Nature Medicine最新文献

{"title":"Inclusion of medical students in the next generation of clinician scientist training programs","authors":"Deniz Buyukkaplan, Yaren Canpolat, Andrea Cuschieri, Devin Inan, Deniz Koc, Benedikt Pelzer","doi":"10.1038/s41591-025-03760-1","DOIUrl":"https://doi.org/10.1038/s41591-025-03760-1","url":null,"abstract":"<p>We appreciate the insights provided by Melk et al. in their Comment¹ in <i>Nature Medicine</i>. The authors effectively highlight the importance of structured programs in preparing clinician scientists to bridge the gap between clinical practice and research. However, we would like to emphasize the critical role of medical students in this ecosystem and the need for greater accessibility and support at the undergraduate level.</p><p>We agree with Melk et al. that career counseling, mentoring and protected research time are fundamental elements of successful clinician scientist programs. However, these opportunities are largely inaccessible to medical students, who are at the very beginning of their professional journeys. Therefore, we suggest extending these structured programs to the undergraduate level, providing early exposure to research and the necessary support systems to cultivate future clinician scientists.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"78 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278785","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":"Strategies for shortening tuberculosis therapy","authors":"Véronique A. Dartois, Valerie Mizrahi, Radojka M. Savic, Jared A. Silverman, David Hermann, Clifton E. Barry","doi":"10.1038/s41591-025-03742-3","DOIUrl":"https://doi.org/10.1038/s41591-025-03742-3","url":null,"abstract":"<p>In the absence of effective patient-stratification approaches, tuberculosis (TB) treatment relies on overtreating most patients to ensure high cure rates. Shortening treatment duration without compromising efficacy is therefore high on the agenda of the global TB community. While new and better drugs are certainly needed, we argue that innovative but rational treatment strategies, using both new and existing therapies, will help achieve this goal. There is growing recognition that patient stratification, based on host and pathogen factors, is key to delivering the right drug regimen for the right duration. In this Perspective, we review the current knowledge on the heterogeneity of TB disease and propose approaches to optimize treatment duration in distinct patient groups, taking into consideration the realities of TB control globally. We emphasize key insights that improve the understanding of bacterial vulnerabilities in patients with easy-to-treat and hard-to-treat TB, helping to reduce diagnostic uncertainties. We explore how the TB research community can integrate disease biology, pathology and symptoms, to rethink therapeutic strategies and reduce TB treatment duration.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"19 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278789","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 AI can deliver the Human Exposome Project","authors":"Thomas Hartung","doi":"10.1038/s41591-025-03749-w","DOIUrl":"https://doi.org/10.1038/s41591-025-03749-w","url":null,"abstract":"An ambitious Human Exposome Project aims to reveal how our environment shapes our health.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"19 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278786","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 power of patient engagement at Peace and Love Hospitals in Ghana","authors":"Lawrencia Bawuah Dsane, Beatrice W. Addai","doi":"10.1038/s41591-025-03756-x","DOIUrl":"https://doi.org/10.1038/s41591-025-03756-x","url":null,"abstract":"<p>In today’s evolving healthcare landscape, patient engagement has emerged as a cornerstone of delivering high-quality care. By incorporating patient voices throughout the care life cycle, including survivorship, healthcare systems are fostering a more holistic and inclusive approach to treatment and recovery. Modern patient engagement strategies prioritize the active involvement of patients at every stage of their healthcare journeys. From initial diagnosis to survivorship, understanding and integrating patient perspectives helps personalize care plans, ensuring that treatment aligns with the unique needs and preferences of individuals.