Nature Medicine最新文献_第5页

Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial 塞马鲁肽治疗超重或肥胖且无糖尿病的慢性肾病患者：随机双盲安慰剂对照临床试验

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-25 DOI: 10.1038/s41591-024-03327-6

Ellen M. Apperloo, Jose L. Gorriz, Maria Jose Soler, Secundino Cigarrán Guldris, Josep M. Cruzado, Maria Jesús Puchades, Marina López-Martínez, Femke Waanders, Gozewijn D. Laverman, Annemarie van der Aart-van der Beek, Klaas Hoogenberg, André P. van Beek, Jacobien Verhave, Sofia B. Ahmed, Roland E. Schmieder, Christoph Wanner, David Z. I. Cherney, Niels Jongs, Hiddo J. L. Heerspink

{"title":"Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial","authors":"Ellen M. Apperloo, Jose L. Gorriz, Maria Jose Soler, Secundino Cigarrán Guldris, Josep M. Cruzado, Maria Jesús Puchades, Marina López-Martínez, Femke Waanders, Gozewijn D. Laverman, Annemarie van der Aart-van der Beek, Klaas Hoogenberg, André P. van Beek, Jacobien Verhave, Sofia B. Ahmed, Roland E. Schmieder, Christoph Wanner, David Z. I. Cherney, Niels Jongs, Hiddo J. L. Heerspink","doi":"10.1038/s41591-024-03327-6","DOIUrl":"https://doi.org/10.1038/s41591-024-03327-6","url":null,"abstract":"Semaglutide reduces albuminuria and the risk of kidney disease progression in patients with type 2 diabetes and chronic kidney disease (CKD). We conducted a randomized placebo-controlled double-blind clinical trial in adults with CKD (estimated glomerular filtration rate (eGFR) ≥25 ml min−1 1.73 m−2 and urine albumin-to-creatinine ratio (UACR) ≥30 and <3,500 mg g−1) and body mass index ≥27 kg m−2. Participants were randomized to semaglutide 2.4 mg per week or placebo. The primary endpoint was percentage change from baseline in UACR at week 24. Safety was monitored throughout. Overall, 125 participants were screened, of whom 101 were randomized to semaglutide (n = 51) or placebo (n = 50). Mean age was 55.8 (s.d. 12) years; 40 participants (39.6%) were female; median UACR was 251 mg g−1 (interquartile range 100, 584); mean eGFR was 65.0 (s.d. 25) ml min−1 1.73 m−2; and mean body mass index was 36.2 (s.d. 5.6) kg m−2. Chronic glomerulonephritis (n = 25) and hypertensive CKD (n = 27) were the most common CKD etiologies. Treatment for 24 weeks with semaglutide compared to placebo reduced UACR by −52.1% (95% confidence interval −65.5, −33.4; P < 0.0001). Gastrointestinal adverse events were more often reported with semaglutide (n = 30) than with placebo (n = 15). Semaglutide treatment for 24 weeks resulted in a clinically meaningful reduction in albuminuria in patients with overweight/obesity and non-diabetic CKD. ClinicalTrials.gov registration: NCT04889183.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"212 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490077","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}

引用次数: 0

Subclassification of obesity for precision prediction of cardiometabolic diseases 对肥胖进行亚分类，精准预测心脏代谢疾病

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-24 DOI: 10.1038/s41591-024-03299-7

Daniel E. Coral, Femke Smit, Ali Farzaneh, Alexander Gieswinkel, Juan Fernandez Tajes, Thomas Sparsø, Carl Delfin, Pierre Bauvain, Kan Wang, Marinella Temprosa, Diederik De Cock, Jordi Blanch, José Manuel Fernández-Real, Rafael Ramos, M. Kamran Ikram, Maria F. Gomez, Maryam Kavousi, Marina Panova-Noeva, Philipp S. Wild, Carla van der Kallen, Michiel Adriaens, Marleen van Greevenbroek, Ilja Arts, Carel Le Roux, Fariba Ahmadizar, Timothy M. Frayling, Giuseppe N. Giordano, Ewan R. Pearson, Paul W. Franks

{"title":"Subclassification of obesity for precision prediction of cardiometabolic diseases","authors":"Daniel E. Coral, Femke Smit, Ali Farzaneh, Alexander Gieswinkel, Juan Fernandez Tajes, Thomas Sparsø, Carl Delfin, Pierre Bauvain, Kan Wang, Marinella Temprosa, Diederik De Cock, Jordi Blanch, José Manuel Fernández-Real, Rafael Ramos, M. Kamran Ikram, Maria F. Gomez, Maryam Kavousi, Marina Panova-Noeva, Philipp S. Wild, Carla van der Kallen, Michiel Adriaens, Marleen van Greevenbroek, Ilja Arts, Carel Le Roux, Fariba Ahmadizar, Timothy M. Frayling, Giuseppe N. Giordano, Ewan R. Pearson, Paul W. Franks","doi":"10.1038/s41591-024-03299-7","DOIUrl":"https://doi.org/10.1038/s41591-024-03299-7","url":null,"abstract":"Obesity and cardiometabolic disease often, but not always, coincide. Distinguishing subpopulations within which cardiometabolic risk diverges from the risk expected for a given body mass index (BMI) may facilitate precision prevention of cardiometabolic diseases. Accordingly, we performed unsupervised clustering in four European population-based cohorts (N ≈ 173,000). We detected five discordant profiles consisting of individuals with cardiometabolic biomarkers higher or lower than expected given their BMI, which generally increases disease risk, in total representing ~20% of the total population. Persons with discordant profiles differed from concordant individuals in prevalence and future risk of major adverse cardiovascular events (MACE) and type 2 diabetes. Subtle BMI-discordances in biomarkers affected disease risk. For instance, a 10% higher probability of having a discordant lipid profile was associated with a 5% higher risk of MACE (hazard ratio in women 1.05, 95% confidence interval 1.03, 1.06, P = 4.19 × 10−10; hazard ratio in men 1.05, 95% confidence interval 1.04, 1.06, P = 9.33 × 10−14). Multivariate prediction models for MACE and type 2 diabetes performed better when incorporating discordant profile information (likelihood ratio test P < 0.001). This enhancement represents an additional net benefit of 4−15 additional correct interventions and 37−135 additional unnecessary interventions correctly avoided for every 10,000 individuals tested.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"143 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488399","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}

