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Health & Medicine

The honey bee stinger: An unusual pump with collapsible double pistons.

Most stinging animals deliver venom by contracting muscles around a venom reservoir, but honey bees employ a fundamentally different strategy. The stingers of worker bees have the unique ability to autotomize, separating from the body, to continue to sting independently. Despite more than a century of anatomical descriptions, the mechanics of venom pumping have remained unresolved due to the challenges of observing them in action. We recorded high-speed videos of active, autotomized stingers, co

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Health & Medicine

Chronic cigarette smoke exposure induces distinct stem cell states driving genetic driver-specific non-small cell lung cancer subtypes.

Cigarette smoke-induced chronic inflammation (CI) potentiates development of non-small cell lung cancer (NSCLC) by mediating genetic and epigenetic events. Using normal lung organoids (LOs), we define how chronic cigarette smoke condensate (CSC) exposure drives two separate stem cell populations to evolve premalignant states harboring progressive epigenetic and linked transcriptomic abnormalities in the absence of major driver mutations. These dynamics facilitate evolution of an immune evasive s

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Cell identity competes with surface tension to determine stromal organization in tumor spheroids beyond the CAF shell paradigm.

Cancer-associated fibroblasts (CAFs) are often found forming a peripheral stromal barrier around tumors. Here, this paradigm is challenged using microfabricated 3D cancer-CAF spheroid models combined with quantitative magnetic force tensiometry. A surface tension atlas is established for eight cancer cell lines, three CAF populations, and heterotypic tumor-CAF assemblies, spanning nearly two orders of magnitude. Surface tension is first shown to govern spheroid morphology and modulate drug respo

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Health & Medicine

Sexual dimorphism in epidermal stem cell dynamics.

The epidermis is a stratified epithelium comprising proliferative basal cells and differentiated suprabasal cells that are continuously renewed throughout life. Conflicting theories have been proposed regarding the heterogeneity of the basal cell layer, with some studies proposing that all proliferative cells have self-renewal potential during homeostasis 1-5 . Meanwhile, others posit a model in which stem cell differentiation occurs through an intermediate transit-amplifying-like progenitor sta

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Engineered TYK2 dependence enables myeloid-selective IL-10 receptor agonism.

Interleukin-10 (IL-10) is a central anti-inflammatory cytokine that suppresses immune responses in myeloid cells but can also activate T cells, limiting its therapeutic use in chronic inflammatory diseases owing to narrow efficacy windows and dose-limiting toxicities 1-5 . Here we show that myeloid and T cells differ in their dependence on JAK-family kinase pairing for IL-10 signalling and function. We took advantage of this differential kinase dependence to engineer a tetravalent nanobody-based

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Talazoparib plus enzalutamide in high-volume metastatic hormone-naive prostate cancer: a randomized phase 2 trial.

Combining inhibition of poly(ADP-ribose) polymerase and androgen receptor (AR) pathway has demonstrated clinical activity in men with metastatic prostate cancer, although the extent of benefit in tumors lacking homologous recombination repair (HRR) gene alterations remains uncertain. We conducted a randomized phase 2 trial evaluating talazoparib plus enzalutamide versus enzalutamide alone in men with high-volume metastatic hormone-naive prostate cancer (mHNPC). Fifty-four patients starting andro

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Personalized neoantigen-targeting cancer vaccines in ovarian cancer: a phase 1 trial.

Personalized neoantigen-targeting cancer vaccines in the adjuvant setting are of increasing interest across malignancies. Here we report the results of a phase 1 clinical trial testing the feasibility and safety of personalized neoantigen-targeting cancer vaccines for high-grade epithelial ovarian cancer. 'NeoVax' consisted of pools of synthetic long peptides targeting patient-specific neoantigens admixed with the immunostimulant poly-ICLC, was combined with delayed administration of anti-PD-1 a

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A pseudoenzyme sensor of trehalose-6-phosphate directly represses the metabolic integrator SnRK1 in plants.

Trehalose-6-phosphate (T6P) is a central metabolic signal linking sugar availability to plant growth, carbon utilization, and productivity, yet its sensing and signaling mechanisms remain elusive. Using chemical biology and functional approaches, we identify the noncatalytic pseudoenzyme Class-II T6P synthase (TPS-II) as a T6P sensor in Arabidopsis. In the apo state, TPS-II dimerizes to form an autoinhibitory inter-subunit interaction. T6P binding to the N-terminal TPS-like domain triggers a con

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Extended fractional Hofstadter states at high field in twisted bilayer graphene above the magic angle.

