Featured
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Article
| Open Access
Proteomic analysis of cardiorespiratory fitness for prediction of mortality and multisystem disease risks
A proteomic risk score for cardiorespiratory fitness, comprising as few as 21 proteins, is dynamic with exercise training and helps predict the risk of mortality and a range of cardiovascular, metabolic and neurological conditions.
- Andrew S. Perry
- , Eric Farber-Eger
- & Ravi V. Shah
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Article |
Heat exposure induced risks of preterm birth mediated by maternal hypertension
Findings from a multicenter study of 197,080 singleton live births in China show maternal hypertension as a mediator of the risks imposed by heat exposure between conception and 20 weeks of gestation on preterm birth and its various clinical subtypes.
- Liyun Wang
- , Jiangli Di
- & Cunrui Huang
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Comment |
The argument framework is a flexible approach to evidence in healthcare
An argument framework, grounded in the sciences of reasoning, provides an alternative to medicine’s measurement framework for evaluating and synthesizing evidence in healthcare.
- Jonathan Fuller
- , Benjamin Chin-Yee
- & Ross E. G. Upshur
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Research Briefing |
New risk score for cardiovascular disease with improved performance
QR4 is a new cardiovascular disease (CVD) risk score developed and evaluated in 16.9 million people that has better performance than other commonly used CVD risk scores. It includes nine new risk factors associated with increased risk of developing CVD (for example, a heart attack or stroke) over the next 10 years.
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Article
| Open Access
Development and validation of a new algorithm for improved cardiovascular risk prediction
The QR4 algorithm for prediction of 10-year cardiovascular disease risk, developed, tested and externally validated in datasets comprising 16.8 million people from the United Kingdom, improves upon the QRISK3 algorithm that is in current use by incorporating new risk factors.
- Julia Hippisley-Cox
- , Carol A. C. Coupland
- & Keith M. Channon
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News & Views |
Tackling heat-related mortality in aging populations
A large study of older adults in China points to physical and cognitive function — not age — as key predictors of heat-related mortality, highlighting the need for climate adaptation policies to prioritize accessibility across all age groups.
- Josiah L. Kephart
- & Safiyyah M. Okoye
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Research Highlight |
A timeline of biomarker changes before Alzheimer’s disease
Longitudinal data from the China Cognition and Aging Study map the sequential biomarker changes that begin almost two decades before clinical onset of Alzheimer’s disease.
- Karen O’Leary
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Article |
Polygenic risk scores, radiation treatment exposures and subsequent cancer risk in childhood cancer survivors
An observational study reports the joint effects of polygenic risk scores and radiation treatment exposure with a subsequent increased risk of multiple solid cancers in two large cohorts of survivors of childhood cancer.
- Todd M. Gibson
- , Danielle M. Karyadi
- & Lindsay M. Morton
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Research Highlight |
Ambitious birth cohort study tracks genetic links to health in China
The Born in Guangzhou Cohort Study prospectively collects genetic and phenotypic data from thousands of families, providing insights into genetics, early-life exposures and long-term health.
- Karen O’Leary
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Article
| Open Access
Clinical surveillance systems obscure the true cholera infection burden in an endemic region
Integrated analysis of clinical, serological and behavioral data estimates that current clinical surveillance systems detect only 1 of 3,280 true community infections in a cholera-endemic region of Bangladesh.
- Sonia T. Hegde
- , Ashraful Islam Khan
- & Andrew S. Azman
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Article
| Open Access
Effectiveness and safety of telehealth medication abortion in the USA
In a prospective study across US states where abortion remains legal, telehealth medication abortion, provided primarily without tests, was effective, safe and comparable to previous findings from large US studies investigating in-person medication abortion care.
- Ushma D. Upadhyay
- , Leah R. Koenig
- & M. Antonia Biggs
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Article
| Open Access
Reductions in smoking due to ratification of the Framework Convention for Tobacco Control in 171 countries
An interrupted time series analysis found that the World Health Organization Framework Convention for Tobacco Control reduced smoking prevalence across 170 countries (excluding China) since the country-specific year of ratification.
