Nature Medicine最新文献

{"title":"Author Correction: Rps14 haploinsufficiency causes a block in erythroid differentiation mediated by S100A8 and S100A9","authors":"Rebekka K Schneider, Monica Schenone, Monica Ventura Ferreira, Rafael Kramann, Cailin E Joyce, Christina Hartigan, Fabian Beier, Tim H Brümmendorf, Ulrich Germing, Uwe Platzbecker, Guntram Büsche, Ruth Knüchel, Michelle C Chen, Christopher S Waters, Edwin Chen, Lisa P Chu, Carl D Novina, R Coleman Lindsley, Steven A Carr, Benjamin L Ebert","doi":"10.1038/s41591-024-03350-7","DOIUrl":"https://doi.org/10.1038/s41591-024-03350-7","url":null,"abstract":"<p>Correction to: <i>Nature Medicine</i> https://doi.org/10.1038/nm.4047, published online 15 February 2016.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487169","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":"Economics, equity and avoidable mortality","authors":"Jeong-Yeon Cho, Nathorn Chaiyakunapruk","doi":"10.1038/s41591-024-03303-0","DOIUrl":"https://doi.org/10.1038/s41591-024-03303-0","url":null,"abstract":"Two new studies characterize the unequal global burden of avoidable mortality and the economic value of reducing it — providing evidence to support targeted investment in health and longevity.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452452","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 Cannabis and Health Research Initiative will help integrate medicinal cannabis in healthcare","authors":"Johannes Thrul, Ryan Vandrey","doi":"10.1038/s41591-024-03288-w","DOIUrl":"https://doi.org/10.1038/s41591-024-03288-w","url":null,"abstract":"<p>In the USA, there are more than 5.5 million registered patients in state-regulated medicinal cannabis programs and many people use hemp products (sourced from cannabis containing &lt;0.3% delta-9-tetrahydrocannabinol (THC) by dry weight) for therapeutic purposes. However, clinical research on non-pharmaceutical cannabis products remains limited¹, healthcare providers feel inadequately trained on integrating medicinal cannabis into their practice², and medicinal cannabis use is poorly documented in electronic medical records (EMRs)³. These issues highlight the need for patient-level data on the impacts of medicinal cannabis use⁴.</p><p>With legalization of retail cannabis sales in some US states, the diversity of cannabis products available to consumers has substantially increased⁵. Products vary in chemical composition⁶, dose and intended route of administration, all of which can affect clinical effect, safety and abuse liability, and should be considered in clinical decision making. The diversity in cannabis products and the use of poorly defined nomenclature contributes to difficulty in assessing the health effects of medicinal cannabis.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452451","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":"Safety principles for medical summarization using generative AI","authors":"Dillon Obika, Christopher Kelly, Nicola Ding, Chris Farrance, Jonathan Krause, Praney Mittal, Donny Cheung, Heather Cole-Lewis, Madeleine Elish, Alan Karthikesalingam, Dale Webster, Bakul Patel, Michael Howell","doi":"10.1038/s41591-024-03313-y","DOIUrl":"https://doi.org/10.1038/s41591-024-03313-y","url":null,"abstract":"Google’s development of MedLM found that risk management processes were an essential tool to protect patient safety.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452449","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":"Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial","authors":"Rachel D. Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J. Lagerberg, Maheen Rizvi, Sarah S. Kwon, Paulette Orhii, David Maislin, Lucia Hernandez, Rodrigo Machado-Vieira, Jair C. Soares, Allan H. Young, Cynthia H. Y. Fu","doi":"10.1038/s41591-024-03305-y","DOIUrl":"https://doi.org/10.1038/s41591-024-03305-y","url":null,"abstract":"<p>Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (<i>n</i> = 87, mean age = 37.09 ± 11.14 years) or sham (<i>n</i> = 87, mean age = 38.32 ± 10.92 years) treatment. tDCS consisted of five sessions per week for 3 weeks then three sessions per week for 7 weeks in a 10-week trial, followed by a 10-week open-label phase. Each session lasted 30 min; the anode was placed over the left dorsolateral prefrontal cortex and the cathode over the right dorsolateral prefrontal cortex (active tDCS 2 mA and sham tDCS 0 mA, with brief ramp up and down to mimic active stimulation). As the primary outcome, depressive symptoms showed significant improvement when measured using the Hamilton Depression Rating Scale: active 9.41 ± 6.25 point improvement (10-week mean = 9.58 ± 6.02) and sham 7.14 ± 6.10 point improvement (10-week mean = 11.66 ± 5.96) (95% confidence interval = 0.51–4.01, <i>P</i> = 0.012). There were no differences in discontinuation rates. In summary, a 10-week home-based tDCS treatment with remote supervision in MDD showed high efficacy, acceptability and safety. ClinicalTrials.gov registration: NCT05202119</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452163","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":"An ethics assessment tool for artificial intelligence implementation in healthcare: CARE-AI","authors":"Yilin Ning, Xiaoxuan Liu, Gary S. Collins, Karel G. M. Moons, Melissa McCradden, Daniel Shu Wei Ting, Jasmine Chiat Ling Ong, Benjamin Alan Goldstein, Siegfried K. Wagner, Pearse A. Keane, Eric J. Topol, Nan Liu","doi":"10.1038/s41591-024-03310-1","DOIUrl":"https://doi.org/10.1038/s41591-024-03310-1","url":null,"abstract":"<p>The deployment of artificial intelligence (AI)-powered prediction models in healthcare can lead to