Nature Medicine最新文献

{"title":"Transmission through a heavy-tailed sexual contact network explains the New York City mpox outbreak","authors":"","doi":"10.1038/s41591-025-03695-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03695-7","url":null,"abstract":"An interdisciplinary analysis revealed that the 2022 mpox outbreak in New York City was initiated by dozens of introductions of mpox virus into New York City. Epidemic modeling suggests that infection of highly connected individuals in a heavy-tailed sexual contact network explains the rapid rise and fall of the outbreak.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"8 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Correction: Conditional ablation of Stat3 or Socs3 discloses a dual role for reactive astrocytes after spinal cord injury","authors":"Seiji Okada, Masaya Nakamura, Hiroyuki Katoh, Tamaki Miyao, Takuya Shimazaki, Ken Ishii, Junichi Yamane, Akihiko Yoshimura, Yukihide Iwamoto, Yoshiaki Toyama, Hideyuki Okano","doi":"10.1038/s41591-025-03737-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03737-0","url":null,"abstract":"<p>Correction to: <i>Nature Medicine</i> https://doi.org/10.1038/nm1425, published online 18 June 2006.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"71 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress with stem cell therapy in Parkinson’s disease","authors":"","doi":"10.1038/d41591-025-00029-5","DOIUrl":"https://doi.org/10.1038/d41591-025-00029-5","url":null,"abstract":"Two early-phase trials demonstrate the safety of stem cell-based therapies in patients with Parkinson’s disease and suggest promising clinical activity — paving the way for larger efficacy studies.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"104 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-voltage-area ablation for persistent atrial fibrillation: a randomized controlled trial","authors":"Masaharu Masuda, Akihiro Sunaga, Nobuaki Tanaka, Tetsuya Watanabe, Hitoshi Minamiguchi, Yasuyuki Egami, Takafumi Oka, Tomoko Minamisaka, Takashi Kanda, Masato Okada, Masato Kawasaki, Yasuhiro Matsuda, Koji Tanaka, Tomomi Yamada, Shungo Hikoso, Tomoharu Dohi, Koichi Inoue, Yohei Sotomi, Yasushi Sakata","doi":"10.1038/s41591-025-03674-y","DOIUrl":"https://doi.org/10.1038/s41591-025-03674-y","url":null,"abstract":"<p>Low-voltage areas (LVAs) in the left atrium may promote atrial fibrillation (AF), but the efficacy of LVA ablation for preventing arrhythmia has not been determined. In the present study, we carried out a multicenter, randomized controlled trial (SUPPRESS-AF) to investigate the efficacy of LVA ablation in patients with persistent AF who had left atrial LVAs. Patients with persistent AF and left atrial LVAs that covered ≥5 cm² of the left atrial surface on a voltage map after pulmonary vein isolation (PVI) were randomized to undergo LVA ablation (PVI + LVA-ABL group) or not (PVI-alone group) in a 1:1 fashion. Recurrence of AF or atrial tachycardia (AT) was monitored using 24-h Holter electrocardiography (ECG) and twice-daily portable ECG recordings. The primary endpoint was freedom from AF or AT recurrence without antiarrhythmic drug use during 1 year of follow-up. Of 1,347 patients (1,003 males and 344 females) who underwent initial ablation for AF, patients with left atrial LVAs were assigned to the PVI + LVA-ABL (<i>n</i> = 170) or the PVI-alone group (<i>n</i> = 171). Although the PVI + LVA-ABL group demonstrated a numerically higher rate of freedom from AF or AT recurrence compared with the PVI-alone group (61% (95% confidence interval (CI) = 53–68%) versus 50% (95% CI = 42–57%)), this difference did not reach statistical significance (<i>P</i> for log(rank) test = 0.127). There was no difference in the procedure-related serious adverse events between the two groups (1.7% versus 1.8%, <i>P</i> &lt; 0.0001). In conclusion, LVA ablation in addition to PVI did not significantly reduce 1-year AF or AT recurrence in patients with persistent AF with left atrial LVAs. Future studies are needed to identify patients who may receive greater benefit from LVA ablation.