Nature Medicine最新文献

{"title":"HIV-1 remission following stem cell transplant without CCR5Δ32 mutation","authors":"","doi":"10.1038/s41591-024-03365-0","DOIUrl":"https://doi.org/10.1038/s41591-024-03365-0","url":null,"abstract":"We report the first case of a person achieving sustained HIV-1 remission after transplantation with allogeneic hematopoietic stem cells that express wild-type CCR5 and thus are permissive to HIV-1 infection. The 53-year-old man received the transplant in 2018 to treat a rare myeloid sarcoma and has not experienced viral rebound since discontinuing antiretroviral therapy in November 2021.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"16 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588606","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":"A systematic review and meta-analysis of heat exposure impacts on maternal, fetal and neonatal health","authors":"Darshnika P. Lakhoo, Nicholas Brink, Lebohang Radebe, Marlies H. Craig, Minh Duc Pham, Marjan M. Haghighi, Amy Wise, Ijeoma Solarin, Stanley Luchters, Gloria Maimela, Matthew F. Chersich","doi":"10.1038/s41591-024-03395-8","DOIUrl":"https://doi.org/10.1038/s41591-024-03395-8","url":null,"abstract":"<p>Climate Change has severe and wide-ranging health impacts, especially for vulnerable groups. Despite growing evidence of heat-associated adverse maternal and neonatal health outcomes, there remains a lack of synthesis quantifying associations and identifying specific risk periods. We systematically reviewed the literature on heat impacts on maternal, fetal, and neonatal health, and quantified impacts through meta-analyses. We found 198 studies across66 countries, predominantly high income (63.3%) and temperature climate zones (40.1%), and 23 outcomes. Results showed increased odds of preterm birth of 1.04 (95%CI = 1.03, 1.06; n = 12) per 1°C increase in heat exposure and 1.26 (95%CI = 1.08, 1.47; n = 10) during heatwaves. Similarly high heat exposure increased the risk for stillbirths (OR = 1.13 (95%CI=0.95, 1.34; n = 9)), congenital anomalies (OR=1.48 (95%CI = 1.16, 1.88; n = 6)), and gestational diabetes mellitus (OR = 1.28 (95%CI = 1.05, 1.74; n = 4)). The odds of any obstetric complication increased by 1.25 (95%CI = 1.09, 1.42; n = 11) during heatwaves. Patterns in susceptibility windows varied by condition. The findings were limited by heterogeneity in exposure metrics and study designs. The systematic review demonstrated that escalating heat exposure poses a major threat to maternal and neonatal health, highlighting research priorities, guiding the selection and monitoring of heat-health indicators, and emphasising the need to prioritise maternal and neonatal health in national climate-health programmes.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"153 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580265","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":"Clinical validation of an AI-based pathology tool for scoring of metabolic dysfunction-associated steatohepatitis","authors":"Hanna Pulaski, Stephen A. Harrison, Shraddha S. Mehta, Arun J. Sanyal, Marlena C. Vitali, Laryssa C. Manigat, Hypatia Hou, Susan P. Madasu Christudoss, Sara M. Hoffman, Adam Stanford-Moore, Robert Egger, Jonathan Glickman, Murray Resnick, Neel Patel, Cristin E. Taylor, Robert P. Myers, Chuhan Chung, Scott D. Patterson, Anne-Sophie Sejling, Anne Minnich, Vipul Baxi, G. Mani Subramaniam, Quentin M. Anstee, Rohit Loomba, Vlad Ratziu, Michael C. Montalto, Nick P. Anderson, Andrew H. Beck, Katy E. Wack","doi":"10.1038/s41591-024-03301-2","DOIUrl":"https://doi.org/10.1038/s41591-024-03301-2","url":null,"abstract":"<p>Metabolic dysfunction-associated steatohepatitis (MASH) is a major cause of liver-related morbidity and mortality, yet treatment options are limited. Manual scoring of liver biopsies, currently the gold standard for clinical trial enrollment and endpoint assessment, suffers from high reader variability. This study represents the most comprehensive multisite analytical and clinical validation of an artificial intelligence (AI)-based pathology system, AI-based measurement of metabolic dysfunction-associated steatohepatitis (AIM-MASH), to assist pathologists in MASH trial histology scoring. AIM-MASH demonstrated high repeatability and reproducibility compared to manual scoring. AIM-MASH-assisted reads by expert MASH pathologists were superior to unassisted reads in accurately assessing inflammation, ballooning, MAS ≥ 4 with ≥1 in each score category and MASH resolution, while maintaining non-inferiority in steatosis and fibrosis assessment. These findings suggest that AIM-MASH could mitigate reader variability, providing a more reliable assessment of therapeutics in MASH clinical trials.