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Breathalyser can tell if you are burning fat from a single exhalation

Nature Mohana Basu Jul 23, 2026 DOI: 10.1038/d41586-026-02295-w

Humanity spoke thousands of languages at the dawn of farming — now many of them are lost

Nature Freda Kreier Jul 23, 2026 DOI: 10.1038/d41586-026-02279-w

What The Odyssey reveals about ancient science — from botany to psychiatry

Nature Jo Marchant Jul 23, 2026 DOI: 10.1038/d41586-026-02275-0

Neural evidence for action-related somatosensory predictions

Journal of Neuroscience Caoimhe Moran, Hinze Hogendoorn, Ayelet N. Landau Jul 23, 2026 DOI: 10.1523/jneurosci.0889-25.2026

The tactile consequences of self-initiated movements are thought to be predicted by a forward model, yet the precise neural implementation of these predictions remains unclear. In non-motor contexts, expectations are thought to activate sensory neurons tuned towards the expected stimulus. This acts as a predictive template against which afferent sensory input is compared. It is unclear whether forward model predictions have a similar neural instantiation. Here we employed time-resolved multivariate decoding on human electroencephalography (EEG) during self-generated movements to examine the content of predictive neural activity. Human participants (males and females) performed index finger movements which were predictably paired with a vibration to either the index or ring finger of the opposite, passive hand. On some trials the tactile stimulus was unexpectedly omitted. Results revealed above-chance finger decoding in the pre-movement period supporting a predictive representation of expected stimulation location. As the movement approached, this predictive activity became similar to late-stage processing of a physical tactile stimulus. On omission trials, we found that despite the absence of afferent input, finger location could be decoded ∼120 ms after expected stimulus onset. This shows a stimulus-specific omission response. Together these findings indicate that self-generated movement pre-activates neurons tuned towards expected tactile consequences. Significance Statement Engaging effectively with the world relies on our ability to anticipate the sensory consequences of our own movements. To characterise how the brain encodes action-driven tactile predictions we recorded EEG while participants performed finger movements paired with vibrations to either the index or ring finger of the opposite hand. Crucially, we introduced unexpected omissions, where no stimulus followed the movement. Applying time-resolved EEG-decoding methods, we show that pre-movement neural activity encodes expected stimulation location. In addition, on omission trials, despite the absence of bottom-up stimulation, we could decode expected stimulation location. Such predictions of self-produced tactile events likely ensure accurate dissociation of self from other and promote a sense of agency over our own motor actions.

International PhD students to face strict limits on time in the US

Nature Kaia Glickman Jul 23, 2026 DOI: 10.1038/d41586-026-02280-3

Myocardial microvascular patterns in histological sections from patients with and without type 2 diabetes

PLoS ONE Jaromír Šrámek, Aneta Pierzynová, Vojtěch Melenovský et al. Jul 23, 2026 DOI: 10.1371/journal.pone.0354451

Type 2 diabetes is associated with small vessels dysfunction. This study assessed whether type 2 diabetes is associated with changes in the myocardial capillary pattern in two-dimensional histological sections as an indirect proxy for the three-dimensional network in the myocardium. We used myocardial samples from the left and right ventricles harvested during cardiac surgery (N = 53; 44 without and 9 with type 2 diabetes). We prepared histological sections with CD34-immunostained endothelium. We used cross-sections through the small vessels as points for two methods of point-pattern analysis: Voronoi-based analysis and fractal-based analysis. We were unable to detect differences in the microvascular pattern on myocardial sections of participants with and without type 2 diabetes.