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"223 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision nutrition for cardiometabolic diseases","authors":"Marta Guasch-Ferré, Clemens Wittenbecher, Marie Palmnäs, Orly Ben-Yacov, Ellen E. Blaak, Christina C. Dahm, Tove Fall, Berit L. Heitmann, Tine R. Licht, Marie Löf, Ruth Loos, Chirag J. Patel, Carmelo Quarta, Leanne M. Redman, Eran Segal, Nicola Segata, Michael Snyder, Qi Sun, Deirdre K. Tobias, Frank B. Hu, Paul W. Franks, Rikard Landberg, Jennifer L. Sargent, Jordi Merino","doi":"10.1038/s41591-025-03669-9","DOIUrl":"https://doi.org/10.1038/s41591-025-03669-9","url":null,"abstract":"<p>Precision nutrition is a vibrant and rapidly evolving field of scientific research and innovation with the potential to deliver health, societal and economic benefits by improving healthcare delivery and policies. Advances in deep phenotyping technologies, digital tools and artificial intelligence have made possible early proof-of-concept research that expands the understanding of within- and between-person variability in responses to diet. These studies illustrate the promise of precision nutrition to complement the traditional ‘one size fits all’ dietary guidelines, which, while considering broad life-stage and disease-specific nutritional requirements, often lack the granularity to account fully for individual variations in nutritional needs and dietary responses. Despite these developments, however, considerable challenges remain before precision nutrition can be implemented on a broader scale. This Review examines the current state of precision nutrition research, with a focus on its application to reducing the incidence and burden of cardiometabolic diseases. We critically examine the evidence base, explore the potential benefits and discuss the challenges and opportunities ahead.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"35 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotics reduce vaccine responses in infants","authors":"","doi":"10.1038/d41591-025-00028-6","DOIUrl":"https://doi.org/10.1038/d41591-025-00028-6","url":null,"abstract":"Neonatal antibiotic exposure was found to negatively impact vaccine responses, probably mediated by decreased Bifidobacterium levels — which highlights potential strategies for enhancing vaccine efficacy in infants.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"44 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting transparency in AI for biomedical and behavioral research","authors":"Tina Hernandez-Boussard, Aaron Y. Lee, Julia Stoyanovich, Laura Biven","doi":"10.1038/s41591-025-03680-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03680-0","url":null,"abstract":"<p>Recent advancements in artificial intelligence (AI) in healthcare have highlighted the need for transparency, including explainability, interpretability, and accountability across the AI lifecycle^1,2. Transparency ensures stakeholders can make informed decisions about data and model reuse, fostering trust and fairness while aligning with regulatory frameworks. However, the concept of transparency lacks a clear definition for both biomedical research and clinical care, resulting in inconsistent practices.</p><p>This Correspondence focuses on transparency within the realm of AI-driven biomedical and behavioral research. Although the effect of AI on clinical care is crucial, this discussion centers on its implications for research, addressing gaps in data reuse, model generalization and fairness. The National Institutes of Health (NIH) Office of Data Science Strategy (ODSS) convened a workshop that brought together leading experts in AI, healthcare and ethics to examine transparency in this context³. The workshop findings highlight practical solutions tailored to research contexts, addressing documentation standards, patient and community co-design, and oversight mechanisms to achieve equitable outcomes.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"46 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"D3S-001 in advanced solid tumors with KRASG12C mutations: a phase 1 trial","authors":"Byoung Chul Cho, Shun Lu, Myung Ah Lee, Zhengbo Song, John J. Park, Sun Min Lim, Ziming Li, Jun Zhao, Gary Richardson, Yanqiao Zhang, Jun Zhang, Anwen Liu, Herbert H. Loong, Cheng Chen, Jia Wang, Yandong Shen, Zifei Fan, Qian Chen, Hui Wang, Jing Zhang, Zhi Jian Chen, Melissa L. Johnson, Tony Mok","doi":"10.1038/s41591-025-03688-6","DOIUrl":"https://doi.org/10.1038/s41591-025-03688-6","url":null,"abstract":"<p>D3S-001 is a next-generation KRAS-G12C inhibitor (G12Ci) designed to enhance target engagement efficiency and overcome growth factor-induced nucleotide exchange. D3S-001 was evaluated in a phase 1a dose-escalation study in patients with advanced solid tumors harboring <i>KRAS</i>^G12C mutation (<i>N</i> = 42) and a phase 1b expansion cohort of patients with non-small-cell lung cancer (NSCLC) whose disease progressed after prior G12Ci therapy (<i>N</i> = 20). The primary endpoints were safety and determination of the maximum tolerated