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This Review presents a comprehensive analysis of the amounts and distribution of public and philanthropic global cancer research funding between 2016 and 2023, including patterns of international collaboration and downstream research output, with an emphasis on the Commonwealth. We show that annual investment decreased globally each year, apart from a rise in 2021. Network analysis revealed that grant and publication collaborations between the Commonwealth, the USA, and the EU are facilitated by linkages through a core group of Commonwealth countries, including the UK, Australia, and Canada. There are inequities in research investment and low funding for treatment modalities for many cancers. These inequities also manifest in the central positioning of high-income Commonwealth countries in research collaborations, but also point to opportunities for high-income Commonwealth countries to facilitate linkages with low-income countries and support active cancer research in the USA and the EU. There is an urgent need to review research investment priorities, both within the Commonwealth and globally, to align with population needs and promote collaborative strategies that can build research skills and infrastructure in low-income settings to impact global cancer control. Finite resources should be invested wisely to achieve maximum improvements in mortality and alleviate the cancer burden.

FDA advisory committees provide useful recommendations for decision-making, but optimization efforts could help reduce burdens and improve public understanding.

The production of herbivore-induced plant volatiles (HIPVs) is a type of indirect defense used by plants to attract natural enemies and reduce herbivory by insect pests. In many crops little is known about genotypic variation in HIPV production or how this may affect natural enemy attraction. In this study, we identified and quantified HIPVs produced by 10 sorghum (Sorghum bicolor) cultivars infested with a prominent aphid pest, the sorghum aphid (Melanaphis sorghi Theobald). Volatiles were collected using dynamic headspace sampling techniques and identified and quantified using GC-MS. The total amounts of volatiles induced by the aphids did not differ among the 10 cultivars, but overall blends of volatiles differed significantly in composition. Most notably, aphid herbivory induced higher levels of methyl salicylate (MeSA) emission in two cultivars, whereas in four cultivars, the volatile emissions did not change in response to aphid infestation. Dual-choice olfactometer assays were used to determine preference of the aphid parasitoid, Aphelinus nigritus, and predator, Chrysoperla rufilabris, between plants of the same cultivar that were un-infested or infested with aphids. Two aphid-infested cultivars were preferred by natural enemies, while four other cultivars were more attractive to natural enemies when they were free of aphids. The remaining four cultivars elicited no response from parasitoids. Our work suggests that genetic variation in HIPV emissions greatly affects parasitoid and predator attraction to aphid-infested sorghum and that screening crop cultivars for specific predator and parasitoid attractants has the potential to improve the efficacy of biological control.

Exposure to e-cigarette vapors alters important biologic processes including phagocytosis, lipid metabolism, and cytokine activity in the airways and alveolar spaces. Little is known about the biologic mechanisms underpinning the conversion to e-cigarette, or vaping, product use-associated lung injury (EVALI) from normal e-cigarette use in otherwise healthy individuals. We compared cell populations and inflammatory immune populations from bronchoalveolar lavage fluid in individuals with EVALI to e-cigarette users without respiratory disease and healthy controls and found that e-cigarette users with EVALI demonstrate a neutrophilic inflammation with alveolar macrophages skewed towards inflammatory (M1) phenotype and cytokine profile. Comparatively, e-cigarette users without EVALI demonstrate lower inflammatory cytokine production and express features associated with a reparative (M2) phenotype. These data indicate macrophage-specific changes are occurring in e-cigarette users who develop EVALI.