When a Chern band is partially filled, a fractional Chern insulator (FCI)-the lattice analog of a fractional quantum Hall state-can arise. Though the full range of possible scenarios for producing such a state is not established, the most tractable models combine strong electronic interactions with the quantum geometry of the parent Chern band meeting specific criteria. In twisted bilayer graphene, the importance of interactions can be tuned by varying the interlayer twist. Here, we study a samp

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Phenotypic screening identifies kenpaullone as a prolymphangiogenic compound to improve heart repair following myocardial infarction.

Myocardial infarction (MI) induces cardiac muscle death and its subsequent replacement by a noncontractile fibrotic scar, which underlies progression to heart failure. Current treatments restore blood flow and assist with cardiac workload but do not promote regeneration. We have previously shown endogenous growth of the cardiac lymphatic system following MI and further stimulation with the lymphatic endothelial specific mutated Vascular Endothelial Growth Factor-C (VEGF-C) isoform, VEGFC-C156S,

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Dopamine suppresses pathological retinal oscillations and enhances the signal-to-noise ratio.

Infantile nystagmus is a debilitating involuntary eye movement disorder often associated with retinal diseases such as congenital stationary night blindness (CSNB). The oscillating eye movements of infantile nystagmus come with reduced visual acuity and strongly impair quality of life. No cure exists for this condition. Previously, we demonstrated that nystagmus in the CSNB mouse model Nyx nob has a retinal cause. Specifically, we found that synchronized oscillations of retinal ganglion cells (R

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Spatial and single-nucleus transcriptomics reveals the molecular pathology of type 2 diabetes-associated cognitive dysfunction.

The mechanisms underlying type 2 diabetes-associated cognitive dysfunction (DACD) remain poorly understood, hindering therapeutic progress. Here, we integrated spatial transcriptomics and single-nucleus RNA sequencing to delineate the spatiotemporal molecular and cellular landscape of DACD in brain tissues from 3- and 6-mo-old mouse models. Our findings revealed region- and cell-type-specific transcriptomic alterations, with excitatory neurons in the hippocampus and isocortex emerging as the mos

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53BP1 condensates regulate DNA replication progression and completion.

DNA replication in mammalian cells proceeds in chromosomal domains during defined windows of S phase; however, the mechanisms coordinating replication with restoration of chromatin states remain incompletely understood. Here, we identify p53-binding protein 1 (53BP1) condensates as regulators of heterochromatin replication and epigenetic restoration. Loss of 53BP1 delays mid-to-late S-phase progression, compromises recruitment of epigenetic restoration factors, and impairs timely completion of h

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Structural basis for membrane-dependent positive feedback regulation of DOCK11 by activated Cdc42.

The guanine nucleotide exchange factor DOCK11 is widely expressed across tissues and activates Cdc42, a Rho family GTPase that regulates cytoskeletal remodeling and cell polarity. Loss-of-function mutations in DOCK11 have recently been linked to inborn errors of immunity. DOCK11 has also been implicated in facilitating hepatitis B virus infection in hepatocytes and has emerged as a potential target for therapeutic interventions. A positive feedback mechanism has been proposed for DOCK11-mediated

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Trans - and cis -interaction dynamics of cadherin complexes on membranes visualized by high-speed atomic force microscopy.

Classical cadherin-mediated cell-cell adhesion is important for maintaining the animal body and defects in adhesion cause severe diseases. The combination of trans - (between cells) and cis - (on the same membrane) interactions of the extracellular domains of cadherins is necessary for cadherin clustering in cell-cell junctions, which is essential for robust tissue formation. However, the solution structure and interaction dynamics of trans / cis -binding cadherin complexes have not been observe

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Diversity and spatial segregation of TRP channels in the closest relatives of animals.

Sensory systems, built around specialized cell types, are central to how animals perceive and respond to their environments. However, the evolutionary origin of these systems remains unclear. Here, we show that choanoflagellates, the sister group of animals, possess remarkably diverse repertoires of transient receptor potential (TRP) channels, an ancient superfamily of sensory ion channels. Comparative analyses indicate that most major animal TRP channel families predate the origin of animals an

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Enhancement of hippocampal synaptic AMPA receptor function by the antidepressant tianeptine and by opioid peptides.