</p><p>For instance, including patients in shared decision-making has been shown to improve treatment adherence and patient satisfaction. Studies suggest that when patients feel heard, they are more likely to participate actively in their own care, leading to better health outcomes¹. Additionally, research highlights shared decision-making as a strategy to overcome common barriers in patient care, ensuring more equitable and effective treatment².</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"11 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278787","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":"Education of healthcare professionals to improve guideline adherence in atrial fibrillation: the STEEER-AF cluster-randomized clinical trial","authors":"Dipak Kotecha, Karina V. Bunting, Samir Mehta, Philipp Sommer, Maciej Sterliński, Kim Rajappan, Lluís Mont, Eduard Guasch, Serge Boveda, Giuseppe Boriani, Yongzhong Sun, Colinda van Deutekom, Chris P. Gale, Tom J. R. De Potter, Isabelle C. van Gelder","doi":"10.1038/s41591-025-03751-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03751-2","url":null,"abstract":"<p>Guideline-adherent care is associated with better patient outcomes, but whether this can be achieved by professional education is unclear. Here we conducted a cluster-randomized controlled trial across 70 centers in six countries to understand if a program for the education of healthcare professionals could improve patient-level adherence to clinical practice guidelines on atrial fibrillation (AF). Each center recruited patients with AF seen in routine practice (total <i>N</i> = 1,732), after which the centers were randomized, accounting for baseline guideline adherence to class I and III recommendations from the European Society of Cardiology on stroke prevention and rhythm control. Healthcare professionals in the intervention centers received a 16-week structured educational program with an average of 9 h of online engagement, whereas those at control centers received no additional education beyond standard practice. For the co-primary stroke prevention outcome, guideline adherence was 63.4% and 58.6% at baseline and 67.5% and 60.9% at 6–9-months follow-up for the intervention and control groups, respectively (adjusted risk ratio 1.10; 95% confidence interval (CI) 0.97 to 1.24; <i>P</i> = 0.13). For the co-primary rhythm control outcome, guideline adherence was 21.4% and 20.4% at baseline and 33.9% and 22.9% at follow-up for the intervention and control groups, respectively (adjusted risk ratio 1.51; 95% CI 1.04 to 2.18; <i>P</i> = 0.03). The secondary outcome of patient-reported integrated AF management showed a 5.1% improvement in the intervention group compared with the control group (95% CI 1.4% to 8.9%; <i>P</i> = 0.01). Thus, while the education of healthcare professionals improved substantial gaps in implementation for rhythm control, it had no significant effect on stroke prevention. ClinicalTrials.gov registration: NCT04396418.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"47 5 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278788","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":"Tackling overweight and obesity in the youth with the PAS GRAS project","authors":"Afshan N. Malik, Anabela Marisa Azul, Eugénia Carvalho, John G. Jones, Paulo Matafome, Paulo J. Oliveira","doi":"10.1038/s41591-025-03721-8","DOIUrl":"https://doi.org/10.1038/s41591-025-03721-8","url":null,"abstract":"<p>It is a startling reality that today, over 245 million children aged 5–14, 249 million adolescents and young adults aged 15–24, and 2.1 billion adults are overweight or obese, with substantial increases for all age groups predicted for 2050^1,2. The younger cohorts in particular are consigned to a lifetime of obesity-related comorbidities, whose treatment will consume an increasingly larger fraction of healthcare resources, with estimated costs reaching US$4.32 trillion by 2035³.</p><p>Youth obesity is particularly concerning because of the unique vulnerabilities of this age group and requires early intervention and decades of management⁵. Indicators of early onset metabolic complications, such as redox and energy imbalances, DNA methylation and transcriptional alterations, are already present in pre-pubertal children with obesity, resulting in greater adulthood metabolic risks. Many, if not most, of the determinants of lifetime obesity and metabolic sequelae are established during early stages of life. Investment in early childhood, from preconception to adolescence, can yield a 10:1 benefit:cost ratio in health and socioeconomic outcomes during later life⁵.