dose. Secondary endpoints included pharmacokinetics, confirmed objective response rate (ORR) and disease control rate. D3S-001 demonstrated dose-dependent pharmacokinetics and no dose-limiting toxicities, and the maximum tolerated dose was not reached. Grade 3 treatment-related adverse events were reported in seven patients (16.7%) in the G12Ci-naive dose-escalation cohort and two patients (10.0%) in the G12Ci-pretreated NSCLC expansion cohort. There were no grade 4 or 5 treatment-related adverse events. D3S-001 600 mg was selected as the dose for further investigation based on pharmacokinetics. Confirmed ORR in the G12Ci-naive population was 73.5% overall (25 of 34), and 66.7% (14 of 21), 88.9% (8 of 9) and 75.0% (3 of 4) in patients with NSCLC, colorectal cancer and pancreatic ductal adenocarcinoma, respectively. Among patients with G12Ci-pretreated NSCLC, ORR was 30.0% (6 of 20) and disease control rate was 80.0% (16 of 20). This study demonstrates the safety and tolerability of D3S-001 monotherapy with promising antitumor activity. The phase 1b expansion phase is ongoing. ClinicalTrials.gov identifier: NCT05410145.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"35 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPIRIT 2025 statement: updated guideline for protocols of randomized trials","authors":"An-Wen Chan, Isabelle Boutron, Sally Hopewell, David Moher, Kenneth F. Schulz, Gary S. Collins, Ruth Tunn, Rakesh Aggarwal, Michael Berkwits, Jesse A. Berlin, Nita Bhandari, Nancy J. Butcher, Marion K. Campbell, Runcie C. W. Chidebe, Diana R. Elbourne, Andrew J. Farmer, Dean A. Fergusson, Robert M. Golub, Steven N. Goodman, Tammy C. Hoffmann, John P. A. Ioannidis, Brennan C. Kahan, Rachel L. Knowles, Sarah E. Lamb, Steff Lewis, Elizabeth Loder, Martin Offringa, Philippe Ravaud, Dawn P. Richards, Frank W. Rockhold, David L. Schriger, Nandi L. Siegfried, Sophie Staniszewska, Rod S. Taylor, Lehana Thabane, David J. Torgerson, Sunita Vohra, Ian R. White, Asbjørn Hróbjartsson","doi":"10.1038/s41591-025-03668-w","DOIUrl":"https://doi.org/10.1038/s41591-025-03668-w","url":null,"abstract":"<p>The protocol of a randomized trial is the foundation for study planning, conduct, reporting and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. Here, we aimed to systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomized trial. We completed a scoping review and developed a project-specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (Harms, Outcomes, Non-pharmacological Treatment) and other reporting guidelines (TIDieR). The potential modifications were rated in a three-round Delphi survey followed by a consensus meeting. Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of two new protocol items, revision to five items, deletion/merger of five items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct and reporting. The updated SPIRIT 2025 statement consists of an evidence-based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrollment, interventions and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policymakers, regulators and other reviewers.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"138 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The stochasticity of biological aging","authors":"David H. Meyer, Björn Schumacher","doi":"10.1038/s41591-025-03687-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03687-7","url":null,"abstract":"<p>The recent <i>Nature Medicine</i> World View by M. Arfan Ikram¹ cites our article on the role of stochasticity in aging clocks as evidence for limited biological information from age predictors². Following a further Correspondence by Ferrucci et al.³, we find it important to clarify the roles of stochasticity in aging and in age prediction and to have an open debate on this topic.</p><p>The idea of aging as a genetically controlled process began with Cynthia Kenyon’s observation that a mutation in the <i>daf-2</i> gene doubled the lifespan of worms. This led to the identification of mechanisms of aging that could be targeted genetically but also pharmacologically to slow the aging process. For example, treating mice with the mTOR inhibitor rapamycin extended lifespan⁴, and current clinical studies of the effects of GLP-1 receptor agonists have shown a reduction in age-related diseases, from heart disease to kidney disease⁵. In fact, the oldest lifespan-extending intervention, calorie restriction, was shown to provide beneficial effects on health in humans⁶.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"43 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}