Management of major depressive disorder (MDD) with conventional therapeutics that enhance monoaminergic neurotransmission requires prolonged treatment prior to clinical benefit and a substantial proportion of patients show little or no improvement. Identifying alternative molecular targets is required to develop efficacious, rapid acting antidepressants. In this regard, tianeptine, an established but atypical clinical antidepressant, is of interest. Tianeptine does not directly influence monoami

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The NAC transcription factor SOMBRERO controls auxin gradients for columella root cap maturation and turnover.

The plant root cap consists of continuously renewed cells that collectively protect meristematic stem cells, sense environmental stimuli, and guide root growth direction. Auxin gradients within the root cap are essential for cell turnover, root responses to external cues, and root cap development. However, our understanding of how the auxin gradient is established and maintained remains limited. Here, we show that the root cap-specific NAC transcription factor SOMBRERO (SMB), previously implicat

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Multiple-oxygen isotope constraints on aerobic respiration and gross primary productivity.

Primary production on land and in the surface ocean is a critical component of Earth's carbon and oxygen cycles, controlling the uptake of CO 2 and the release of O 2 to the atmosphere. Quantitative estimates of these O 2 and CO 2 fluxes remain challenging. Of the methods used, the triple-oxygen-isotope analysis of O 2 is considered to provide the most robust in situ estimate of gross productivity. However, this method relies on one key assumption-that the oxygen isotope fractionation of aerobic

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Dystrophic changes of nigrostriatal axons harboring a SYNJ1 Parkinson's mutation suggest catastrophic failure of endocytic mechanisms.

Synaptojanin 1 is a brain enriched phosphoinositide phosphatase implicated in endocytosis at the synapse. A mutation (R258Q) that selectively impairs its Sac1 phosphatase domain causes early onset familial Parkinsonism. Neurons of mice with this mutation display synaptic vesicle traffic defects across the brain, but selective dystrophic changes in a subset of dopaminergic axons in the dorsolateral striatum. Using correlative light microscopy-FIB-SEM of mutant mouse striata to visualize in 3D the

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IGF2BP1 in 17q-gain cooperates with MYCN to regulate purine biosynthesis and immunotherapy efficacy in neuroblastoma.

Concurrent chromosomal 17q-gain and MYCN amplification define a subset of neuroblastoma associated with particularly adverse clinical outcomes. However, how these genetic alterations synergize to promote tumor progression and whether their cooperation confers therapeutic vulnerabilities remain elusive. We herein performed a CRISPR-based functional screen targeting 17q-gain genes and identified the RNA m 6 A reader IGF2BP1 as a critical MYCN collaborator to promote aggressive neuroblastomas via a

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A high-dimensional population code in the bat motor cortex during natural dexterous flight.

Elucidating the neural computations underlying natural, complex movement remains a fundamental challenge in neuroscience. Bat flight presents a formidable motor control challenge, requiring hand-like wings whose many degrees of freedom must be precisely coordinated to enable rapid three-dimensional (3D) maneuvers. Here, we performed large-scale wireless recordings from the wing motor cortex of freely flying bats, combined with 3D tracking of wing kinematics. Despite the complexity of flight cont

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PTPRS mediates invasion of tetanus neurotoxin into the central nervous system.

Tetanus neurotoxin (TeNT) invades the central nervous system (CNS) via retrograde transport through motoneurons. Whether a host factor is needed to mediate TeNT trafficking has remained unknown. Here, using pull-down and mass spectrometry analysis, and by developing a luciferase-based in vivo transport assay, we identify receptor protein tyrosine phosphatase sigma (PTPRS; PTPσ) as the retrograde transport receptor for TeNT. Global or motoneuron-specific PTPRS knockout (KO) abolishes TeNT e

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Mechanisms of transcription control by distal enhancers from single-gene nanoscopy.

Distal enhancers activate genes over vast genomic distances, but how this communication occurs and what signals are transmitted are poorly understood. Using real-time single-gene nanoscopy and targeted perturbations, we define physical parameters and mechanisms of enhancer-promoter communication. We find that productive interactions are dynamic, occur at a proximity of ≲100 nm, and are coordinated with transcriptional bursts. Enhancers and promoters find one another not only through passi

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Rare k-mers reveal centromere haplogroups underlying human diversity and cancer translocations.

