT Technology Review)

2 SpaceX plans to manufacture its own GPUs
To support the company’s growing AI ambitions. (Reuters $)
+ Musk is shifting SpaceX’s focus from Mars to AI ahead of its IPO. (NYT $)
+ SpaceX and Tesla may be on a collision course. (FT $)

3 Chinese tech giant Tencent has unveiled its first flagship AI model
A former OpenAI researcher is at the helm. (SCMP)
+ Chinese open models are spreading fast. (MIT Technology Review)

4 High earners are racing ahead on AI, deepening workplace divides
The division in adoption risks widening inequality. (FT $)
+ Startups are bragging they spend more on AI than staff. (404 Media)

5 Thousands of Samsung workers are demanding a new share of AI profits
Chip-division employees want 15% of the operating profit. (Bloomberg $)
+ Here’s why opinion on AI is so divided. (MIT Technology Review)

6 AI is helping mediocre Korean hackers steal millions
They’re vibe coding their malware. (Wired $)
+ AI is making online crimes easier. (MIT Technology Review)

7 Kalshi suspended three political candidates for betting on their own races
Including a Democrat and a Republican running for Congress. (CNN)
+ And an independent candidate who said he did it to make a point. (Gizmodo)
+ Lawmakers argue that prediction markets are a loophole for gambling. (NPR)

8 A ping-pong robot is beating elite human players for the first time
The Sony AI system was trained with reinforcement learning. (New Scientist)
+ Just days earlier, a humanoid smashed the human half-marathon record. (AP)

9 Crypto scammers are luring ships into the Strait of Hormuz
By falsely promising safe passage. (Ars Technica)

10 ‘Age tech’ could help us grow old comfortably at home
Apps, wearables, and remote monitoring could fill caregiving gaps. (NYT $)

 

Quote of the day

“It’s a hallucinogenic business plan.”

—Ross Gerber, the chief executive of Gerber Kawasaki, an investment firm that owns SpaceX shares, tells the New York Times that he’s unimpressed by Musk’s changing goals for the aerospace company. 

One More Thing

Photos of victims are displayed under white crosses at a memorial for the August 2023 wildfire victims

AP PHOTO/LINDSEY WASSON


This grim but revolutionary DNA technology is changing how we respond to mass disasters

After hundreds went missing in Maui’s deadly fires, victims were identified with rapid DNA analysis—an increasingly vital tool for putting names to the dead in mass-casualty events.

The technology helped identify victims within just a few hours and bring families some closure more quickly than ever before. But it also previews a dark future marked by the rising frequency of catastrophic events.

Find out how this forensic breakthrough is preparing us for a more volatile world.


—Erika Hayasaki

We can still have nice things

A place for comfort, fun and distraction to brighten up your day. (Got any ideas? Drop me a line.)

+ This fascinating dive into botanical history reveals the origins of the first true plants.
+ Here’s how to use Google’s reference desk to find what ordinary search engines miss.
+ Watch duct tape get deconstructed to reveal the physics behind its legendary stickiness.
+ When Radiohead covers Joy Division, the result is a beautiful intersection of two legendary musical eras.

Speech recognition performance with dual-microphone audio processors in mandarin-speaking cochlear implant users

BackgroundCochlear implant (CI) audio processor upgrades have demonstrated speech recognition benefits in non-tonal language populations, but high-level evidence for native Mandarin-speaking CI users (a tonal language with unique signal processing requirements) remains critically limited. This study aimed to assess the speech perception performance of the SONNET 2 and RONDO 3 dual-microphone audio processors in native Mandarin-speaking CI users.MethodsThis prospective single-subject repeated-measures study enrolled 51 native Mandarin-speaking CI users. Speech recognition performance was tested across five processor configurations: the legacy baseline processor, SONNET 2 (S2) in omnidirectional (S2.OMNI) and adaptive intelligence (S2.Adaptive) modes, and RONDO 3 (R3) in omnidirectional (R3.OMNI) and adaptive intelligence (R3.Adaptive) modes. Outcome measures included monosyllabic words, disyllabic words, and sentence recognition in quiet, and sentence recognition in co-located speech-shaped noise (S0N0 paradigm). The pre-specified primary endpoint was sentence recognition in noise for S2.OMNI vs. the legacy processor; confirmatory linear mixed-effects models (LMMs) and subgroup analyses were exclusively performed for the primary endpoint, with pairwise comparisons for all secondary exploratory endpoints.ResultsIn quiet, all four upgraded configurations yielded significantly higher monosyllabic word recognition scores vs. the legacy baseline (all p < 0.05, FDR-adjusted); all configurations except R3. Adaptive showed significant improvements in disyllabic word recognition (all p < 0.05, FDR-adjusted). In the S0N0 noise condition, S2.OMNI and R3.OMNI significantly enhanced sentence recognition vs. the legacy processor (p < 0.001 and p = 0.011, respectively, FDR-adjusted), while no significant benefit was detected for either adaptive mode after FDR correction. LMM analysis confirmed that upgrading to the S2.OMNI configuration was an independent positive predictor of noise sentence recognition (F = 9.885, p = 0.003), with consistent significant benefits across pediatric/adult and unilateral/bilateral users in pre-specified subgroup analyses.ConclusionThis study provides confirmatory evidence that upgrading to the S2.OMNI configuration significantly improves sentence recognition in noise in native Mandarin-speaking CI users, with consistent benefits across key clinical subgroups. Exploratory analyses show that the S2 and R3 processors also deliver significant improvements in word recognition in quiet, These results fill a critical evidence gap for tonal language CI populations and may help guide clinical device selection.