Sustained dynamics of saccadic inhibition and adaptive oculomotor responses during continuous exploration

Journal of Neuroscience Celeste Cafaro, Giovanni Cirillo, Giovanna Vermiglio et al. Jul 23, 2026 DOI: 10.1523/jneurosci.1064-25.2026

In natural environments, stimuli often recur across time and space, requiring the visual system to remain sensitive to novelty while managing predictability. A central question in systems neuroscience is how motor systems adapt to repeated sensory events without compromising responsiveness. We investigated this adaptive capacity using saccadic inhibition (SI)—a reflexive suppression of eye movements triggered by sudden visual transients—as a probe of oculomotor dynamics during naturalistic viewing. Human participants (17 females, 4 males) freely explored visual arrays while brief gaze-contingent flashes appeared five times at random intervals, either foveally or parafoveally. SI reliably occurred ∼120 ms post-flash across repetitions and locations, indicating robust sensory-driven inhibition. However, the rebound phase—reflecting saccade reprogramming—showed a progressive decline. In a second experiment (14 females, 5 males), only the first or the fifth flash was visible on each trial. In this case, neither inhibition nor rebound was altered, suggesting that the rebound decline is driven by repeated sensory stimulation rather than exploration time. This dissociation reveals selective habituation of motor re-engagement mechanisms, while reflexive inhibitory gating remains stable. We propose that inhibition is mediated by circuitry that transiently suppresses saccade initiation and resists habituation. By contrast, the weakening rebound reflects a separate, habituation-prone route that reduces saccade generation to irrelevant events. Functionally, this imbalance implies a recalibration within the saccade generator, preserving inhibitory capacity while constraining motor output. Our findings uncover a distinct form of oculomotor habituation and demonstrate how SI reveals dynamic decoupling of sensory input and motor output under repeated stimulation. Significance Statement The ability to interrupt and resume eye movements in response to environmental changes is fundamental to visual exploration. We investigated how this process unfolds across repeated visual transients in naturalistic conditions. Our findings show that saccadic inhibition remains stable across time, whereas the subsequent rebound phase habituates. This dissociation suggests that distinct processes mediate reflexive interruption and motor recovery habituation. Our data indicate that dynamic modulation of motor gating circuits is a mechanism for optimizing oculomotor behavior. These results deepen our understanding of visual-motor coordination, provide insight about the constraints governing the underlying system circuitry, and may inform clinical tools for assessing sensorimotor adaptability in health and disease.

Daily briefing: Orcas smash sunfish to smithereens

Nature Jacob Smith Jul 23, 2026 DOI: 10.1038/d41586-026-02307-9

Machine learning–optimized discharge timing in typhoid care: Implications for clinical outcomes, cost efficiency, and health system performance

PLoS ONE Shekoofeh Sadat Momahhed, Atefehsadat Haghighathoseini Jul 23, 2026 DOI: 10.1371/journal.pone.0354148

Objective To develop and validate a machine learning model identifying typhoid fever patients at risk of unnecessarily prolonged hospitalization, and to quantify the clinical, financial, and systemic consequences of model-guided discharge optimization in a fragmented, multi-payer public insurance system. Setting Iran Health Insurance Organization inpatient claims for typhoid fever, all provinces, 2024–2025; 80,223 raw claims aggregated into 13,105 hospitalization episodes. Design Retrospective observational study with embedded computational modelling. A gradient-boosted classifier was developed on administrative claims and validated through stratified five-fold cross-validation. Predictions were translated into clinical, financial, and systemic impact levels. Results The model achieved an area under the receiver operating characteristic curve of 0.862, outperforming logistic regression (0.831). Among 13,105 episodes, 4,658 patients were identified as potentially having reducible length of stay, projecting 6,459 potentially recoverable bed-days pending clinical review. Restricted to 5,784 inpatient admissions, optimized discharge timing reduced total expenditure by 22.9% (USD 1,306,306, purchasing power parity-adjusted); 75.0% of savings accrued to patients as reduced out-of-pocket payments and only 25.0% to the insurer, reflecting a mean insurance coverage rate of 27.7% for this care pathway. Freed capacity could accommodate 1,328 additional admissions without infrastructure expansion. Public hospital patients and those aged 60 years and above showed the greatest benefit, with out-of-pocket reductions of 43.8% and 35.5% respectively. The strongest predictor of prolonged stay was payer-classification status rather than any clinical variable, revealing a structural misalignment between insurance administration and discharge practice. Conclusion Machine learning applied to routine insurance claims can reliably flag patients for clinical discharge review and quantify multi-dimensional system impacts. Discharge optimization in typhoid care functions primarily as a patient financial protection intervention, and should be prioritized in public hospitals and among elderly patients where financial vulnerability and optimization potential are both greatest.