Human centromeres are highly variable but remain among the least characterized regions of the genome because their repetitive structure has hindered conventional analysis of population diversity and disease relevance. Here, we show that rare k-mers in centromeric regions capture lineage-specific variation, defining discrete haplogroups with distinct structural features. We developed ascairn to infer these haplogroups from short-read whole-genome sequencing (WGS) data. Applying this framework to

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Population-scale reconstruction of menopause dynamics reveals a physiological cliff at the final menstrual period.

Menopause reshapes female physiology, yet current understanding is limited by small longitudinal cohorts that characterize it as a gradual transition. Large-scale biomedical datasets remain underutilized because the final menstrual period (FMP) age is rarely recorded. Here we present a computational framework, inspired by astronomy, that reconstructs FMP-anchored trajectories from cross-sectional data by removing the blurring caused by variation in FMP age across individuals. Applying this to tw

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Strengthening health systems to prioritise, provide care, and prevent osteoarthritis: a roadmap for global health policy.

By 2050, almost 1 billion people are expected to live with osteoarthritis-a disabling musculoskeletal condition with currently no cure. Despite its burden and costs, osteoarthritis remains largely invisible in national and global health agendas, is poorly integrated within service models for other chronic health conditions, and is frequently perceived as inevitable with ageing and associated with limited therapeutic options. This context drives an osteoarthritis identity problem that fuels frust

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Health & Medicine

Addressing threats to future global health-what is the right timeframe?

Our decisions today can support or threaten future human health. Insofar as we protect the planet or invest in fruitful research on pandemic countermeasures, we promote future wellbeing and health, sometimes at the present generation's expense. As we warm the planet, accelerate antibiotic resistance, or consume finite natural resources, we might serve present-day wellbeing or health at the expense of future generations. To decide which such trade-offs are legitimate or advisable, we need to know

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AI-assisted scoping review of code sharing in clinical prediction model research.

Clinical prediction models are increasingly deployed to support diagnostic and prognostic decisions, making reproducibility essential for assessing their reliability and generalizability. Analytical code supports independent assessment of these processes, yet its availability in the literature remains limited. This scoping review quantifies current practices in sharing analytical code to inform the development of TRIPOD-Code, a reporting guideline for code availability and reproducibility. Here

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Mapping transcriptional responses to cellular perturbations with RNA fingerprinting.

Single-cell perturbation dictionaries measure how cells respond to genetic and chemical perturbations, creating the opportunity to assign causal interpretations to observational data. We introduce RNA fingerprinting, a statistical framework that maps transcriptional responses from new experiments onto reference perturbation dictionaries. RNA fingerprinting learns perturbation representations, or "fingerprints," from single-cell data, then probabilistically assigns query cells to one or more cand

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Optogenetic Therapy for Restoring Aspects of Visual Function.

Retinitis pigmentosa is an inherited degenerative retinal disease that can lead to irreversible blindness. Optogenetic therapy has shown potential for restoring visual function at late stages of the disease. In this open-label study, we evaluated the safety of ganglion cell-directed optogenetic therapy in 10 participants with blindness due to advanced retinitis pigmentosa. Each participant received a single intravitreal injection of an adeno-associated viral (AAV) vector encoding the red-shifted

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Nutritional interventions' impacts on human milk: Three trials in low-resource settings.

Human milk (HM) composition is variable to support changing infant needs and is influenced by maternal diet and health. We harmonized HM data from three randomized trials in Burkina Faso (MISAME-III), Pakistan (Mumta-LW), and Tanzania (ELICIT) within the International Milk Composition (IMiC) Consortium to test how maternal nutrition affects HM composition. Balanced energy-protein (BEP) supplements or nicotinamide given to lactating mothers increased milk B-vitamins, while macronutrients, oligosa

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A DNA Typewriter records the cell lineage history of a mouse, from zygote to late organogenesis.

Mammalian biology unfolds over time, within tissues and organs opaque to our eyes and instruments. We applied DNA Typewriter, a sequential molecular recorder, to record the cell lineage of a mouse over nearly two weeks of development. From one embryo, we reconstruct a time-calibrated, parsimony-supported, zygote-rooted phylogeny of 1.28 million transcriptionally profiled cells. A burst of editing unequivocally marks the daughters of the first cleavage, which serve as inline replicates. We quanti

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Oral deucrictibant for on-demand treatment of hereditary angioedema attacks: a phase 3, multicentre, randomised, double-blind, placebo-controlled crossover trial.