- Guillermo Paraje
- , Mauricio Flores Muñoz
- & Prabhat Jha
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Article
| Open Access
Real-world implementation of a multilevel interventions program to prevent mother-to-child transmission of HBV in China
Interim analysis of the SHIELD program, adopting multilevel interventions, showcases low mother-to-child transmission (MTCT) rates of hepatitis B virus (HBV) across different hospital and community settings in China.
- Xueru Yin
- , Wei Wang
- & Jinlin Hou
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Correspondence |
AI-based decision support to optimize complex care for preventing medication-related falls
- Bob van de Loo
- , Annemiek J. Linn
- & Nathalie van der Velde
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Article
| Open Access
Benefits, harms and cost-effectiveness of cervical screening, triage and treatment strategies for women in the general population
A modelled evaluation of screening and treatment strategies for prevention of cervical cancer in 78 low- and lower-middle-income countries provides evidence to support the World Health Organization’s recommendation of primary HPV testing for women in the general population.
- Kate T. Simms
- , Adam Keane
- & Karen Canfell
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Article
| Open Access
Model-based predictions of protective HIV pre-exposure prophylaxis adherence levels in cisgender women
Modeling shows that antiretroviral treatment as pre-exposure prophylaxis (PrEP) can be highly effective in cisgender women at preventing HIV-1 acquisition, but underscores the need to understand the barriers that limit PrEP adherence in women.
- Lanxin Zhang
- , Sara Iannuzzi
- & Max von Kleist
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Article
| Open Access
Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
Analysis of HbA1c and FPG levels across 117 population-based studies demonstrates regional variation in prevalence of previously undiagnosed screen-detected diabetes using one or both measures and suggests that use of elevated FPG alone could underestimate diabetes prevalence in low- and middle-income countries.
- Bin Zhou
- , Kate E. Sheffer
- & Majid Ezzati
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Article
| Open AccessRisk of hematological malignancies from CT radiation exposure in children, adolescents and young adults
Analysis of a European cohort estimated that 1–2 per 10,000 children, adolescents and young adults are expected to develop a hematological malignancy within 12 years following computed tomography examination.
- Magda Bosch de Basea Gomez
- , Isabelle Thierry-Chef
- & Elisabeth Cardis
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Article
| Open Access
Modeling policy interventions for slowing the spread of artemisinin-resistant pfkelch R561H mutations in Rwanda
A model investigating 26 possible malaria treatment policy intervention scenarios showed that introducing multiple first-line antimalarial therapies is the most effective single policy change in slowing the spread of artemisinin-resistant pfkelch R561H mutations in Rwanda over 5 years.
- Robert J. Zupko
- , Tran Dang Nguyen
- & Maciej F. Boni
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Article
| Open Access
Longitudinal genomic surveillance of carriage and transmission of Clostridioides difficile in an intensive care unit
A low rate of Clostridioides difficile transmission within an intensive care unit supports the effectiveness of prevention practices and highlights the greater risk to carriers of toxigenic C. difficile.
- Arianna Miles-Jay
- , Evan S. Snitkin
- & Vincent B. Young
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Article
| Open Access
Hobby engagement and mental wellbeing among people aged 65 years and older in 16 countries
A meta-analysis of longitudinal studies representing 16 countries found that hobby engagement was associated with better mental and self-reported health in adults aged 65 years and older as well as correlation with higher life expectancy and national happiness levels.
- Hei Wan Mak
- , Taiji Noguchi
- & Daisy Fancourt
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Correspondence |
Defining a research agenda for environmental wastewater surveillance of pathogens
- Alexander G. Shaw
- , Catherine Troman
- & Julia Fitzner
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Comment |
Principles for the prevention and control of non-communicable disease
Non-communicable diseases in low- and middle-income countries can be tackled with integrated health systems interventions that consider multimorbidity, supported by patient involvement and new technologies.
- Sailesh Mohan
- , Kamlesh Khunti
- & Dorairaj Prabhakaran
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Article
| Open Access
Heat-related mortality in Europe during the summer of 2022
This ecological analysis using the Eurostat database estimated that summer 2022, the hottest summer on record, was associated with over 61,000 heat-related deaths across 35 countries in Europe, with the highest mortality rates in countries near the Mediterranean Sea.