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"19 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268783","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":"Publisher Correction: Integrating liver endpoints in clinical trials of cardiovascular and kidney disease","authors":"Faiez Zannad, Arun J. Sanyal, Javed Butler, Veronica Miller, Stephen A. Harrison","doi":"10.1038/s41591-025-03818-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03818-0","url":null,"abstract":"<p>Correction to: <i>Nature Medicine</i> https://doi.org/10.1038/s41591-024-03223-z, published online 3 September 2024.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"41 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268782","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":"Battle of the mosquitoes","authors":"","doi":"10.1038/s41591-025-03753-0","DOIUrl":"https://doi.org/10.1038/s41591-025-03753-0","url":null,"abstract":"Malaria has found a new ally in the concrete jungle — but scientists are fighting back with mosquitoes of their own.","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"256 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260552","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":"TERN-501 monotherapy and combination therapy with TERN-101 in metabolic dysfunction-associated steatohepatitis: the randomized phase 2a DUET trial","authors":"Mazen Noureddin, Naim Alkhouri, Eric J. Lawitz, Kris V. Kowdley, Rohit Loomba, Lois Lee, Christopher Jones, Amnon Schlegel, Tonya Marmon, Kacey Anderson, Yizhao Li, Erin Quirk, Stephen A. Harrison","doi":"10.1038/s41591-025-03722-7","DOIUrl":"https://doi.org/10.1038/s41591-025-03722-7","url":null,"abstract":"<p>Thyroid hormone receptor-β (THRβ) agonism is a validated mechanism for treating metabolic dysfunction-associated steatohepatitis (MASH). DUET was a 12-week, randomized, double-blind, placebo-controlled, multicenter phase 2a study investigating the efficacy, safety and pharmacodynamics and pharmacokinetics of once-daily TERN-501 (THRβ agonist) as monotherapy or combined with TERN-101 (farnesoid X receptor agonist), in patients with presumed MASH. Overall, 162 patients were randomized to: TERN-501 monotherapy (1 mg (<i>n</i> = 23), 3 mg (<i>n</i> = 23) or 6 mg (<i>n</i> = 22)), TERN-101 10-mg monotherapy (<i>n</i> = 24), TERN-501 (3 mg (<i>n</i> = 23) or 6 mg (<i>n</i> = 23)) plus TERN-101 10-mg combination therapy or placebo (<i>n</i> = 24). The primary endpoint was relative change from baseline at week 12 in liver fat content with TERN-501 monotherapy versus placebo, using magnetic resonance imaging proton density fat fraction (MRI-PDFF). Least squares mean (s.e.) changes from baseline at week 12 in MRI-PDFF with TERN-501 were: −15.4% (5.2%) with 1 mg, −27.5% (5.7%) with 3 mg (<i>P</i> = 0.0036) and −44.8% (5.9%) with 6 mg (<i>P</i> &lt; 0.0001), versus −4.0% (5.4%) with placebo. The incidence of adverse events was similar with TERN-501 monotherapy or placebo. In conclusion, TERN-501 treatment resulted in dose-dependent, significant reductions from baseline in MRI-PDFF compared to placebo in patients with MASH. ClinicalTrials.gov registration: NCT05415722.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"17 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260279","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: Intracerebroventricular bivalent CAR T cells targeting EGFR and IL-13Rα2 in recurrent glioblastoma: a phase 1 trial","authors":"Stephen J. Bagley, Arati S. Desai, Joseph A. Fraietta, Dana Silverbush, Daniel Chafamo, Nelson F. Freeburg, Gayathri Konanur Gopikrishna, Andrew J. Rech, Ali Nabavizadeh, Linda J. Bagley, Jungmin Park, Danuta Jarocha, Rene Martins, Nicolas Sarmiento, Eileen Maloney, Lester Lledo, Carly Stein, Amy Marshall, Rachel M. Leskowitz, Julie K. Jadlowsky, Shane Mackey, Shannon Christensen, Bike Su Oner, Gabriela Plesa, Andrea Brennan, Vanessa Gonzalez, Fang Chen, David Barrett, Robert Colbourn, MacLean P. Nasrallah, Zissimos Mourelatos, Wei-Ting Hwang, Cecile Alanio, Donald L. Siegel, Carl H. June, Elizabeth O. Hexner, Zev A. Binder, Donald M. O’Rourke","doi":"10.1038/s41591-025-03824-2","DOIUrl":"https://doi.org/10.1038/s41591-025-03824-2","url":null,"abstract":"<p>Correction to: <i>Nature Medicine</i> https://doi.org/10.1038/s41591-025-03745-0, published online 1 June 2025.</p>","PeriodicalId":19037,"journal":{"name":"Nature Medicine","volume":"9 1","pages":""},"PeriodicalIF":82.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260278","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}