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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.

In this Review, the authors examine anticipated patterns of late morbidities that could emerge as a result of current treatments for Wilms tumour. Given the importance of a patient-centred follow-up strategy, they propose a practical classification system based on the likelihood of developing therapy-related late sequelae.

Wastewater-based surveillance tends to focus on specific pathogens. Here, the authors mapped the wastewater virome from 62 cities worldwide to identify over 2,500 viruses, revealing city-specific virome fingerprints and showing that wastewater metagenomics enables early detection of emerging viruses.

A global network of researchers was formed to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity; this paper reports 13 genome-wide significant loci and potentially actionable mechanisms in response to infection.

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.

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.

A genome-wide study by the Long COVID Host Genetics Initiative identifies an association between the FOXP4 locus and long COVID, implicating altered lung function in its pathophysiology.

The T cell response to SARS-CoV-2 is detected by a PCR assay on whole blood.

Marine protected areas are proposed to protect elasmobranchs (sharks, skates, and rays) but the fishing impact from small-scale fisheries in these areas is unknown. From 1256 fishing operations carried out in partially protected and unprotected areas in six Mediterranean countries, this study shows that catches were higher in partially protected areas than in unprotected areas, indicating poor small-scale fisheries management as a threat for these species.

The past year provided strong evidence on the use of the instantaneous wave-free ratio to determine the severity of coronary artery disease, the improving outcomes of contemporary percutaneous coronary intervention, the increased risk of thrombosis with bioresorbable vascular scaffolds, and the benefits of a simple revascularization strategy in cardiogenic shock.

Revascularization is currently recommended for patients with unprotected left main coronary artery disease. In this review, Chieffo and Colombo discuss the safety and effectiveness of percutaneous interventions involving drug-eluting stents as an alternative approach for treating this disease.

Michael Seldin and colleagues report a genome-wide association study and meta-analyses for primary biliary cirrhosis. They identify three loci newly associated with susceptibility to this autoimmune liver disease.

The medical literature contains a huge number of studies on the safety and performance of novel stent platforms, with primary outcomes usually assessed at 6 months or 1 year. The 5-year analysis from SORT OUT III demonstrates that, when assessing clinical outcomes in stent trials, 1-year follow-up is not enough.

Whole-genome sequencing, transcriptome-wide association and fine-mapping analyses in over 7,000 individuals with critical COVID-19 are used to identify 16 independent variants that are associated with severe illness in COVID-19.

Serum Amyloid P is a humoral component with established roles in the response to bacterial infection and regulation of tissue remodeling. Here the authors provide evidence to a further crucial role of serum amyloid P in the context of fungal pathogen Aspergillus fumigatus.

Identification of selective and effective anti-leishmanial compounds with potent in vitro and in vivo activity making them promising candidates for future drug development.

Magrini et. al. study sarcoma development and antitumor immune response in complement-deficient murine hosts, demonstrating a role for the C3a–C3aR axis in promoting immunosuppressive macrophages.

Bioresorbable vascular scaffolds (BVS) are new-generation stents that offer considerable advantages over traditional metallic implants. In this Review, Indolfi and colleagues provide an overview of the clinical studies on BVS, highlighting the importance of BVS implantation technique and the emerging safety profile of these devices in percutaneous coronary intervention.

Understanding the emergence, evolution, and transmission of antibiotic resistance genes (ARGs) is essential to combat antimicrobial resistance. Here, Munk et al. analyse ARGs in hundreds of sewage samples from 101 countries and describe regional patterns, diverse genetic environments of common ARGs, and ARG-specific transmission patterns.

Sera from vaccinated individuals and some monoclonal antibodies show a modest reduction in neutralizing activity against the B.1.1.7 variant of SARS-CoV-2; but the E484K substitution leads to a considerable loss of neutralizing activity.

The impact of overlap of drug-eluting stents on clinical and angiographic outcomes is controversial. Individuals with long coronary lesions requiring implantation of multiple stents are an important patient subgroup for whom careful evaluation and decision-making with optimal stent deployment is needed to ensure the best possible short-term and long-term results.

The primary objective of invasive treatment strategies for multivessel coronary artery disease is complete anatomical revascularization. As objective evidence of ischemia can be provided by a functional assessment based on fractional flow reserve, the focus of contemporary treatment could shift from anatomical to functional revascularization. In this Perspectives article, the authors summarize the data that supports contemporary functional revascularization and its applicability to real-world practice.

Primary biliary cirrhosis is an autoimmune liver disease with poor therapeutic options. Here Cordell et al. a perform meta-analysis of European genome-wide association studies identifying six novel risk loci and a number of potential therapeutic pathways.

Human primary and metastatic tumors harbor CD4⁺ T_reg cells that can suppress antitumor immune responses. Bonnal et al. identify an intratumoral type 1 T_reg-like CD4⁺ T cell subset that expresses the transcription factor EOMES, granzyme K and CHI3L2. This EOMES⁺ T cell subset correlates with disease progression but is responsive to PD-1 checkpoint blockade immunotherapy.

Notch signalling is a fundamental negative regulator of epidermal stemness. Here, the authors show that cell mechanics through YAP/TAZ activity prevent primary human keratinocytes from differentiating by inhibiting cell-autonomous Notch signals.

Obtaining data on antimicrobial resistance (AMR) from healthy human populations is difficult. Here, Hendriksen et al. use metagenomic analysis to obtain AMR data from untreated sewage from 79 sites in 60 countries, finding correlations with socio-economic, health and environmental factors.