- Joan Ballester
- , Marcos Quijal-Zamorano
- & Hicham Achebak
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Research Highlight |
International transmission complicates HCV elimination
A study finds evidence of substantial international transmission of hepatitis C virus among men who have sex with men, particularly in Europe.
- Karen O’Leary
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Article |
The airway microbiome mediates the interaction between environmental exposure and respiratory health in humans
Examining the interplay of environmental exposure with the airway microbiome provides insights for possible intervention in lung health.
- Lifeng Lin
- , Xinzhu Yi
- & Zhang Wang
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Article
| Open Access
Alcohol consumption and risks of more than 200 diseases in Chinese men
Observational analyses from the China Kadoorie Biobank found that alcohol consumption was associated with higher risks of 61 diseases in Chinese men, with most of these associations confirmed by genetic analyses.
- Pek Kei Im
- , Neil Wright
- & Xiaoyi Zhang
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Comment |
Observational studies must be reformed before the next pandemic
Observational studies provide crucial information early during epidemics and pandemics, but they often suffer from methodological shortcomings, which can be resolved.
- Emily E. Ricotta
- , Annette Rid
- & Nicholas G. Evans
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Correspondence |
AI-generated text may have a role in evidence-based medicine
- Yifan Peng
- , Justin F. Rousseau
- & Chunhua Weng
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Matters Arising
| Open AccessConcerns about the Burden of Proof studies
- Andrea J. Glenn
- , Xiao Gu
- & Walter C. Willett
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Article |
Community-integrated self-collected HPV-based cervix screening in a low-resource rural setting: a pragmatic, cluster-randomized trial
The ASPIRE Mayuge trial in rural Uganda showed that implementation of door-to-door HPV screening led to better attendance of follow-up treatment services but requires more personnel compared to community health days.
- Anna Gottschlich
- , Beth A. Payne
- & Gina Ogilvie
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Article |
Maternal third dose of BNT162b2 mRNA vaccine and risk of infant COVID-19 hospitalization
Analysis from a population cohort in Israel found that a third booster dose of the BNT162b2 mRNA vaccine in mothers before or during pregnancy was associated with greater protection against COVID-19 hospitalization in their infants compared to two doses.
- Michal Lipschuetz
- , Joshua Guedalia
- & Ofer Beharier
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Correspondence |
Patient and public involvement within epidemiological studies of long COVID in the UK
- Ash Routen
- , Lauren O’Mahoney
- & Kamlesh Khunti
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Research Highlight |
Viruses linked to neurodegenerative disease
Certain viruses — many of which have vaccines available — are linked to a significantly increased risk of neurodegenerative disease in the years following infection.
- Karen O’Leary
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Correspondence |
An EU task force to assess the burden of rare diseases
- Pavel Kolkhir
- , Diana Alecsandra Grad
- & Juanita Haagsma
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Research Briefing |
Population screening for smoldering multiple myeloma reveals high prevalence
Smoldering multiple myeloma is an asymptomatic precursor condition to multiple myeloma, a cancer in the bone marrow. We conducted a population-based screening study — in which 51% of the population over 40 years of age in Iceland participated — and found that the prevalence of smoldering multiple myeloma was 0.5% in the study population.
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Article |
Prevalence of smoldering multiple myeloma based on nationwide screening
A nationwide screening program from the iStopMM study performed in Iceland to detect smoldering multiple myeloma reported a prevalence of 0.5% in individuals over 40 years of age, with increasing risks with age and in males.
- Sigrún Thorsteinsdóttir
- , Gauti K. Gíslason
- & Sigurður Y. Kristinsson
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Article |
Real-world effectiveness of a single dose of mpox vaccine in males
Effectiveness of one subcutaneous dose of MVA-BN, the smallpox and mpox vaccine, was estimated to be 86% in a cohort of vaccine-eligible males in Israel, supporting its use to curtail the outbreak of mpox virus.
