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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.

Using carbonyl sulfide as a tracer, gross primary production in the Midwest USA is shown to significantly exceed that of any other region of North America. This approach provides a valuable means of assessing the regional accuracy of ecosystem land models.

Treatment with 4′-fluorouridine (also known as EIDD-2749) in an African green monkey (Chlorocebus aethiops) model of Lassa disease resulted in complete clearance of infectious virus in a high proportion of cases and prolonged survival to the pre-determined study end-point in all cases.

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.

Emissions from croplands are an important source of GHG emissions that can be shaped by management. This study presents maps of emissions globally for different crops, showing that drained peatlands, rice paddies and fertilizer were the main drivers, and highlights differences in emission intensity.

The contribution of ether lipid species in cancer cell fate has not been fully understood yet. Here the authors show that malignant cancer cells employ ether lipids to modulate membrane biophysical properties, enhancing iron endocytosis and ferroptosis susceptibility.

Understanding collective behaviour is an important aspect of managing the pandemic response. Here the authors show in a large global study that participants that reported identifying more strongly with their nation reported greater engagement in public health behaviours and support for public health policies in the context of the pandemic.

Donahue et al. show that ageing is associated with changes in ER morphology. ER-phagy drives age-associated ER remodelling through tissue-specific factors.

Global Burden of Disease estimates show that between 1990 and 2023, the prevalence and burden of drug use disorders, inclusive of amphetamine, cannabis, cocaine and opioid use, have been increasing in high-income countries, particularly in the USA.

This study shows that excessive atmospheric nitrogen deposition can enhance methane production and emissions by impacting microbial phosphorus acquisition due to the change of N/P ratios in oxygenated surface oceans.

Oceans provide essential ecosystem services to human society, yet the climate impacts on blue capital have long been ignored. Incorporating the latest works on ocean science and economics, researchers show that accounting for the potential damage would almost double the social cost of carbon estimation.

Projected impacts of climate change on malaria burden in Africa by 2050 highlight the urgent need for climate-resilient malaria control strategies and robust emergency response systems to safeguard progress towards malaria eradication.

Currently, there is no licensed vaccine for Burkholderia pseudomallei, the causative agent of melioidosis. Here, the authors evaluate the efficacy and safety of an outer-membrane vesicle vaccine in macaques and demonstrate that it prevents lung pathology.

Estimates from the Global Burden of Disease study reveal declines in chronic respiratory disease mortality between 1990 and 2023—especially during the COVID-19 pandemic—but the burdens on people affected remain substantial.

This study analyses the geographic patterns of US federal environmental crime prosecutions over 2011–2020, showing that, on average, they tend to occur more in counties with higher socioeconomic status than in the most environmentally degraded areas of the USA.

cellSTAAR advances noncoding rare variant association analysis by integrating single-cell genomics data.

A library of 400 phage protein-coding genes is used to find a trove of antiphage systems, revealing systems that target tail fibre and major capsid proteins.

The authors survey community palaeontological databases, documenting their contributions to science as well as their vulnerabilities, and provide recommendations for the future of open science databases.

Current long acting HIV therapies face challenges like prolonged pharmacokinetic tails, which increase resistance risk. The authors develop dimeric bictegravir prodrug nanosuspensions that sustain therapeutic levels for six months with a short PK tail, supporting safer ultra-long-acting HIV treatment.

Solitons are waves, occurring in systems such as water channels and optical fibres that preserve their shape as they travel. Here the observation of solitons in multimode optical fibres offers a platform for studying spatiotemporal wave packets, and could allow high peak power transmission along with increased data rates in low-cost telecommunications.

Moutsopoulos, Williams and colleagues show oral mucosal barrier tissues exhibit dynamic zonal immune cell environments, including tonic inflammatory features in healthy individuals and development of tertiary lymphoid structures with the potential to support local antibody production in periodontitis.

Data provided by Amazonian peoples are used to estimate the value of wild animals as a source of food, including its spatial distribution and nutritional value, providing information that will be key for improved management of forest ecosystems in the region.

Identifying jets originating from heavy quarks plays a fundamental role in hadronic collider experiments. In this work, the ATLAS Collaboration describes and tests a transformer-based neural network architecture for jet flavour tagging based on low-level input and physics-inspired constraints.

Total precipitation, temperature and soil nitrogen are the main drivers of gross primary productivity in dry rangelands in sub-Saharan Africa, with more variable rainfall having a small but negative impact, according to analysis of remote sensing datasets using generalised additive models.

Mutations in GJB2 cause DFNB1, the most common hereditary deafness. ATAC-seq identification of gene regulatory elements enables targeted GJB2 delivery to cochlear cells, preventing hearing loss in mouse models.

Prasad et al. assess four therapeutics in preventing lethal disease in an established nonhuman primate model of Ebola virus infection. They find that each therapy results in ~ 40% survival, suggesting the use of alternative strategies, such as combining therapeutics to combat Ebola.

Cellular nuisance compounds are a burden in chemical biology and drug screening. Here the authors profile prototypical cytotoxic and nuisance compounds using the cell painting assay to systematically characterise cellular morphologies associated with compound-dependent cellular injury and nuisance activity.

Improved vaccines and antivirals are needed for many enveloped viruses. Here, the authors identify sulfur-based small molecules that disrupt viral membrane properties, inhibiting fusion and entry, and safely inactivate influenza virus. The resulting inactivated influenza vaccine is protective in mice.

Humanity’s Last Exam, a multi-modal benchmark at the frontier of human knowledge, is designed to be an expert-level closed-ended academic benchmark with broad subject coverage.

Identifying low-cost options for a healthy diet is an essential step towards allowing all people to meet their nutritional needs. This study measures the frontiers of the lowest available cost and greenhouse gas emissions for a healthy diet in 171 countries, as well as healthy diets reflecting consumption patterns in each country.

An estimated area of 215 million hectares has the potential for natural forest regeneration across tropical forested countries and biomes, representing an above-ground carbon sequestration potential of 23.4 Gt C.

Peripartum cardiomyopathy (PPCM) is a potentially fatal heart condition with poorly understood molecular causes. Here, the authors show that loss of the protein PTRH2 in female mice leads to postpartum heart failure, identifying it as a potential therapeutic target.

Myeloid cells are implicated in the innate immune and inflammatory response during infection with Chlamydia trachomatis. Here the authors show the evasion of the neutrophil response to infection and concomitant induction of sterile immunity via the purinergic P2X7 receptor.

The authors couple calculations of historical heatwave intensity at present and future global temperatures with exposure–response functions to quantify mortality from extreme heat events in Europe. They project tens of thousands of excess deaths, with limited attenuation from existing adaptations.