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In a cluster-randomized trial conducted across 70 medical centers in six countries, a 16-week structured educational program for healthcare providers improved adherence to guidelines for rhythm control but not for stroke prevention in individuals with atrial fibrillation.

Hegazy and colleagues demonstrate that epithelial oncostatin M receptor expression drives gut inflammation and tumor formation.

Familial adenomatous polyposis (FAP) is an inherited gastrointestinal syndrome associated with duodenal adenoma formation. Here the authors show that IL17A-producing NKp44- group 3 innate lymphoid cells accumulate in FAP duodenal tissue and are associated with duodenal adenoma formation in patients with FAP.

This flagship study from the European Solve-Rare Diseases Consortium presents a diagnostic framework including bioinformatic analysis of clinical, pedigree and genomic data coupled with expert panel review, leading to 500 new diagnoses in a cohort of 6,000 families with suspected rare diseases.

Ascaroside pheromones reflect population density in Caenorhabditis elegans. Here, the authors show that variation in ascaroside receptor genes contributes to differences in pheromone responses in natural populations of C. elegans.

The conserved eukaryotic heterotrimeric NatC complex co-translationally acetylates the N-termini of numerous target proteins. Here, the authors provide insights into the catalytic mechanism of NatC by determining the crystal structures of Saccharomyces cerevisiae NatC in the absence and presence of cofactors and peptide substrates and reveal the molecular basis of substrate binding by further biochemical analyses.

Although many glaciers in the Cordillera Darwin Icefield calve into fjords or lakes, the icefield’s evolution is largely controlled by atmospheric conditions. Over the recent two decades surface melt has increased significantly due to rising air temperatures.

In a post-approval study including more than 17,000 patients on the safety of pulsed field ablation, a new method for treatment of atrial fibrillation, the procedure was found to have a low rate of adverse events but was associated with some unexpected rare complications that will need further study.

Zeiser and colleagues show that CAR T cell therapy results in upregulation of the TGFβ-activated kinase-1 (TAK1)–NF-κB–p38 MAPK pathway in microglia, causing neurocognitive defects, and find that TAK1 inhibition can reduce immune effector cell-associated neurotoxicity syndrome.

An intercomparison exercise reassesses mass loss from glaciers worldwide based on the main in situ and satellite methods from 2000 to 2023; the results are consistent with previous assessments and provide a refined and comprehensive observational baseline for future impact and modelling studies.

Human encroachment into nature alters species communities and can lead to changes in disease dynamics. Here, Meyer et al. find that coronavirus prevalence increased in less diverse bat communities, which were dominated by susceptible host species.

ADAM17 is a member of the ‘Disintegrin and Metalloproteinase’ family of proteases, that cleaves transmembrane substrates from the surfaces of cells. Here the authors show that surface exposure of phosphatidylserine is required for ADAM17 sheddase activity, possibly by directing the protease to its substrates.

In the nematode Pristionchus pacificus, a developmental switch, the sulfatase eud-1, controls mouth-form plasticity. Here, the authors show that mutations in two conserved histone modifying enzymes mimic the eud-1 phenotype, in part mediated by an antisense eud-1RNA, resulting in the absence of one mouth-form

Anti-NMDA receptor encephalitis is the most common autoimmune encephalitis. Michalski et al. reveal epitope diversity, conformational changes and functional impacts of the autoantibodies using cryo-EM and electrophysiology.

Genomic analyses show that two independent fusions involving the same chromosome altered recombination patterns and contributed to reproductive isolation between two Pristionchus nematodes.

During wound healing and infection in the skin there is a hypoxic environment involving HIF-1α and NK cells. Here the authors show that NK cells through HIF-1α provide a cross-regulatory balance to provide an adequate antimicrobial defence that can inhibit subsequent wound healing.

Development of bacterial resistance to an antibiotic can lead to collateral sensitivity to another drug. Here, the authors study collateral sensitivity conferred by mutations in the horizontally acquired β-lactamase CTX-M-15, and identify antibiotic combinations that constrain the evolution of resistance.

Studying long-range interactions in the controlled environment of trapped ultracold gases can help our understanding of fundamental many-body physics. Here the authors excite a gas of Rydberg atoms with a ps laser pulse, demonstrating behaviour consistent with many-body correlations beyond mean-field.

Dietary lipids are linked to the development of inflammatory bowel diseases through unclear mechanisms. Here, the authors report that dietary polyunsaturated fatty acids trigger intestinal inflammation resembling aspects of Crohn’s disease, which is restricted by glutathione peroxidase 4 in the intestinal epithelium.

Glaciers in the European Alps are strongly affected by global warming, yet there is no methodologically consistent alpine-wide analysis on glacier changes. Here the authors show significant glacier retreat and an ice mass loss of 1.3 ± 0.2 Gt a⁻¹, derived from contemporaneous measurements of glacier areas and elevations.