Single-neuron connectome of the central amygdala in the mouse brain

Journal of Neuroscience Lin-Han Wang, Wei Song, Xu Chen et al. Jul 23, 2026 DOI: 10.1523/jneurosci.0393-26.2026

The central amygdala (CeA) orchestrates defensive behaviors, pain processing, and stress responses, yet how its molecularly defined neuronal subtypes are embedded in brain-wide circuits remains unclear. Here, we reconstructed the brain-wide input and output architecture of three neuronal subtypes, CeA Sst , CeA Pkc-δ , and CeA Crh neurons, at single-cell resolution in male mice. Single-cell reconstruction revealed various projection-defined classes within each molecular-defined subtype, ranging from locally restricted neurons to broadly broadcasting neurons that co-innervate hypothalamic, midbrain, and brainstem. CeA outputs exhibit subtype-specific hemispheric asymmetry, providing an anatomical substrate for functional lateralization of CeA circuits. Co-projection analysis showed segregated and convergent CeA output pathways across midbrain and brainstem structures, supporting functional heterogeneity in the selection of appropriate defensive behaviors. Mapping of the input of these neurons further uncovered segregated and spatially organized upstream networks. Cortical projection neurons, particularly from the insular cortex, sent lateralized projections to distinct CeA subregions. Joint analysis of cortical and CeA projection architectures revealed structural signatures of both serial and parallel coordination. Taken together, these findings demonsatrate a multi-level, subtype-specific, and lateralized architecture linking molecular identity to brain-wide CeA connectivity. Significance Statement Despite extensive studies of central amygdala function, the circuit architecture underlying its cellular and behavioral diversity remains poorly understood. Here, we reconstruct the brain-wide input and output connectivity of three major CeA neuronal subtypes at single-neuron resolution. We identify projection-defined classes within molecularly defined populations, reveal subtype-specific hemispheric asymmetries, and uncover organized relationships between cortical inputs and CeA outputs. This work establishes a structural framework for understanding how the CeA coordinates defensive, autonomic, and affective responses.

Urinary podocalyxin as an early biomarker for diabetic nephropathy

PLoS ONE Md. Sabbir Hossain, Shamsia Tasnim Dwipi, Nazma Ahmed et al. Jul 23, 2026 DOI: 10.1371/journal.pone.0347975

Background Conventional biomarkers, such as the urinary albumin-to-creatinine ratio (uACR), detect diabetic nephropathy (DN) late in its course and may miss early podocyte injury. Urinary podocalyxin (u-PDX), a sialylated glycoprotein shed from podocytes, may offer an earlier means of detection. Methods We conducted a cross-sectional analytical study at Bangabandhu Sheikh Mujib Medical University between March 2023 and August 2024. Eighty-eight adults were enrolled: 59 participants with type 2 diabetes mellitus (T2DM) and 29 healthy controls. Participants with diabetes were stratified into normoalbuminuric (n = 29), microalbuminuric (n = 15), and macroalbuminuric (n = 15) subgroups based on uACR. Clinical variables and biochemical indices were recorded. u-PDX concentrations were measured using ELISA, and associations with uACR and eGFR were analyzed using Kendall’s tau-b and Pearson’s correlation coefficients. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves with bootstrap internal validation. Results Among participants with diabetes, u-PDX levels increased progressively across normo-, micro-, and macroalbuminuric groups (p < 0.001). u-PDX correlated positively with fasting blood glucose, post-glucose plasma glucose, HbA1c, serum creatinine, serum urea, and uACR, with the strongest correlation for uACR (r = 0.79, p < 0.001), and inversely with serum albumin (r = −0.62, p < 0.001) and eGFR (r = −0.51, p < 0.001). In pairwise ROC analysis, a u-PDX cutoff of 0.80 ng/mL discriminated healthy controls from diabetic patients without albuminuria (sensitivity 100.0%, specificity 96.4%); 1.60 ng/mL discriminated diabetic patients without albuminuria from those with microalbuminuria (86.7%, 93.1%); and 5.51 ng/mL discriminated microalbuminuric from macroalbuminuric patients (86.7%, 93.3%). For overall discrimination of albuminuria-defined DN among diabetic patients, the optimal u-PDX cutoff was 2.92 ng/mL (AUC 0.96, 95% CI 0.90–1.00). Conclusions Urinary podocalyxin is a sensitive early biomarker of diabetic nephropathy, rising before overt albuminuria and correlating with albuminuria severity and declining eGFR. However, longitudinal validation is required before u-PDX can be recommended for routine screening in adults with T2DM.

