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This Commission aims to resolve the current dialysis policy challenges in Thailand and generate lessons for the global kidney community by drawing on empirical evidence, systems thinking and multidisciplinary expertise to generate policy goals and recommendations.

Here, the authors conduct a metagenomic-based study of England’s rivers to show that biofilm bacteria are taxonomically and functionally diverse and are key to biogeochemical cycling, highlighting the importance of river biofilm bacteria in understanding and monitoring freshwater ecosystem health.

Here the authors assess baloxavir, oseltamivir, favipiravir, or amantadine for treatment of severe influenza A(H5N1) in female mice and find that baloxavir provides best survival outcomes with reduced lung replication and viral neuroinvasion, supporting its consideration for use in human A(H5N1) infections.

The mediobasal hypothalamus plays a central role in integrating nutritional and sex-related signals to regulate energy homeostasis. Here, through snRNA-seq of the mediobasal hypothalamus in female and male mice across nutritional states, authors show that Agrp neurons are nutrition-sensitive, DA neurons exhibit transcriptional differences in a sex-dependent manner, and KNDy neurons are responsive to both sex and nutrition.

In this work, authors provide evidence that bacteria in spatially structured populations protect each other from antibiotics through collective nutrient consumption, creating ‘death fronts’ that sweep through the colony– explaining why infections often survive treatments that work in lab tests.

In this work, authors use whole genome tracking in a neonatal intensive care unit to reveal a strong link between Staphylococcus aureus colonization and invasive infection, pinpointing critical new targets for infection prevention in high-risk infants.

Cavity-adaptive crystals have useful phototunable properties, but can be challenging to prepare. Here, the authors report the development of such cocrystals by use of a non-macrocyclic host, with elasticity and lasing action.

Currently reported early-diagnostic method for Pancreatic Ductal Adenocarcinoma (PDAC) tends to be invasive and usually time-consuming. Here, this group reports an early diagnostic method of PDAC using a signal-enhanced lateral flow immunoassay which can generate a strong colorimetric signal through multiple hotspots formed by plasmonic gold nanoparticles assembled on silica nanoparticles.

Khairallah et al., investigate the host proteins associated with a strong neutralizing antibody response to SARS-CoV-2. High neutralizing antibody responses to SARS-CoV-2 are associated with specific protein expression patterns, especially HSPA8 and pathways like fatty acid metabolism, which can predict immune strength and correlate with disease severity.

PhytoBabel is an AI model designed to capture the semantic similarity of cis-regulatory sequences across phylogenetically distant plant species, thereby establishing an approach for cross-species knowledge transfer and gene function prediction.

Trimodal single-cell analysis reveals gene-regulatory architecture in complex tissues.

Radiation reaction (RR) on particles in strong fields is the subject of intense experimental research, but previous efforts lacked statistical significance due to the extreme regimes required. Here, the authors report a 5σ observation of RR and obtain strong, quantitative evidence favouring quantum models over classical, using an all-optical setup where electrons are accelerated by a laser in a gas jet before colliding with a second, intense pulse.

Greenwald, Nederlof and colleagues developed a computational pipeline analyzing multiplex imaging data and established spatial patterns within breast cancer microenvironment that are predictive of immune checkpoint blockade response across treatment time course.

In a phase 1 trial, personalized mRNA vaccines tailored to individual tumour mutations in triple-negative breast cancer induced robust, long-lasting T cell responses and improved prognosis.

A technique called condense-seq has been developed to measure nucleosome condensability and used to show that mononucleosomes contain sufficient information to condense into large-scale compartments without requiring any external factors.

Sleep apnea is clinically diagnosed by labor-intensive manual scoring of breathing events from sleep studies. Here, the authors show that a deep learning model can automatically detect apneas at human expert level across cohorts and inform the cause of sleep apnea.

Nanochannel-confined polymerization enables polymer curing inside nanometre-scale two-dimensional channels. This strategy produces selective, mechanically robust, densely packed membranes and reveals how nanoconfinement reshapes polymer structure and membrane transport pathways, opening a general route to engineer functional materials by controlling chemistry in nanoscale pores.

Interfacial water is of crucial importance in biology and engineering. Here, the authors identify structural transitions of interfacial water at graphite surfaces under varying electric fields and environmental conditions.

Crystalline materials for optical applications are synthesized in living dinoflagellates.

Using two newly developed immunoassays tested in three clinical cohorts, this study highlights CSF DOPA decarboxylase as a promising biomarker for differentiating dementia with Lewy bodies and Parkinson’s disease from Alzheimer’s disease and controls.

Molecular glue degraders have consistently been discovered retrospectively, despite their increasing importance. Herein, a high-throughput approach is described that modifies existing ligands into molecular glue degraders.

A multi-source dataset including a survey on 2,364 Ukrainian citizens pinpoints the spatial and temporal features associated with stronger interactions between conflict-related and baseline stressors and health-related outcomes, in a Ukraine-wide analysis involving 461 cities.

Extending their previous findings of brain changes in a first pregnancy, the authors show that a second pregnancy uniquely alters women’s brains, involving both a further fine-tuning of first-pregnancy effects and distinct changes in other networks.