Cortical activity during cognitive and walking tasks in individuals with chronic nonspecific low back pain: a functional near-infrared spectroscopy study

IntroductionPrevious research demonstrates that individuals with chronic nonspecific low back pain (CNSLBP) exhibit changes of gait patterns. However, the neural mechanisms responsible for these adverse events remain unelucidated. In this study, we used functional near-infrared spectroscopy (fNIRS) to investigate cortical activities during cognitive and walking tasks to provide evidence of the central mechanisms responsible for changes of gait patterns in individuals with CNSLBP.MethodsIn this cross-sectional study, we evaluated 18 individuals with CNSLBP (the CNSLBP group) and 18 healthy controls (the HC group) under three specific conditions: Task 1 (a single walking task), Task 2 (a single cognitive task) and Task 3 (a cognitive-walking dual task). Cortical activities were measured using fNIRS, including the bilateral premotor cortex and supplementary motor area (PMC/SMA), primary motor cortex (M1), somatosensory association cortex (SAC), and primary somatosensory cortex (S1). Gait parameters, including step duration, step length, stride length, velocity, cadence, swing power, and cycle, were measured using a three-dimensional gait analysis system.ResultsIn Task 1, the CNSLBP group exhibited a significantly lower velocity (p = 0.029) and higher activation in the left SAC (p = 0.001) and right S1 (p = 0.018) than that of the HC group. In Task 2, the CNSLBP group exhibited higher activation in the left SAC (p = 0.028), right SAC (p = 0.033), and left S1 (p = 0.032). In Task 3, the CNSLBP group exhibited significantly lower step length (p = 0.031), stride length (p = 0.041), velocity (p = 0.016), and swing power (p = 0.047). Correlation analysis in Task 1 revealed stronger associations between parameters in the CNSLBP group.ConclusionOur findings suggest that individuals with CNSLBP exhibit distinct patterns of cortical activities and gait performance. The SAC and S1 were involved in walking, and central sensitization was observed in individuals with CNSLBP in daily cognitive and walking tasks. These findings could contribute to the recovery and rehabilitation of CNSLBP.

Intracerebroventricular diphtheria toxin causes off-target toxicity in CD11b-DTR and wild-type mice, revealing limitations of DTR-based depletion studies

Diphtheria toxin receptor (DTR)–based depletion models are widely used to study microglial and macrophage function, yet the extent to which diphtheria toxin (DT) produces off-target effects remains incompletely defined. Here, we examined tolerability, behavioural outcomes, and cellular responses following intracerebroventricular (i.c.v.) DT administration in wild-type (WT) and CD11b-DTR mice. Mice received bilateral i.c.v. infusions of DT or vehicle over a 10-day period and were assessed for survival, motor and cognitive behaviour, myeloid cell changes, and neuropathology. Unexpectedly, DT induced dose-dependent mortality in WT mice, demonstrating that toxicity can occur independently of DTR expression. CD11b-DTR mice exhibited greater susceptibility, with reduced survival and the emergence of illness at lower DT doses. Behavioural testing revealed significant dose-dependent impairments in rotarod performance and Y-maze spontaneous alternation in both genotypes, while open-field mobility was largely preserved among animals. Region-specific analysis of myeloid cells in CD11b-DTR mice showed robust depletion in the midbrain at higher DT doses, whereas hippocampal cell numbers remained unchanged with marked morphological signs of activation. These findings indicate that DT-mediated myeloid cell responses vary across brain regions, potentially reflecting differential toxin exposure following ventricular delivery. Consistent with this, focal abnormalities in the brain—including ventriculitis, meningoencephalitis and spongiotic changes—were observed in a subset of clinically affected DT-treated animals, whereas peripheral organs were largely unremarkable and haematological changes were infrequent. Together, these data demonstrate that i.c.v. DT administration can induce mortality, behavioural dysfunction, and focal CNS pathology in both WT and CD11b-DTR mice, with transgene expression amplifying susceptibility. Our findings highlight the need for careful dose optimisation, appropriate DT-treated controls, and cautious interpretation of behavioural phenotypes when employing this model.

