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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.

Non-pharmaceutical interventions for COVID-19 also reduced circulation of endemic viruses which may have led to immune waning. Here, the authors use multiplex serology data from King County, Washington, US to characterise age-specific changes in antibody levels to a range of endemic viruses during the COVID-19 pandemic.

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.

Several transmission-blocking vaccine candidates based on Pfs230 and Pfs48/45 are in clinical development, but it remains unclear whether they will demonstrate high efficacy. Here, the authors develop a stabilized chimeric antigen presenting potent epitopes from Pfs230 and Pfs48/45 in a single construct and demonstrate induction of transmission-reducing antibodies when female mice are immunized with the antigen in a self-assembling protein nanoparticle formulation.

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.

A large cross-population atlas of gene–environment interactions reveals how age, sex and lifestyle shape genetic effects, heritability, prediction accuracy and disease biology, with implications for personalized medicine and drug development.

There is a lack of effective therapies for patients with non-V600E BRAF mutant cancer. Here, the authors report limited response in a phase II trial investigating the combination of binimetinib (MEK inhibitor) and encorafenib (BRAF inhibitor) for the treatment of non-V600E BRAF mutant cancer and subsequently investigate resistance mechanisms and combination therapeutic strategies in patient-derived models.

Women of reproductive age may have specific concerns relating to perceived impacts on fertility and menstrual cycles that make them hesitant to receive COVID-19 vaccination. In this study, the authors explore COVID-19 vaccine uptake rates in women of reproductive age using linked data for ~13 million women in England.

A royal banquet has been reconstructed from residues in pots found inside the tomb.

King Richard III was a controversial English King whose remains are presumably deposited in Grey Friars in Leicester. Here the authors sequence the mitochondrial genome and Y-chromosome DNA of the skeletal remains and living relatives of Richard III and confirm that the remains belong to King Richard III.

Nuzum et al. used cross-sectional data from the UK PROTECT study to evaluate the relationship between high autistic traits and suicidality in older adults.

While oral bacteria rarely colonize the healthy gut, they dominate the gut microbiome of patients with chronic liver disease. Here a bacterial gene encoded by microbial translocators is linked to gut barrier disruption and fibrosis.

The electronic behaviour of complex oxides such as LaNiO₃ depends on many intrinsic and extrinsic factors, making it challenging to identify microscopic mechanisms. Here the authors demonstrate the influence of oxygen vacancies on the thickness-dependent metal-insulator transition of LaNiO₃ films.

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.

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.

This study finds that native tree extinctions and alien naturalizations are pushing forests towards fast-growing, resource-demanding species. This global shift could affect carbon storage and ecosystem stability, highlighting the need to protect slow-growing trees.

Many studies assess which jobs risk automation, but less is known about how skill demands shift within surviving jobs. Here the authors show that U.S. lower-skilled occupations face the steepest upskilling requirements, especially in small firms and labor markets.

The study reports the discovery of a persistent bow shock around a diskless magnetic accreting white dwarf, revealing a powerful energy-loss mechanism that challenges current models of accretion and compact binary evolution.

A van der Waals heterostructure made from atomic layers of ferroelectric CuCrP₂S₆ and ferromagnetic Fe₃GeTe₂ can offer reversible, non-volatile ferroelectric control of two-dimensional magnetism.

A wide survey of pesticide effects on soil biodiversity across 373 sites in Europe reveals that pesticide residues occur in 70% of sites and have major effects on soil biodiversity and functional ecology.

Cullin-RING ligases are regulated by the COP9 signalosome (CSN) through deneddylation. Here, authors report high-resolution cryo-EM structures that capture catalytic and dissociation intermediates, identify CSNAP within the complex, and reveal a stepwise pathway for CSN disengagement.

The microbiomes associated with reef corals are complex and diverse. Here, the authors investigate fire coral clones naturally occurring in distinct habitats as a model system to disentangle the contribution of host genotype and environment on their microbiome, and predict genomic functions based on taxonomic profiles.

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.

The Taiwan Precision Medicine Initiative (TPMI) has built a cohort of more than half a million individuals with Han Chinese ancestry, providing a rich resource of genetic and medical data for this group.

There are limited data on mpox immunity in West Africa. In this study, authors present serological and genomic evidence of residual smallpox vaccination immunity and possibly unrecognized mpox exposure among ostensibly healthy Nigerian adults.

From 6,141 Qatari genomes the authors chart structural variants tied to large-scale protein data, biobank traits and everyday health measures. When combined with single nucleotide variants, they find that 1 in 30 participants have a medically actionable genomic finding. The work builds a detailed structural variation reference for Arab ancestries worldwide.

Here, a combination of forward genetics and genome-wide association analyses has been used to show that variation at a single genetic locus in Arabidopsis thaliana underlies phenotypic variation in vegetative growth as well as resistance to infection. The strong enhancement of resistance mediated by one of the alleles at this locus explains the allele's persistence in natural populations throughout the world, even though it drastically reduces the production of new leaves.

During development of eutherian females, one of the X-chromosomes is silenced. Here, authors show that alleles on the inactive X-chromosome are dynamically expressed along neural differentiation enhancing resilience of female neural tissue.

Addressing how the nitrogen-induced changes in plant diversity differ from those in soil organisms is critical. This global meta-analysis suggests that nitrogen enrichment has stronger negative effects on plant diversity but modest to negligible effects on soil bacterial and fungal diversity.

Superconducting-qubit quantum annealers have served as platforms for simulating condensed-matter phenomena. Sathe et al. use a quantum annealer to probe critical phenomena in classical magnets by reliably sampling thermal distributions, revealing universal signatures of phase transitions without classical slowdowns.

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Antarctica is increasingly popular as a site for tourism and scientific research. The growth of marine traffic and the presence of major research stations have increased the anthropogenic deposition of heavy metals into this fragile ecosystem.

Structural and functional analysis shows that only SH3 domains forming tertiary contacts with p85 release p110 inhibition, revealing a binding-mode–based selection mechanism that ensures specific activation of PI3K.

Genomic analyses applied to 14 childhood- and adult-onset psychiatric disorders identifies five underlying genomic factors that explain the majority of the genetic variance of the individual disorders.

The phase 3 STEER trial showed that a single intrathecal dose of onasemnogene abeparvovec significantly improved motor function in children and adolescents with spinal muscular atrophy versus sham, with a similar and acceptable safety profile.

De novo and inherited dominant variants in genes encoding U4 and U6 small nuclear RNAs are identified in individuals with retinitis pigmentosa. The variants cluster at nucleotide positions distinct from those implicated in neurodevelopmental disorders.