In hereditary angioedema, a rare bradykinin-mediated condition, oral on-demand treatments facilitating prompt administration and providing rapid, sustained relief and attack resolution remain scant. We investigated the efficacy and safety of deucrictibant, an oral bradykinin B2 receptor antagonist, for on-demand treatment of hereditary angioedema attacks. RAPIDe-3 was a phase 3, double-blind, 2 × 2 crossover trial in adolescent and adult participants (aged ≥12 to <18

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Integrating Fragment Screening and Covalent Chemistry to Drug DNA-Binding Proteins: RAD52 as a Case Study.

Protein-DNA interfaces are central to genome maintenance but remain challenging targets for small-molecule discovery because they are often broad, polar, solvent-exposed, and lack classical druggable pockets. Here, we establish a structure-guided strategy to chemically target such interfaces by combining the fragment-based identification of DNA-mimetic binders with the covalent capture of a proximal nucleophilic residue. Using the ssDNA-binding groove of RAD52 as a representative model system, a

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Volatile eutectics to tailor crystallization for perovskite optoelectronics

Improvements to the radiative efficiency of halide perovskite thin films are necessary to approach fundamental solar cell performance limits. We tailored perovskite crystallization by leveraging the eutectic interaction between zinc bromide and methylammonium chloride additives. The resulting films had high photoluminescence quantum yield and charge carrier decay times and low surface recombination velocity. Nanoprobe x-ray microscopy revealed local melting of the eutectic at grain boundaries du

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Golgi-derived vesicles containing PI(3,4)P 2 drive mitochondrial fusion

Mitochondria are dynamic organelles that remodel their shape to regulate cell fate. Mitochondrial division involves interactions with the endoplasmic reticulum (ER), lysosomes, and trans-Golgi network–derived vesicles to facilitate membrane scission. How interorganelle contacts regulate mitochondrial membrane fusion remains largely unknown. Here, we identified a role for Golgi-derived vesicles enriched in phosphatidylinositol 3,4-bisphosphate [PI(3,4)P 2 ] in regulating mitochondrial fusion. We

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Cellular remodeling during reversible life-stage transition in sessile ciliates: Genomic and transcriptomic insights.

Unraveling mechanisms driving dramatic life-stage transitions in response to environmental stress is central to understanding cellular adaptation. We studied a distinctive group of sessile ciliates that undergo profound morphological and organellar remodeling when transitioning from sessile trophonts to motile telotrochs. We generated chromosome-level genomes for two colonial species ( Campanella sinica , Epistylis hentscheli ) and one solitary species ( Vorticella campanula ), revealing genome

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Zinc mediates the allosteric activation of Shiftless to suppress programmed -1 ribosomal frameshifting.

Many medically important viruses, including HIV-1 and severe acute respiratory syndrome coronavirus 2, utilize programmed -1 ribosomal frameshifting (-1 PRF) to synthesize certain proteins essential for the viral life cycle. Shiftless (SHFL) is an interferon-simulated, zinc finger-containing protein that restricts -1 PRF and viral infection. However, its regulatory spectrum and mechanism remain largely unclear. Here, we showed that SHFL orthologs potently suppress a wide variety of viral and cel

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Tandem RNA-binding domain architecture drives PKR activation through an intramolecular interface.

Tandem repeats of RNA-binding domains (RBDs), often linked by intrinsically disordered sequences, are prevalent among RNA-binding proteins (RBPs). The inherent flexibility of these arrangements, however, raises the question of whether such domains can adopt defined configurations critical for function. Here, we reveal that in Protein Kinase R (PKR)-an RBP that triggers the innate immune response upon sensing double-stranded RNAs (dsRNAs)-its two dsRNA-binding domains (dsRBDs) assemble into a uni

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Targeted extracellular degradation of LRP8 promotes ferroptosis in cancer cells.

Tumor reliance on antioxidant defenses creates a vulnerability to ferroptosis, yet strategies to therapeutically disable these systems remain limited. Here, we identify targeted degradation of the selenium uptake receptor lipoprotein receptor-related protein 8 (LRP8) as an effective approach to decrease the abundance of the ferroptosis-protective enzyme glutathione peroxidase 4 (GPX4). Using bispecific cytokine receptor-targeting chimeras (KineTACs) that couple LRP8 to cytokine receptor internal

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LAT condensation gates PLCγ1 activation via bimodal LAT phosphorylation.

