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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.

Chronic care manages long-term, progressive conditions, while acute care handles short-term ones. Here, authors show chronic conditions account for most of the global health burden, with 68% of DALYs and 93% of YLDs attributed to chronic care needs.

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.

NBCn1 plays an important role as a base loader allowing breast cancer cells to survive in an acidic environment. Here, Wang et al report its near atomic structure and transport cycle involving minimal structural changes associated with an exceptionally high turnover rate, enabling efficient cellular base loading and tumor survival

This Resource paper presents a global SARS-CoV-2 phylogenetic tree of 4,471,579 high-quality genomes consistently constructed by Viridian, an efficient amplicon-aware assembler.

Ion-channel conductance levels are controlled by the bending patterns of pore-forming transmembrane helices in the heterotetrameric neuronal channel GluN1a-2B N-methyl-D-aspartate receptor.

Fine-scale geospatial mapping of overweight and wasting (two components of the double burden of malnutrition) in 105 LMICs shows that overweight has increased from 5.2% in 2000 to 6.0% in children under 5 in 2017. Although overall wasting decreased over the same period, most countries are not on track to meet the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025.

Combining patch-clamp electrophysiology, molecular dynamics simulations, cryo-electron microscopy and imaging of neuronal synapses, the authors reveal how AMPA glutamate receptors are regulated by protons that are released from synaptic vesicles during signal transmission.

Multi-ancestry meta-analyses of genome-wide association studies for self-reported physical activity during leisure time, leisure screen time, sedentary commuting and sedentary behavior at work identify 99 loci associated with at least one of these traits.

Hundreds of genetic loci associated with age at menopause, combined with experimental evidence in mice, highlight mechanisms of reproductive ageing across the lifespan.

SPNS2 exports S1P and FTY720-P to control immune cell migration. Here, the authors use cryo-EM, immunofluorescence, in vitro binding and in vivo S1P export, and MD simulations to uncover the mechanisms of SPNS2’s transport and inhibition.

Crystal structures of BAK core domain dimers suggest a mechanism by which lipids contribute to the oligomerization of BAK, which is essential for BAK-mediated permeabilization of the mitochondrial outer membrane.

Material from the Hokioi crater on asteroid Bennu experienced space weathering and suggests microcratering plays a more active role on carbonaceous bodies than initially thought, according to a study of OSIRIS-REx asteroid return samples.

Cryo-electron microscopy structures of NMDA receptors in open and apo states reveal the molecular mechanism underlying the dual ligand requirement for its channel gating and opening.

The use of ferroeletric materials for multi-state device applications is still challenging. Here, the authors present a mechanism to stabilize non-volatile polarization states by populating volume fractions of two domain structures in PbZr_0.2Ti_0.8O₃ via kinetic control of switching pathways.

Standalone photocatalysts, when combined with sacrificial electron donors like methanol, often exhibit high hydrogen production rates. However, these catalysts typically fail to maintain performance in Z-scheme systems. Recent studies have provided insights into this longstanding issue.

A chemically complex alloy that exhibits a high elastic strain limit and low internal friction is described; it also has an Elinvar effect (invariant elastic modulus) over a large temperature range, up to 627 °C.

A high-resolution, global atlas of mortality of children under five years of age between 2000 and 2017 highlights subnational geographical inequalities in the distribution, rates and absolute counts of child deaths by age.

The mechanisms involved in SLC4-mediated ion transport are still under debate. Here, the authors present a cryoEM structure of the Sodium-driven Chloride/Bicarbonate Exchanger NDCBE, which - together with computational modeling and mutagenesis - reveals molecular determinants of ion transport by SLC4.

Cryo-EM structures of nick forming complexes of the mouse RAG recombinase with DNA substrates demonstrate how the RAG active site is reconfigured for two consecutive DNA cleavage reactions.

Analysis of the pulse profile of a fast radio burst showed sub-second periodicity, providing evidence for a neutron-star origin of the event and favouring emission arising from the magnetosphere.

Bhattacharjee and Schaeffer et al. map exclusive breastfeeding (EBF) in 94 low- and middle-income countries (LMICs), finding increased EBF practice and reduced subnational variation across the majority of LMICs from 2000 to 2018. However, only six LMICs will meet WHO’s target of ≥70% EBF by 2030 nationally, and only three will achieve this in all districts.

Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations.

Base editor technology combined with a fluorescent reporter of DNA methyltransferase activity enable in situ mutational scanning of DNMT3A, revealing a requirement of DNA binding by the PWWP histone reader domain for full activity.

Extra-intestinal pathogenic Escherichia coli cause urinary tract and bloodstream infections. Here, the authors show how mutations that disrupt the production of cellulose, a polysaccharide produced by many bacteria, drive enhanced virulence.

Mass spectrometry and biochemical analyses reveal that the major form of VKOR found in cells features a disulfide bond between Cys51 and Cys132, and this intermediate is the target of the anticoagulant drug warfarin.

Shwachman-Diamond syndrome (SDS) is a leukemia predisposition disorder that is caused by defective release of eIF6 during ribosome assembly. Here the authors show that acquired somatic EIF6 mutations are frequent in the hematopoietic cells from individuals with SDS and provide a selective advantage over non-modified cells.

An analysis of the impact of logging intensity on biodiversity in tropical forests in Sabah, Malaysia, identifies a threshold of tree biomass removal below which logged forests still have conservation value.

Only one repeating fast radio burst has been localized, to an irregular dwarf galaxy; now another is found to come from a star-forming region of a nearby spiral galaxy.

Dimethyl fumarate (DMF) is an anti-inflammatory drug proposed as a treatment for COVID19. Here the results are reported from a randomised trial testing DMF treatment in 713 patients hospitalised with COVID-19. DMF was not associated with any improvement in day 5 outcomes.

In the quest for green ethylene production, perovskite oxides show promise as photocatalysts able to strip hydrogen from ethane and generate ethylene with solar energy.

The fast radio burst FRB 20200120E is shown to originate from a globular cluster in the galaxy M81, and may be a collapsed white dwarf or a merged compact binary star system.

The cryo-EM structure of the full-length TRPV5 channel in complex with inhibitor econazole reveals a domain-swapped architecture and provides insights into mechanisms of inhibition.

Systemic lupus erythematosus is associated with neurological impairment. Here the authors show that exposure of hippocampal neurons to lupus autoantibodies in mice initiates a neuroinflammatory state sustained by continuous HMGB1:RAGE signaling that can be reversed with an ACE inhibitor.

Hv1 voltage-gated proton channels lack a canonical pore domain and selectivity filter, suggesting the mechanism of permeation differs from other cation channels. Mutagenesis with conductance measurements coupled with molecular dynamics simulations now indicate that Hv1 has an internal water wire mediating selective H⁺ transport.

John Perry, Ken Ong and colleagues analyze genotype data on ∼370,000 women and identify 389 independent signals that associate with age at menarche, implicating ∼250 genes. Their analyses suggest causal inverse associations, independent of BMI, between puberty timing and risks for breast and endometrial cancers in women and prostate cancer in men.

The neuronal sorting receptor SorLA protects against Alzheimer's disease by binding Aβ peptides. Three new structures of the Vps10p Aβ-binding domain in ligand-free and ligand-bound forms explain the basis of SorLA peptide recognition.

Paul Gissen and colleagues show that mutations in VIPAR cause a syndrome marked by arthrogryposis, renal dysfunction and cholestasis accompanied by defects in epithelial polarization. Their functional studies suggest that VIPAR forms a functional complex with VPS33B that interacts with RAB11A.