Genome-wide analyses in the Norwegian HUNT study with replication in Swedish and Finnish cohorts identify host genetic variants associated with gut microbiome features and provide evidence of a causal effect of body mass index on gut microbiota composition.

Immunopeptidomics identify CD4⁺ T cell epitopes from the conserved bacterial Hup protein that confer protection against multiple bacterial infections in mice suggesting potential for development of broader-spectrum vaccines against staphylococci and streptococci.

Persistent synthesis challenges constrain the stabilization of single-atom lanthanide catalysts across many substrates. Using a method based on molten-nitrite chemistry, the atomic dispersion of lanthanide atoms on diverse substrates is achieved and exemplified by Dy₁/Pt for acidic hydrogen evolution.

Chemical imaging probes enable visualization of dynamic biological processes, but engineering high sensitivity probes remains challenging. Here, the authors present Sensight, a quantitative multivariate framework that integrates key photophysical and physicochemical descriptors to predict and optimize probe performance, and design G₃, a superoxide probe with high sensitivity for detecting early oxidative events.

Recent work has revealed quantum coherent phase slips and current quantization in superconductors, phenomena dual to Cooper pair tunneling and voltage quantization. By combining the two effects, the authors demonstrate a Bloch transistor, a device that delivers quantized current and features a unique phase-locking mechanism.

Cell-free DNA is widely used in clinical testing, but its genetic basis remains unclear. Here, the authors perform cfGWAS in 28,016 pregnant women, identifying 15 loci linked to cfDNA end motifs and confirming roles for neutrophils through validation studies.

A probe with month-long molecular afterglow luminescence targeting a downregulated cancer biomarker detects small liver tumours for image-guided resection in mice and rabbits.

Here the authors compare genetic testing strategies in rare movement disorders, improve diagnostic yield with genome analysis, and establish CD99L2 as an X-linked spastic ataxia gene, showing that CD99L2–CAPN1 signaling disruption likely drives neurodegeneration.

Plasma p-tau217 tests used to develop clocks that predict when cognitively unimpaired individuals would develop symptoms of Alzheimerʼs disease.

This study presents a clinical-grade autonomous pipeline combining high-resolution whole-slide tomography, edge computing and artificial intelligence, achieving high accuracy in cervical cytology and enabling scalable and objective diagnostics.

Active matter systems, which include biological and synthetic components that consume energy to generate motion, exhibit complex behaviors influenced by their interactions with boundaries. This study reveals that surface-attached active drops can adopt a diverse range of stable shapes and internal flows, significantly expanding our understanding of their morphodynamics and providing insights for the design of advanced active materials.

DeepRare—a multi-agent system for rare disease differential diagnosis decision support powered by large language models, integrating specialized tools and up-to-date knowledge sources—has the potential to reduce healthcare disparities in rare disease diagnosis.

Biogenic–anthropogenic interactions increase the formation and prevalence of secondary organic aerosol coatings on urban black carbon in Nanjing, China. These coatings amplify radiative effects, according to a model–data analysis for 2023.

Gao and colleagues describe the characterization of an erythrocyte–anti-PD1 conjugate, reporting antitumor activity in preclinical models and results of a first-in-human clinical trial in persons with advanced solid tumors resistant to anti-PD(L)1.

In a randomized controlled study involving 1,298 participants from a general sample, performance of humans when assisted by a large language model (LLM) was sensibly inferior to that of the LLM alone when assessing ten medical scenarios leading to disease identification and recommendations for treatment.

From 2014–2017, marine heatwaves caused global mass coral bleaching, where the corals lose their symbiotic algae. The authors find, this event exceeded the severity of all prior global bleaching events in recorded history, with approximately half the world’s reefs bleaching and 15% experiencing substantial mortality.

This study detects Chlamydia pneumoniae in human retina and brain, increasing with AD severity. Retinal pathogen load with Aβ₄₂ may predict AD stage. In models, infection drives Aβ deposition and NLRP3 activation, worsening pathology and cognition.

MASH is driven by the secreted GPNMB ectodomain, which binds hepatocyte RYK to activate ERK1/2 and promote lipid uptake and lipogenic programs; blocking the GPNMB–RYK axis prevented and treated MASH in preclinical models.

Survival of reef-building oysters peaks at specific combinations of fractal dimension and height that reduce predation, showing how optimal three-dimensional habitat geometry can guide more effective ecosystem restoration.

Earth’s core dynamo, which produces the magnetic field, may have been influenced by spatial variations in heat flux across the core–mantle boundary, according to combined palaeomagnetic datasets and geodynamo simulations.

Langstein-Skora, Schmid, Huth et al. propose that intrinsically disordered region functionality can be driven by the interplay between linear binding motifs and contextual chemical characteristics such as charge and hydrophobicity.

HIV-1 integrase forms an RNA-binding module on the luminal side of the mature capsid lattice.

Genome-wide association meta-analysis identifies 58 independent risk loci for major anxiety disorders among individuals of European ancestry and implicates GABAergic signaling as a potential mechanism underlying genetic risk for these disorders.

Native state proteomics of PV interneurons revealed unique molecular features of high translational and metabolic activity, and enrichment of Alzheimer’s risk genes. Early amyloid pathology exerted unique effects on mitochondria, mTOR signaling and neurotransmission in PV neurons.