ethical concerns about their implementation and upscaling. For example, AI prediction models can hinder clinical decision-making if they advise different diagnoses or treatments by sex and gender or by race and ethnicity without clear justification. Recent guidance (such as the WHO guidance on ethics and governance of AI for health and the Dutch guideline on AI for healthcare) and legislation (such as the European Union AI Act and the White House Executive Order on Safe, Secure, and Trustworthy Development and Use of AI in United States) have outlined important principles for the implementation of AI, including ethical considerations^1,2. Health systems have responded by establishing governance committees and processes to ensure the safe and equitable implementation of AI tools³. However, there is currently no assessment tool that can identify and mitigate ethical issues during the implementation of AI prediction models in healthcare practice, including for public health.</p><p>The development and validation of AI prediction models has benefited from detailed reporting and risk-of-bias tools, such as TRIPOD+AI⁴ and PROBAST (with its forthcoming AI extension) for fairness and bias control and CLAIM⁵ for data privacy, security and interpretability of AI imaging studies. However, when planning the implementation of a rigorously developed and well-performing AI prediction model in healthcare practice, existing recommendations and guidance on ethics are sparse and lack operational detail. For example, the DECIDE-AI reporting guideline⁶ contains a small number of ethics-related recommendations for early clinical evaluation of AI concerning equity, safety and human-AI interaction, and FUTURE-AI⁷ provides recommendations based on six principles (fairness, universality, traceability, usability, robustness and explainability) in model design, development, validation and deployment. A bioethics-centric delivery science toolkit for responsible AI implementation in healthcare is needed⁸.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448336","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":"Systems education can train the next generation of scientists and clinicians","authors":"Péter Hegyi, András Varró","doi":"10.1038/s41591-024-03315-w","DOIUrl":"https://doi.org/10.1038/s41591-024-03315-w","url":null,"abstract":"<p>In recent years, there has been growing concern about waning interest in science, as despite advances in research and technology, fewer young people seem to be pursuing careers in these fields¹. This decline can be attributed to various factors, including a lack of early engagement, inadequate integration of practical experience and insufficient alignment between educational stages. To address this issue, the National Academy of Scientist Education (NASE) and Academia Europaea (AE) propose the concept of ‘multigenerational systems education’, a comprehensive approach that draws inspiration from systems biology and systems medicine.</p><p>The traditional methods of teaching science have failed to keep pace with the rapid advancements of the twenty-first century. Evidence of declining interest is reflected in the decreasing number of students enrolling in science courses at both the high school level and the university level¹. According to recent studies, fewer students are choosing to specialize in life sciences, with many perceiving these fields as inaccessible or irrelevant to real-world applications^2,3.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440841","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":"How to prepare for the next inevitable Ebola outbreak: lessons from West Africa","authors":"Henry Kyobe Bosa, Neema Kamara, Merawi Aragaw, Misaki Wayengera, Patrick D. M. C. Katoto, Chikwe Ihekweazu, Mosoka P. Fallah, Moussa Douno, Robert Kwame Agyarko, Placide Mbala, Mamadou Souncalo Traoré, Ambrose Talisuna, James Bangura, Henry G. Mwebesa, Abdoulaye Bousso, Obasanya Joshua, James Sylvester Squire, Tolbert Nyenswah, Thelma V. Nelson, Justin Maeda, Olushayo Oluseun Olu, Yonas Tegegn Woldemariam, Benjamin Djoudalbaye, Alain Ngashi Ngongo, Tajudeen Raji, Francis Chisaka Kasolo, Ibrahima Socé Fall, Ahmed Ouma Ogwell, Jane Ruth Aceng, Jean Kaseya","doi":"10.1038/s41591-024-03295-x","DOIUrl":"https://doi.org/10.1038/s41591-024-03295-x","url":null,"abstract":"Many lessons have been learned 10 years after the Ebola virus disease outbreak in West Africa, but urgent work is now needed to prevent another outbreak.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440848","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":"Helicobacter pylori, gastric cancer and the screening conundrum","authors":"","doi":"10.1038/d41591-024-00075-5","DOIUrl":"https://doi.org/10.1038/d41591-024-00075-5","url":null,"abstract":"A large study failed to show a reduction in gastric cancer incidence or mortality when Helicobacter pylori screening was added to standard colon cancer screening.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448337","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":"Perioperative immunotherapy for bladder cancer","authors":"","doi":"10.1038/d41591-024-00074-6","DOIUrl":"https://doi.org/10.1038/d41591-024-00074-6","url":null,"abstract":"In the NIAGARA trial, the addition of perioperative durvalumab to standard treatment for muscle-invasive bladder cancer improved event-free and overall survival, marking a new treatment option for this condition.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":null,"pages":null},"PeriodicalIF":82.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440821","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}