Estuaries worldwide have been altered by anthropogenic modifications including land clearing, dredging, and land reclamation, which impact sediment routing and accumulation on tidal flats. Numerous studies have explored tidal flat and marsh vulnerability to submergence or “drowning” under accelerating sea-level rise, but recent work along the Oregon coast suggests estuaries are maintaining positive accretionary balances (at least in marshes) despite ongoing sea-level rise. In this study, accretion rates (sediment accumulation rates) were evaluated from 210Pb profiles at eight sites on broad intertidal flats in Coos Bay, one of the largest estuaries on the U.S. West Coast and a site of substantial development and logging since the mid-1800s. Based on the century-scale record of sediment accretion represented by 210Pb profiles, tidal flats have been accreting at rates of ~ 1–3 mm/yr with little spatial relationship to relative sea-level rise or patterns of tectonic uplift. Thus, accretion is generally not accommodation- or supply-limited, and therefore likely not regulated by sea-level rise. Peaks in sediment accretion are well-preserved from the last 30 years, and accretion rates averaged over this more modern time span tend to be four times greater than rates averaged over the whole-core (century-scale) 210Pb records. It is unclear whether the higher, more modern rates represent a real change in estuarine accretion patterns over the past decades or a Sadler effect (i.e., an apparent but not real increase in accretion in younger sediments). The results highlight the spatial variability in accretion rates within a single estuary, the potential resiliency of this tectonically active estuary to sea-level rise (in the form of a positive accretionary balance), and raise the issue of whether management decisions are best made based on century-scale accretion rates or multi-decadal accretion rates.

Differential hypoxaemia (DH) is common in patients supported by femoral veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and can cause cerebral hypoxaemia. To date, no models have studied the direct impact of flow on cerebral damage. We investigated the impact of V-A ECMO flow on brain injury in an ovine model of DH. After inducing severe cardiorespiratory failure and providing ECMO support, we randomised six sheep into two groups: low flow (LF) in which ECMO was set at 2.5 L min −1 ensuring that the brain was entirely perfused by the native heart and lungs, and high flow (HF) in which ECMO was set at 4.5 L min −1 ensuring that the brain was at least partially perfused by ECMO. We used invasive (oxygenation tension—PbTO 2 , and cerebral microdialysis) and non-invasive (near infrared spectroscopy—NIRS) neuromonitoring, and euthanised animals after five hours for histological analysis. Cerebral oxygenation was significantly improved in the HF group as shown by higher PbTO 2 levels (+ 215% vs − 58%, p  = 0.043) and NIRS (67 ± 5% vs 49 ± 4%, p  = 0.003). The HF group showed significantly less severe brain injury than the LF group in terms of neuronal shrinkage, congestion and perivascular oedema ( p  < 0.0001 ) . Cerebral microdialysis values in the LF group all reached the pathological thresholds, even though no statistical difference was found between the two groups. Differential hypoxaemia can lead to cerebral damage after only a few hours and mandates a thorough neuromonitoring of patients. An increase in ECMO flow was an effective strategy to reduce such damages.

The policy community generally has assumed Medicare Advantage (MA) plans negotiate hospital payment rates similar to those for commercial insurance products and well above those in traditional Medicare. After surveying senior hospital and health plan executives, we found, however, that MA plans nominally pay only 100-105 percent of traditional Medicare rates and, in real economic terms, possibly less. Respondents broadly identified three primary reasons for near-payment equivalence: statutory and regulatory provisions that limit out-of-network payments to traditional Medicare rates, de facto budget constraints that MA plans face because of the need to compete with traditional Medicare and other MA plans, and a market equilibrium that permits relatively lower MA rates as long as commercial rates remain well above the traditional Medicare rates. We explored a number of policy implications not only for the MA program but also for the problem of high and variable hospital prices in commercial insurance markets.