- Yael Wolff Sagy
- , Roy Zucker
- & Doron Netzer
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Research Briefing |
Missed routine cardiovascular treatments during the COVID-19 pandemic
We demonstrate the power of a data-informed medicines-based approach in discovering the indirect effect of the COVID-19 pandemic on cardiovascular events using 1.32 billion records of dispensed medications in England, Scotland and Wales. We estimate that interruption of preventive care could result in more than 13,000 extra cardiovascular events.
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Article |
The impact of the COVID-19 pandemic on cardiovascular disease prevention and management
Analysis of 1.32 billion records of medication data from England, Scotland and Wales reveals that the COVID-19 pandemic led to substantial declines in dispensing of antihypertensive and lipid-lowering medications, leading to increased risks for future cardiovascular disease.
- Caroline E. Dale
- , Rohan Takhar
- & Reecha Sofat
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Article
| Open Access
Real-world COVID-19 vaccine effectiveness against the Omicron BA.2 variant in a SARS-CoV-2 infection-naive population
An analysis of sera samples collected between January and July of 2022 in Hong Kong shows that the effectiveness of both the BNT162b2 and CoronaVac COVID-19 vaccines against SARS-CoV-2 Omicron BA.2 variant infection waned rapidly after the third and fourth doses.
- Jonathan J. Lau
- , Samuel M. S. Cheng
- & Joseph T. Wu
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Brief Communication |
Estimating the transmission dynamics of SARS-CoV-2 Omicron BF.7 in Beijing after adjustment of the zero-COVID policy in November–December 2022
With the lifting of the zero-COVID policy and requirements governing reporting case numbers in China, it has become imperative to estimate the dynamics and cumulative infection rate of SARS-CoV-2 to help guide public health responses.
- Kathy Leung
- , Eric H. Y. Lau
- & Joseph T. Wu
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Article |
Infectiousness of SARS-CoV-2 breakthrough infections and reinfections during the Omicron wave
Analysis of data from California prisons shows that both COVID-19 vaccination and prior SARS-CoV-2 infection reduces the risk of virus transmission to close contacts.
- Sophia T. Tan
- , Ada T. Kwan
- & Nathan C. Lo
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Article |
Leukocyte telomere length in children born following blastocyst-stage embryo transfer
Analyses of whole-genome sequencing data in children and validation in mouse models show that offspring born from blastocyst-stage embryo transfer have shorter leukocyte telomere lengths.
- Cheng Wang
- , Yayun Gu
- & Zhibin Hu
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Research Briefing |
Vigorous intermittent lifestyle physical activity improves mortality risk
Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of strenuous movement performed as part of daily living, such as walking uphill or running for a bus. We find that as little as 3–4 minutes of VILPA per day is associated with substantially reduced mortality risk compared to no VILPA.
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Article
| Open Access
Association of wearable device-measured vigorous intermittent lifestyle physical activity with mortality
Using data from wearable activity monitors, this study shows that short bursts of physical activity that are done as part of daily life activities and that are only 1 or 2 minutes in length are associated with lower mortality, similar to the effects of regular exercise.
- Emmanuel Stamatakis
- , Matthew N. Ahmadi
- & Mark Hamer
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Article
| Open Access
Retrospectively modeling the effects of increased global vaccine sharing on the COVID-19 pandemic
Retrospective simulation of several global COVID-19 distribution scenarios shows that equitable and altruistic vaccine sharing strategies could have substantially reduced the global burden of SARS-CoV-2 infections and associated mortality.
- Sam Moore
- , Edward M. Hill
- & Matt J. Keeling
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News & Views |
Meat, vegetables and health — interpreting the evidence
Although questions remain about several diet and disease associations, current evidence supports dietary guidelines to limit red meat and increase vegetable intake.
- Tammy Y. N. Tong
- , Keren Papier
- & Timothy J. Key
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News & Views |
Systolic blood pressure and cardiovascular health
New analyses are prompting a shift in how we think about systolic blood pressure, with substantial benefits to be gained from population-wide interventions alongside targeting high-risk groups.
- Panniyammakal Jeemon
- & Sivadasanpillai Harikrishnan
Divergent age-associated and metabolism-associated gut microbiome signatures modulate cardiovascular disease risk