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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.

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.

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.

Federated learning (FL) algorithms have emerged as a promising solution to train models for healthcare imaging across institutions while preserving privacy. Here, the authors describe the Federated Tumor Segmentation (FeTS) challenge for the decentralised benchmarking of FL algorithms and evaluation of Healthcare AI algorithm generalizability in real-world cancer imaging datasets.

Here the authors provide an explanation for 95% of examined predicted loss of function variants found in disease-associated haploinsufficient genes in the Genome Aggregation Database (gnomAD), underscoring the power of the presented analysis to minimize false assignments of disease risk.

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.

Faure Walker and colleagues review the existing literature on intradiverticular bladder tumours, highlighting the challenges that exist in the management of malignant and premalignant conditions within bladder diverticula. They outline the only guidelines currently available, and provide their own recommendations for the diagnosis and treatment of these conditions.

Martini 3.0 is an updated and reparametrized force field for coarse-grained molecular dynamics simulations with new bead types and an expanded ability to model molecular packing and interactions.

Although plant functional trait combinations reflect ecological trade-offs at the species level, little is known about how this translates to whole communities. Here, the authors show that global trait composition is captured by two main dimensions that are only weakly related to macro-environmental drivers.

Predicting species responses to climate change may be complicated by the influence of other factors. Here, the authors report that warming is linked to terrestrial and freshwater community shifts towards warm-adapted species overall, but body size, thermal niche breadth, species richness and baseline temperature modulate the trends.

Correlations in momentum space between hadrons created by ultrarelativistic proton–proton collisions at the CERN Large Hadron Collider provide insights into the strong interaction, particularly the short-range dynamics of hyperons—baryons that contain strange quarks.

The authors show in an animal model and in a study in patients with dementia with Lewy bodies (DLB) that the drug neflamapimod has potential to treat diseases, such as DLB, associated with loss of neurons that produce the neurotransmitter acetylcholine.

By combining fisheries, nutrient, and carbon cycling data, this synthesis suggests that marine kelp forests, a dominant but often undescribed habitat, provide services with a potential value of $111,000/ha/year and a global yearly value of $500 billion.

Ureteropelvic junction obstruction (UPJO) is characterized by impaired flow of urine from the renal pelvis to the ureter and if left untreated can significantly impair renal function. Khan and colleagues provide an overview of the diagnosis and surgical treatment of UPJO, proposing optimal management strategies for this common condition.

Serotonin inhibits adipose tissue thermogenesis. Here the authors show that obese mice housed in thermoneutrality have increased mast cell serotonin synthesis, and that inhibiting this pathway through deletion of mast cell Tph1 increases white adipose tissue browning and protects against diet-induced obesity, insulin resistance and liver steatosis.

Lassa virus can cause haemorrhagic fever for which no specific treatment currently exists. Here the authors have cloned 113 monoclonal antibodies from the survivors of Lassa infection and show that the majority of neutralizing antibodies target a complex of GP1 and GP2 viral proteins.

Abbasi et al. evaluate the value of source data verification, a costly but traditional element of clinical trials. They find it is largely redundant when used with a systematic strategy to promote efficient and accurate data capture, monitoring, and safety in a phase II platform trial.

Trial Registration: https://clinicaltrials.gov/study/NCT04488081

This Perspective discusses fungal taxonomy and provides guidance for the naming of fungal taxa known only from sequences.

In patients with symptomatic femoroacetabular impingement (FAI), early correction of the anatomical dysfunction could delay or prevent the development of hip osteoarthritis. Accordingly, the past 5 years has seen a huge increase in minimally invasive, arthroscopic correction of FAI and a correspondingly rapid rise in FAI-related research. Khan and colleagues discuss the clinical evidence and emerging concepts of the pathophysiology, biomechanics and management of FAI.

High-resolution manometry (HRM) has transformed our understanding of oesophageal motility disorders, in particular achalasia. In this Consensus Statement, the authors explore the effect HRM has had on the diagnosis and management of achalasia and related syndromes.

IBS is a common gastrointestinal condition characterized by abdominal pain associated with altered bowel habits. Limited and judicious use of diagnostic testing is recommended, particularly in patients with typical symptoms without alarm signs and symptoms. Management of IBS is multifaceted and is often driven by illness severity, predominant symptoms and patient and practitioner preferences. Sarah Khan and Lin Chang discuss the current evidence-based recommendations for the diagnosis and management of IBS.

Authors from India and the US have systematically reviewed the literature on acute kidney injury. Their comprehensive exploration of this condition in developing countries reveals surprising commonalities between areas that are influenced by seemingly disparate geographical, etiological and cultural factors. Determining the true incidence of acute kidney injury is key to increasing awareness of the problem in underdeveloped regions, and to initiation of efforts to prevent its occurrence.

South Asia is thought to be the highest contributor to stroke mortality in the world, probably accounting for more than 40% of global stroke deaths. Wasay et al. review stroke epidemiology and management issues in four South Asian countries: India, Pakistan, Sri Lanka and Bangladesh. The authors highlight the prevalence of traditional and nontraditional stroke risk factors in this region, and consider the barriers to effective implementation of stroke prevention and treatment strategies.

Winski et al. evaluate the miRNA abundance in plasma of around 200 patients with abdominal aortic aneurysm (AAA) and matched controls. MiR-15a is identified as a candidate biomarker and AAA mouse models and additional patient samples are used to determine miR-15a’s localization, expression, and the impact of miR-15a dysregulation.

Simulation has become widely accepted as a supplementary method of training in urological skills, with the greatest number of procedure-specific models and subsequent validation studies carried out in the field of endourology. Skills simulators have been created for laparoscopic and robot-assisted surgery, but only a limited number of validated models are available for open procedures. In this Review, Aydin and colleagues discuss the various modalities of simulators available to urologists and suggest a curriculum for structured surgical training.

Extracellular vesicles mediate intercellular signalling and are potential sources of cancer biomarkers. Nawaz and colleagues describe the biogenesis of extracellular vesicles, and the methods available for their isolation and characterization. The authors also discuss current research into the identification of vesicle-derived biomarkers for cancers of the prostate, kidney and bladder.

Biomarkers have the potential to refine prognosis, improve risk stratification and guide therapy in patients on hemodialysis. The authors of this Review discuss the validation and potential use of biomarkers, including markers of chronic kidney disease-related mineral and bone disorders, markers of protein–energy wasting and inflammation, and markers of cardiovascular disease, in patients on hemodialysis. The authors also describe how proteomics can be used to identify and study new biomarkers.

Shifts in the position of adherens junctions, triggered by a change in the ratio of Bazooka and Par-1, initiate epithelial folding in the Drosophila embryo.

A diode that emits light at a shorter wavelength than ever before shows huge — albeit destructive — technological promise. But further work is needed to ensure that this promise is fulfilled.

In this Review article, Abboudi et al. provide an overview of the incidence, diagnosis, and management of ureteric injuries, particularly regarding the benefits of minimally invasive surgery compared with open techniques.

Beitel and colleagues show that the proto-oncogene Src regulates tracheal tube dimensions in Drosophila by directing anisotropic apical membrane growth in concert with the formin dDaam.

Researchers at Nichia Corporation have demonstrated green InGaN-based lasers grown on c-plane sapphire, with lifetimes capable of supporting commercial applications.