引用次数: 0

An explainable foundation model for drug repurposing 药物再利用的可解释基础模型

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-24 DOI: 10.1038/s41591-024-03333-8

Alaa Bessadok, Francesca Grisoni

引用次数: 0

Global genomic surveillance of monkeypox virus 全球猴痘病毒基因组监测

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-23 DOI: 10.1038/s41591-024-03370-3

James R. Otieno, Christopher Ruis, Anyebe B. Onoja, Krutika Kuppalli, Ana Hoxha, Andreas Nitsche, Annika Brinkmann, Janine Michel, Placide Mbala-Kingebeni, Daniel Mukadi-Bamuleka, Muntasir Mohammed Osman, Hanadi Hussein, Muhammad Ali Raja, Richard Fotsing, Belinda L. Herring, Mory Keita, Jairo Mendez Rico, Lionel Gresh, Amal Barakat, Victoria Katawera, Karen Nahapetyan, Dhamari Naidoo, R. Andres Floto, Jane Cunningham, Maria D. Van Kerkhove, Rosamund Lewis, Lorenzo Subissi

{"title":"Global genomic surveillance of monkeypox virus","authors":"James R. Otieno, Christopher Ruis, Anyebe B. Onoja, Krutika Kuppalli, Ana Hoxha, Andreas Nitsche, Annika Brinkmann, Janine Michel, Placide Mbala-Kingebeni, Daniel Mukadi-Bamuleka, Muntasir Mohammed Osman, Hanadi Hussein, Muhammad Ali Raja, Richard Fotsing, Belinda L. Herring, Mory Keita, Jairo Mendez Rico, Lionel Gresh, Amal Barakat, Victoria Katawera, Karen Nahapetyan, Dhamari Naidoo, R. Andres Floto, Jane Cunningham, Maria D. Van Kerkhove, Rosamund Lewis, Lorenzo Subissi","doi":"10.1038/s41591-024-03370-3","DOIUrl":"https://doi.org/10.1038/s41591-024-03370-3","url":null,"abstract":"Monkeypox virus (MPXV) is endemic in Western and Central Africa and, in May 2022, a clade IIb lineage (B.1) caused a global outbreak outside Africa, resulting in its detection in 116 countries/territories. To understand the global phylogenetics of MPXV, we analysed all available MPXV sequences, including 10,670 sequences from 65 countries collected between 1958 and 2024. Our analysis reveals high mobility of clade I viruses within Central Africa, sustained human-to-human transmission of clade IIb lineage A viruses within the Eastern Mediterranean region, and distinct mutational signatures that can distinguish sustained human-to-human from animal-to-animal transmission. Moreover, distinct clade I sequences from Sudan suggest local MPXV circulation in areas of Eastern Africa over the past four decades. Our study underscores the importance of genomic surveillance in tracking spatiotemporal dynamics of MXPV clades and the need to strengthen such surveillance, including in some parts of Eastern Africa.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"67 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487138","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}

引用次数: 0

Author Correction: Rps14 haploinsufficiency causes a block in erythroid differentiation mediated by S100A8 and S100A9 作者更正：Rps14单倍体缺陷导致由S100A8和S100A9介导的红细胞分化受阻

IF 58.7 1区医学

Nature Medicine Pub Date : 2024-10-23 DOI: 10.1038/s41591-024-03350-7

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

引用次数: 0

Economics, equity and avoidable mortality 经济学、公平和可避免的死亡率

IF 58.7 1区医学

Nature Medicine Pub Date : 2024-10-22 DOI: 10.1038/s41591-024-03303-0

Jeong-Yeon Cho, Nathorn Chaiyakunapruk

引用次数: 0

The Cannabis and Health Research Initiative will help integrate medicinal cannabis in healthcare 大麻与健康研究计划将帮助把药用大麻纳入医疗保健中

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-22 DOI: 10.1038/s41591-024-03288-w

Johannes Thrul, Ryan Vandrey

{"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":"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 <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.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.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"31 1","pages":""},"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}

引用次数: 0

Safety principles for medical summarization using generative AI 使用生成式人工智能进行医学摘要的安全原则

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-22 DOI: 10.1038/s41591-024-03313-y

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

引用次数: 0

Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial 基于家庭的经颅直流电刺激治疗重度抑郁障碍：完全远程 2 期随机假对照试验

IF 82.9 1区医学

Nature Medicine Pub Date : 2024-10-21 DOI: 10.1038/s41591-024-03305-y

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

{"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":"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 (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 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, P = 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","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"1 1","pages":""},"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}

引用次数: 0

An ethics assessment tool for artificial intelligence implementation in healthcare: CARE-AI 医疗保健领域实施人工智能的伦理评估工具：CARE-AI

IF 58.7 1区医学

Nature Medicine Pub Date : 2024-10-18 DOI: 10.1038/s41591-024-03310-1

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

引用次数: 0