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"16 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574584","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":"Culturally adapted CBT for postnatal depression","authors":"","doi":"10.1038/d41591-024-00077-3","DOIUrl":"https://doi.org/10.1038/d41591-024-00077-3","url":null,"abstract":"In British South Asian women, a culturally adapted and community-informed cognitive behavioral therapy intervention led to higher early recovery rates than the usual treatment.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"87 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556372","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":"Exploring the limits of life extension","authors":"","doi":"10.1038/d41591-024-00076-4","DOIUrl":"https://doi.org/10.1038/d41591-024-00076-4","url":null,"abstract":"The twentieth century saw unprecedented rises in life expectancy in high-income countries, but data suggest that this trend will not continue in the current century without radical interventions to slow biological aging.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"16 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556373","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":"Mapping metastatic breast cancer complexity through single-cell and spatial profiling","authors":"","doi":"10.1038/s41591-024-03308-9","DOIUrl":"10.1038/s41591-024-03308-9","url":null,"abstract":"Techniques for single-cell and spatial expression profiling hold great promise for defining the complexity of metastatic microenvironments, but different methods give different representations. We profile 67 biopsies of metastatic breast cancer using up to 6 different methods, provide a systematic comparison and reveal spatial aspects of breast cancer biology across diverse clinicopathological features.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"30 11","pages":"3067-3068"},"PeriodicalIF":58.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541945","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":"A multi-modal single-cell and spatial expression map of metastatic breast cancer biopsies across clinicopathological features","authors":"Johanna Klughammer,&nbsp;Daniel L. Abravanel,&nbsp;Åsa Segerstolpe,&nbsp;Timothy R. Blosser,&nbsp;Yury Goltsev,&nbsp;Yi Cui,&nbsp;Daniel R. Goodwin,&nbsp;Anubhav Sinha,&nbsp;Orr Ashenberg,&nbsp;Michal Slyper,&nbsp;Sébastien Vigneau,&nbsp;Judit Jané‐Valbuena,&nbsp;Shahar Alon,&nbsp;Chiara Caraccio,&nbsp;Judy Chen,&nbsp;Ofir Cohen,&nbsp;Nicole Cullen,&nbsp;Laura K. DelloStritto,&nbsp;Danielle Dionne,&nbsp;Janet Files,&nbsp;Allison Frangieh,&nbsp;Karla Helvie,&nbsp;Melissa E. Hughes,&nbsp;Stephanie Inga,&nbsp;Abhay Kanodia,&nbsp;Ana Lako,&nbsp;Colin MacKichan,&nbsp;Simon Mages,&nbsp;Noa Moriel,&nbsp;Evan Murray,&nbsp;Sara Napolitano,&nbsp;Kyleen Nguyen,&nbsp;Mor Nitzan,&nbsp;Rebecca Ortiz,&nbsp;Miraj Patel,&nbsp;Kathleen L. Pfaff,&nbsp;Caroline B. M. Porter,&nbsp;Asaf Rotem,&nbsp;Sarah Strauss,&nbsp;Robert Strasser,&nbsp;Aaron R. Thorner,&nbsp;Madison Turner,&nbsp;Isaac Wakiro,&nbsp;Julia Waldman,&nbsp;Jingyi Wu,&nbsp;Jorge Gómez Tejeda Zañudo,&nbsp;Diane Zhang,&nbsp;Nancy U. Lin,&nbsp;Sara M. Tolaney,&nbsp;Eric P. Winer,&nbsp;Edward S. Boyden,&nbsp;Fei Chen,&nbsp;Garry P. Nolan,&nbsp;Scott J. Rodig,&nbsp;Xiaowei Zhuang,&nbsp;Orit Rozenblatt-Rosen,&nbsp;Bruce E. Johnson,&nbsp;Aviv Regev,&nbsp;Nikhil Wagle","doi":"10.1038/s41591-024-03215-z","DOIUrl":"10.1038/s41591-024-03215-z","url":null,"abstract":"Although metastatic disease is the leading cause of cancer-related deaths, its tumor microenvironment remains poorly characterized due to technical and biospecimen limitations. In this study, we assembled a multi-modal spatial and cellular map of 67 tumor biopsies from 60 patients with metastatic breast cancer across diverse clinicopathological features and nine anatomic sites with detailed clinical annotations. We combined single-cell or single-nucleus RNA sequencing for all biopsies with a panel of four spatial expression assays (Slide-seq, MERFISH, ExSeq and CODEX) and H&amp;E staining of consecutive serial sections from up to 15 of these biopsies. We leveraged the coupled measurements to provide reference points for the utility and integration of different experimental techniques