In order to make optimal choices, it is adaptive for the brain to build a model of the world to enable predictions about likely later events. Here, the authors show that activity across learning in the orbitofrontal cortex comes to represent expected states, up to 30 s in the future.

A molecular mechanism is revealed through which commensal bacteria modulate intestinal epithelial barrier function.

A systematic analysis of the proteostasis network of secreted proteins in Caenorhabditis elegans identifies numerous regulators of protein homeostasis outside the cell, and highlights the contribution of extracellular proteostasis to host defence.

Antibiotic resistance spreads among bacteria through horizontal transfer of antibiotic resistance genes (ARGs). Here, Ellabaan et al. use a statistical approach to identify putative mobilisation elements and other features associated with ARG transfer among bacterial clades to predict the potential future dissemination of known ARGs.

Dedifferentiation state has been associated with therapy resistance in melanoma. Here, the authors uncover a pre-existing NGFR-expressing, targetable subpopulation that is resistant to immunotherapy and other treatments in melanoma cells and preclinical models.

Risk assessment for the development of antibiotic resistance against a new drug candidate is of paramount importance in preclinical development. In this Opinion article, Sommeret al. propose a new preclinical paradigm for the prediction of antibiotic resistance.

Phage engineered with tail fibers and CRISPR–Cas reduce Escherichia coli load in animals.

Stalled bacterial ribosomes can be rescued by interaction with SmpB protein and a highly structured transfer-messenger RNA, and a cryo-electron microscopy map of this complex now shows how EF-G-dependent translocation of this non-canonical ligand is facilitated by conformational changes in the ribosome and the transfer-messenger RNA.

A monomer molecular dopant with high electron affinity is shown to accept up to two electrons from conjugated polymers with low ionization efficiency and then generate free charge carriers with an efficiency of up to 170%.

DNA methyltransferase 3 A (DNMT3A) is involved in DNA methylation, and genetic variants in the DNMT3 locus have been associated with inflammatory bowel disease. Here the authors report that DNMT3A controls intestinal epithelial barrier function and restoration of the gut barrier function after intestinal epithelial perturbation.

Some antibiotic resistance genes found in pathogenic bacteria might derive from antibiotic-producing actinobacteria. Here, Jianget al. provide bioinformatic and experimental evidence supporting this hypothesis, and propose a specific mechanism for the transfer of these genes between bacterial phyla.

Methanotrophic bacteria can consume methane emitted from the ocean floor before it reaches the atmosphere. Variations in coastal currents can reduce methane oxidation in the ocean by limiting methanotroph residence time above methane seeps.

The resilience of the microbiota can protect us from disease, but a resilient dysbiotic microbiota may also cause disease. This Opinion article discusses the concepts and mechanisms of microbial resilience against dietary, antibiotic or bacteriotherapy-induced perturbations and the implications these have for human health.

A general method of cooling polyatomic molecules to ultracold temperatures is reported; the optoelectrical cooling technique removes kinetic energy via a Sisyphus effect, effectively causing the molecules to continually ‘climb’ a hill of potential energy.

Wastewater treatment plants (WWTPs) are thought to play a central role in the dissemination of antibiotic resistance genes. Here, the authors identify novel antibiotic resistance genes in WWTPs and show that only a few of the most abundant resistance genes are found outside the WWTP environment.

It remains unclear when and why the world’s oceans, once largely occupied by bacteria, became dominated by photosynthetic algae. Here, using fossil lipids in million year old rocks, the authors show that predation after the Snowball Earth glaciations created the opportunity for a global shift to algal ecosystems.

Andre Franke and colleagues perform a genome-wide association study for the gut microbiome, examining the influence of host genetics on overall microbial variation and individual taxa. They find significant associations at the VDR (vitamin D receptor) locus and observe correlations between microbiota and metabolites of VDR, including bile acids.

Moreno-Layseca et al. identify Swip1 as an integrin-specific endocytic adaptor controlling the dynamics of integrin adhesion complexes as well as the migration and invasion of breast cancer cells.

Two papers by Kather and colleagues and Gerstung and colleagues develop workflows to predict a wide range of molecular alterations from pan-cancer digital pathology slides.

Massively parallel but cost-effective testing is essential to monitor the spread of pathogenic agents. Here the authors present SARSseq, which uses a dual indexing strategy in a multiplexed RT-PCR reaction to diagnose SARS-CoV-2 at scale.

Cortex morphology varies with age, cognitive function, and in neurological and psychiatric diseases. Here the authors report 160 genome-wide significant associations with thickness, surface area and volume of the total cortex and 34 cortical regions from a GWAS meta-analysis in 22,824 adults.