Abstract Background The disease severity index (DSI) for inflammatory bowel disease (IBD) combines measures of disease phenotype, inflammatory activity, and patient-reported outcomes. We aimed to validate the DSI and assess its utility in predicting a complicated IBD course. Methods A multicenter cohort of adults with IBD was recruited. Intraclass correlation coefficients (ICCs) and weighted Kappa assessed inter-rater reliability. Cronbach’s alpha measured internal consistency of DSI items. Spearman’s rank correlations compared the DSI with endoscopic indices, symptom indices, quality of life, and disability. A subgroup was followed for 24 months to assess for a complicated IBD course. Area under the receiver operating characteristics curve (AUROC) and multivariable logistic regression assessed the utility of the DSI in predicting disease progression. Results Three hundred and sixty-nine participants were included (Crohn’s disease [CD], n = 230; female, n = 194; mean age, 46 years [SD, 15]; median disease duration, 11 years [interquartile range, 5-21]), of which 171 (CD, n = 99; ulcerative colitis [UC], n = 72) were followed prospectively. The DSI showed inter-rater reliability for CD (ICC 0.93, n = 65) and UC (ICC 0.97, n = 33). The DSI items demonstrated inter-rater agreement (Kappa > 0.4) and internal consistency (CD, α > 0.59; UC, α > 0.75). The DSI was significantly associated with endoscopic activity (CDn=141, r = 0.65, P < .001; UCn=105, r = 0.80, P < .001), symptoms (CDn=159, r = 0.69, P < .001; UCn=132, r = 0.58, P < .001), quality of life (CDn=198, r = −0.59, P < .001; UCn=128, r = −0.68, P < .001), and disability (CDn=83, r = −0.67, P < .001; UCn=52, r = −0.74, P < .001). A DSI of 23 best predicted a complicated IBD course (AUROC = 0.82, P < .001) and was associated with this end point on multivariable analyses (aOR, 9.20; 95% confidence interval, 3.32-25.49). Conclusions The DSI reliably encapsulates factors contributing to disease severity and accurately prognosticates the longitudinal IBD course. Lay Summary This study shows that the disease severity index (DSI) for inflammatory bowel disease (IBD) is a valid and reliable instrument encapsulating the disease phenotype, disease activity, and impact of the disease on the patient; and it accurately predicts for incident disease complications. Graphical Abstract Graphical Abstract

Ecosystem services are crucial for animals, plants, the planet, and human well-being. Decreasing biodiversity and environmental destruction of ecosystems will have severe consequences. Designing technologies that could support, enhance, or even replace ecosystem services is a complex task that the Manufactured Ecosystems Project team considers to be only achievable with transdisciplinarity, as it unlocks new directions for designing research and development systems. One of these directions in the project is bio-inspiration, learning from natural systems as the foundation for manufacturing ecosystem services. Using soil formation as a case study, text-mining of existing scientific literature reveals a critical gap: fewer than 1% of studies in biomimetics address soil formation technological replacement, despite the rapid global decline in natural soil formation processes. The team sketches scenarios of ecosystem collapse, identifying how bio-inspired solutions for equitable and sustainable innovation can contribute to climate adaptation. The short communication opens the discussion for collaboration and aims to initiate future research.

As ecological collapse accelerates under the pressures of anthropogenic climate change, adaptation strategies increasingly include technological proxies for nature’s functions. But can ecosystem services (ES) be meaningfully replaced by technology? Revisiting this urgent question first posed by Fitter (2013), we assess the extent to which bio-inspired design—particularly biomimetics—has advanced the capacity to support, enhance, or replace natural ES. We convened an interdisciplinary team to synthesize and refine a comprehensive list of 22 ecosystem services, integrating often-overlooked cultural and relational dimensions. Using this framework, we conducted a large-scale analysis of over 68,000 peer-reviewed publications from the biomimetics and bio-inspired design literature between 2004 and 2025, applying AI-assisted classification to evaluate whether, and how, these technologies map onto specific ES functions and benefits. Our findings reveal both promise and profound limitations. Bio-inspired research engages with 20 of the 22 ES, but over 78% of this work concentrates on five technologically tractable functions—biochemicals, disease regulation, waste treatment, fibre/hide/wood, and fuel. Foundational supporting and regulating services such as pollination, soil formation, and nutrient cycling are almost entirely absent. Moreover, only 3% of technologies described in the academic literature aim to support existing systems; the overwhelming emphasis on enhancement (39%) and replacement (58%) suggests a design paradigm skewed toward substitution rather than coexistence. Intangible, co-produced services—particularly those related to culture, identity, and meaning—remain outside the current reach of biomimetic design. This skew reveals a dangerous imbalance: while certain ES can be technologically approximated, the relational, emergent, and systemic qualities of ecosystems elude replication. Technological replacement must not become a substitute for preservation. Instead, bio-inspired design should be mobilized as a tool for adaptation that amplifies and protects the living systems on which human and more-than-human futures depend.