Psychological function in the context of protracted stress during war: a multi-sample, multivariate longitudinal study

Continuous traumatic stress has wide-ranging implications for important life outcomes across multiple domains. We present the design protocol from the first waves of one of the most comprehensive studies of the impact of one pervasive continuous traumatic stress context—war—on individuals. In this ongoing project we have been collecting quantitative and qualitative data on psychological function, risk, and resilience at different levels of influence and at various junctures during the ongoing 2023–2025 Hamas-Israel war from three samples (total N = 16,330). We present this large-scale, multi-sample, multivariate, mixed-method, longitudinal study, and showcase select, preliminary findings at different levels of analysis and in different samples (e.g., concerning war exposure, trust in institutions, and well-being). We document the design, scope, and future trajectory of the project, encouraging interdisciplinary, cross-border collaborations among researchers across diverse fields. This is important not only for understanding responses to the current conflict, but also for understanding risk and resilience in other conflict-affected regions and among populations facing continuous traumatic stress more broadly.

Association between the geriatric nutritional risk index and postoperative delirium: a meta-analysis

BackgroundMalnutrition has been suggested as an important contributor to postoperative delirium (POD). The geriatric nutritional risk index (GNRI), a simple indicator based on serum albumin and body weight, has been increasingly evaluated in surgical patients. This meta-analysis aimed to clarify the association between GNRI and the risk of POD.MethodsPubMed, Embase, and Web of Science were searched for observational studies evaluating the association between categorized GNRI and POD. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models accounting for heterogeneity.ResultsTwelve cohort studies involving 12,332 surgical patients were included. Overall, low GNRI was associated with a significantly increased risk of POD (RR = 1.62, 95% CI: 1.34–1.96; I² = 27%). Subgroup analyses showed a stronger association in studies with mean patient age > 74 years compared to ≤ 74 years (p for subgroup difference = 0.02) and in those using GNRI cutoffs < 98 compared to ≥ 98 (p = 0.04). The association was weaker in studies using multivariate analyses compared with univariate analyses (p = 0.01). Meta-regression indicated that GNRI cutoff values significantly influenced the pooled effect (p = 0.04). The funnel plot showed mild asymmetry, whereas Egger’s test was not significant (p = 0.11), and trim-and-fill analysis produced a similar pooled estimate (RR = 1.54, 95% CI: 1.26–1.87).ConclusionsLow GNRI is associated with an increased risk of POD in surgical patients, suggesting that preoperative nutritional assessment may help identify individuals at higher risk for this complication.Systematic Review RegistrationThe study protocol was registered prospectively in the PROSPERO database (registration number: CRD420261335609).

Auditory processing and communication in autism: exploring verbal abilities and vocal affective cues

This study examined the role of auditory processing in autism spectrum disorder, focusing on its association with verbal and non-verbal vocal communication skills in children and adolescents. A total of 97 English-speaking autistic participants (ages 7.9–17.4 years, mean = 12.3) and 44 neurotypical peers (ages 8.4-16.8, mean= 12.3) completed assessments of auditory processing and communication skills. We analyzed the relationships between scores on the SCAN-3 Tests for Auditory Processing Disorders time-compressed sentences, auditory figure-ground (+ 8dB), gap detection, and competing words-free recall subtests, the Clinical Evaluation of Language Fundamentals-Fifth Edition (CELF-5) expressive and receptive language indices, the Goldman-Fristoe Test of Articulation-3rd Edition (GFTA-3) Sounds-In-Words subtest, and the Diagnostic Analysis of Nonverbal Accuracy-2nd Edition (DANVA-2) paralanguage subtests. Measures of auditory processing were associated with both verbal and non-verbal communication skills in the autistic participants. Specifically, we found that SCAN-3 time-compressed sentence and gap detection scores were associated with expressive and receptive language skills, receptive vocabulary scores, and ability to recognize vocal emotional cues. Gap detection abilities additionally correlated positively with expressive and receptive language skills, while auditory figure-ground task performance was related to articulation. In conclusion, this study suggests specific aspects of auditory processing may be important for development of specific aspects of auditory communication skills in children on the spectrum. Specifically, spectral aspects of auditory processing abilities were associated with articulation accuracy whereas temporal components of auditory processing may impact broader verbal and nonverbal communication skills. Further research is needed to better understand the underlying mechanisms of these associations and potential directions of causality to inform development of interventions that target auditory processing and auditory communication skills in ASD.