Reviews & Analysis

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  • Chronic pain is common, with more than one in five adult Americans reporting having pain daily or on most days. A multi-ancestry genomic analysis in 598,339 military veterans in the USA identifies 126 genetic variants associated with pain intensity, highlights shared genetic risk with substance use and psychiatric disorders, and reveals enrichment in GABAergic neurons as a key molecular contributor to experiencing pain.

    Research Briefing
  • Acute kidney injury affects one in five hospitalized patients and can lead to lasting kidney damage or death. We show that clonal hematopoiesis of indeterminate potential — a common age-related condition caused by blood cell mutations — increases the risk of acute kidney injury in multiple cohorts of human patients and in mouse models.

    Research Briefing
  • After many lean years, important progress has been made in updating the anti-tuberculosis drug armamentarium; a new drug that targets bacterial protein synthesis is one of several that could help transform the treatment of this neglected and deadly disease.

    • Eric L. Nuermberger
    • Richard E. Chaisson
    News & Views
  • Self-care interventions have the potential to improve health coverage for women while offering greater agency and autonomy, but only if certain barriers—such as stigma and cost—can be overcome.

    • Manjulaa Narasimhan
    • James R. Hargreaves
    • Kate Gilmore
    Perspective
  • Primary fetal organoids are currently derived from tissue samples obtained at termination of pregnancy. We developed an approach that enables prenatal derivation of epithelial organoids from fetal fluids. Single-cell mapping of the human amniotic fluid content unveiled the presence of viable fetal epithelial progenitors of multiple tissues that can form fetal lung, kidney and intestinal organoids.

    Research Briefing
  • In a difference-in-differences analysis among Medicare beneficiaries in the USA, billion-dollar weather disasters were associated with higher rates of emergency department visits and deaths in the weeks after the disaster. Observed changes were more pronounced among counties that experienced the most loss and damage compared to all affected counties.

    Research Briefing
  • A new study shows the benefits of treating anxiety to prevent postnatal depression — and highlights the need for more pragmatic research to simplify treatment packages, address other comorbid symptoms, and deliver effective perinatal mental health care at scale.

    • Daisy R. Singla
    News & Views
  • A flurry of emerging treatment options is transforming the therapeutic landscape of hepatocellular carcinoma; two new studies highlight the complexities and gaps in knowledge, but also hint at a greater understanding of how to apply immunotherapy in early and advanced disease.

    • David J. Pinato
    • Claudia A. M. Fulgenzi
    • Antonio D’Alessio
    News & Views
  • Robust validation of biomarkers of aging will be critical to their clinical translation; here, authors review the key challenges and propose recommendations to overcome them.

    • Mahdi Moqri
    • Chiara Herzog
    • Luigi Ferrucci
    Review Article
  • In a prospective study involving 1,090 high-risk pregnancies, a comprehensive screening test of fetal cell-free DNA successfully detected pathogenic aneuploidies, microdeletions and monogenic variants linked to fetal anomalies. The inclusion of monogenic conditions alongside chromosomal abnormalities in this test resulted in a 60.7% increase in the detection rate for suspected fetal structural abnormalities.

    Research Briefing
  • A pilot trial of the WHO’s Labour Care Guide reveals important considerations for implementation and for future trials aimed at reducing the inappropriate use of cesarean section, particularly in low- and middle-income countries.

    • Cristina Fernandez-Turienzo
    • Jane Sandall
    News & Views
  • Senolytic therapy for diabetic macular edema (DME) refractory to anti-VEGF treatment appears safe, and preliminary data suggest a therapeutic effect on visual acuity and macular thickness.

    • Tomoaki Murakami
    • Thomas W. Gardner
    News & Views
  • An AI-enabled chatbot increased self-referrals to psychological therapies for common mental health disorders; but further research is needed to ensure that better access translates into high-quality treatment experiences and outcomes for everyone.

    • Jacqueline Sin
    News & Views
  • In a large-scale digital experiment on dermatology diagnosis, we found that specialists and generalists achieved diagnostic accuracy of 38% and 19%, respectively. With decision support from a fair deep learning system, the diagnostic accuracy of physicians improved by more than 33%, but the gap in accuracy of generalists widened across skin tones.

    Research Briefing
  • Credible evidence suggests that, under extraordinary circumstances, Alzheimer’s disease may be transmitted by a prion-like mechanism — yielding insights into both the basic biology of this neurodegenerative disorder and strategies for early prevention.

    • Mathias Jucker
    • Lary C. Walker
    News & Views
  • In military veterans with traumatic brain injury, treatment with ibogaine plus magnesium led to dramatic clinical improvements and a favorable safety profile; further studies with state-of-the art safety monitoring will be crucial to unlocking the potential benefits of this psychedelic compound.

    • David L. Brody
    • Shan H. Siddiqi
    News & Views