and used them to assess variability in cell type composition and expression as well as emerging spatial expression characteristics across clinicopathological and methodological diversity. Finally, we assessed spatial expression and co-localization features of macrophage populations, characterized three distinct spatial phenotypes of epithelial-to-mesenchymal transition and identified expression programs associated with local T cell infiltration versus exclusion, showcasing the potential of clinically relevant discovery in such maps. Single-nucleus and single-cell RNA sequencing plus spatial profiling with four methods of core biopsies from 60 patients with metastatic breast cancer reveal patient-specific gene expression programs of breast cancer metastases that are maintained across time, site of metastasis and spatial profiling method, with spatial phenotypes correlating with microenvironmental features.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"30 11","pages":"3236-3249"},"PeriodicalIF":58.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41591-024-03215-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations to promote equity, diversity and inclusion in decentralized clinical trials","authors":"Olalekan Lee Aiyegbusi,&nbsp;Samantha Cruz Rivera,&nbsp;Paul Kamudoni,&nbsp;Nicola Anderson,&nbsp;Philip Collis,&nbsp;Alastair K. Denniston,&nbsp;Rosie Harding,&nbsp;Sarah E. Hughes,&nbsp;Kamlesh Khunti,&nbsp;Dipak Kotecha,&nbsp;Harlan Krumholz,&nbsp;Xiaoxuan Liu,&nbsp;Christel McMullan,&nbsp;Barbara Molony-Oates,&nbsp;Joao Monteiro,&nbsp;Puja Myles,&nbsp;Khadija Rerhou Rantell,&nbsp;Katherine Soltys,&nbsp;Ravinder Verdi,&nbsp;Roger Wilson,&nbsp;Melanie J. Calvert","doi":"10.1038/s41591-024-03323-w","DOIUrl":"10.1038/s41591-024-03323-w","url":null,"abstract":"Decentralized clinical trials involving the use of digital tools to facilitate remote research are gaining momentum. Rapid advancements in digital technologies have supported the adoption of these trials. These innovations facilitate virtual interactions between clinical trial teams and participants by making it easier to collect, transfer and store electronic data. While some studies have demonstrated the potential for these approaches to reduce barriers to clinical trial participation, they are associated with several challenges that may create or worsen existing health inequalities and limit the generalizability of trial results. Here we review the potential for digitally enabled and decentralized clinical trials to enhance clinical trial participation in an equitable manner. We describe the key barriers individuals from underserved groups may face, and provide recommendations to promote equity, diversity and inclusion. Digitally enabled and decentralized clinical trials could enable large-scale recruitment of diverse participants—but careful consideration of the barriers faced by underserved groups will be crucial to their success.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"30 11","pages":"3075-3084"},"PeriodicalIF":58.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41591-024-03323-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory reforms will boost African vaccine production and access","authors":"Niteen Wairagkar, Alex Juma Ismail, Dalia M. N. Abouhussein, Moji Christianah Adeyeye, Delese Mimi Darko, Adam Mitangu Fimbo, Richard T. Rukwata, Boitumelo (Tumi) Semete-Makokotlela, Michele Sidibe, Nicaise Ndembi","doi":"10.1038/s41591-024-03314-x","DOIUrl":"https://doi.org/10.1038/s41591-024-03314-x","url":null,"abstract":"Growing momentum to transform the African regulatory landscape should enable 60% of the vaccines needed in Africa to be locally produced by 2040.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"126 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520152","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":"Unprecedented spread and genetic evolution of the Oropouche virus","authors":"Marcia C. Castro, Antônio Silva Lima Neto","doi":"10.1038/s41591-024-03336-5","DOIUrl":"https://doi.org/10.1038/s41591-024-03336-5","url":null,"abstract":"The current Oropouche fever outbreak has been traced to a novel reassortant virus that emerged about a decade ago, which highlights the importance of One Health surveillance in preventing, predicting, detecting and responding to emerging threats.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"49 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142519277","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}