T cells can respond to even a single molecular binding event of antigen to a TCR. A key step in the TCR signaling pathway that definitively exhibits this single-molecule response is the initiation of calcium influx by activation of PLCγ1 in the LAT protein condensate. Here, we describe detailed kinetic measurements examining how protein condensation of LAT regulates activation of PLCγ1 using a reconstituted membrane system. The results reveal that membrane recruitment of PLCγ1

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PAK4 exacerbates melanoma immunosuppression by promoting exosome release.

Melanoma remains a lethal malignancy with frequent resistance to immune checkpoint blockade therapy. Clinical evidence associates elevated PAK4 expression with poor response to anti-PD-1 treatment in melanoma patients. While tumor-derived exosomes are recognized as key immunosuppressive mediators, the role of PAK4 in regulating exosome secretion to induce immunosuppression remains incompletely understood. Here, we demonstrate that PAK4-mediated phosphorylation of Annexin-A2 (ANXA2) at Ser26 prom

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Cell size modulates SBF and Whi5 chromatin association to regulate the Start of the budding yeast cell cycle.

Cell growth and division are tightly coordinated with cell size. In budding yeast, increasing cell size promotes the G1/S transition, called Start , by activating the transcription factor SBF, which regulates cell cycle-dependent gene expression. Part of this regulation arises because the concentration of the SBF inhibitor Whi5 decreases as cells grow. However, cells lacking Whi5 can still maintain accurate size control when the SBF activator Cln3 is also removed, indicating that additional size

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Lineage and renewal dynamics of sebaceous glands govern skin barrier integrity in mice.

Sebaceous glands (SGs) are essential for maintaining skin homeostasis and barrier function. However, the cell biology and lineage of SGs remain poorly understood in vivo. Here we performed bulk isolation of murine SGs, uncovered their molecular features, and generated SG-specific tool mouse models. Tracing with SG-Chaser mice revealed SG heterogeneity and their dynamic and distinct responses to common external stimuli. Specifically, some SG stem cell (SGSC) descendants homed back to the bulge an

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The public health challenges of children's and adolescents' digital media use: applying the digital determinants of health as an interpretive framework.

Children and adolescents are growing up in a hybrid world in which digital media has become part of the infrastructure of everyday life and a structural determinant of their health. In the second paper of this Series on the digital determinants of health, we apply the framework introduced in the first paper to one of the most contested questions in public health: how young people's digital media use shapes their health and wellbeing. Using the digital determinants of health framework to interpre

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Governing the digital determinants of health for children and young people: a global public health imperative.

The digital determinants of health are the structural conditions through which digital infrastructures, business models, and design choices shape health outcomes. Yet these determinants remain largely outside public health policy and remain fragmented across regulatory sectors. Rather than regulating individual technologies in isolation, governance should ensure that digital systems and environments advance population health and reduce inequities. A public health approach shifts attention from i

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The digital determinants of health: a new era for global public health.

Digital transformations exert increasing influence over the lives of the global population, shaping opportunities and generating harms for health and wellbeing across the spectrum of digital access and engagement. The scale of influence of digital transformations on human and planetary health marks the urgency of attention to the digital determinants of health (DDoH). In this Series paper, we describe a prevailing digital sociotechnological order (DSTO) as the structural source of the DDoH. The

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Urine cell-free RNA for bladder cancer detection and treatment response prediction.

Urine biomarkers promise to improve noninvasive detection and molecular characterization of genitourinary malignancies. Here we describe urine random priming and affinity capture of cell-free RNA (cfRNA) fragments for enrichment analysis by sequencing (uRARE-seq), a liquid biopsy method for urine cfRNA profiling, and apply it to 683 urine samples from patients with cancer and controls. Urine cfRNA contained transcripts from genitourinary tissues and, in patients with prostate, kidney or bladder

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Small quantity lipid-based nutritional supplementation and measles vaccination coverage in children aged 6-23 months: a pragmatic cluster-randomized trial.

Undernutrition and infectious diseases pose a double threat to child survival, especially in areas with a high malnutrition burden and low vaccination coverage. In this study, we evaluated whether distributing preventive small-quantity lipid-based nutrient supplements (SQ-LNS) alongside routine immunization services may increase vaccine uptake in a pediatric, pragmatic, cluster-randomized controlled trial in northern Nigeria. Twenty geographically defined clusters across two Local Government Are

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