A shared brain state for episodic and semantic retrieval

Journal of Neuroscience Matthew B. Bair, Nicole M. Long Jul 23, 2026 DOI: 10.1523/jneurosci.0558-26.2026

It is critical to identify which factors induce specific brain states as these large-scale patterns of coordinated neural activity drive downstream processing and behavior. The retrieval state, a brain state engaged when attempting to retrieve the past, is thought to specifically support episodic memory, remembering experiences within a spatiotemporal context, as opposed to semantic memory, remembering general knowledge. However, we hypothesize that the retrieval state reflects internal attention engaged to access stored episodic and semantic information. To test these alternatives, we recorded scalp electroencephalography while male and female human participants made episodic, semantic, or perceptual judgments, and applied an independently validated mnemonic state classifier to measure retrieval state engagement. We found that retrieval state engagement was greater for both episodic and semantic judgments compared to perceptual judgments. These findings suggest that the retrieval state reflects a domain-general internal attention process that supports not just episodic memory, but internally directed cognition. Significance Statement Understanding brain states, whole-brain activity/connectivity patterns, is critical as brain states influence downstream processing and behavior. The retrieval state is a multivariate brain state that influences behavior and is thought to be specific to episodic remembering, accessing stored information about one’s past experiences. Here we use a machine learning decoding approach to show that the retrieval state is also recruited to support semantic remembering, accessing stored general knowledge and facts. These findings suggest that the retrieval state reflects a domain-general internal attention state.

Selective Pt–S Anchoring at Interfacial Defects for Atom‐Economical Solar Hydrogen Production

Advanced Materials Chiyao Zheng, Tianyun Liu, Dongniu Wang et al. Jul 23, 2026 DOI: 10.1002/adma.74254

ABSTRACT Defects in photocatalysts strongly influence charge transfer behavior, and selectively exploiting defect‐rich interfacial sites as chemically addressable anchors provides a new pathway for atom‐economical hydrogen production. Here, we report a defect anchoring strategy that selectively exploits sulfur‐defect‐rich interfacial sites as chemically specific docking sites for Pt–S coordination, enabling stable Pt deployment at an ultralow loading of only 0.084 wt%. In situ spectroscopy and first‐principles calculations reveal that these defect‐anchored Pt–S motifs efficiently extract electrons from interfacial sulfur sites and optimize hydrogen adsorption thermodynamics for accelerated HER kinetics. The optimized photocatalyst delivers hydrogen evolution rates of 22.43 mmol g −1 h −1 under visible light and 91.35 mmol g −1 h −1 under full‐spectrum irradiation, exhibiting excellent long‐term stability. When immobilized as a scalable catalyst film via an immersion process, it achieves an areal H 2 flux of 331.34 mmol m −2 h −1 . More broadly, we show that the same defect‐guided Pt‐anchoring rule operates across multiple ZnIn 2 S 4 ‐based heterojunctions, highlighting a transferable site‐definition strategy for atom‐economical noble‐metal deployment. Ultimately, this approach redefines interfacial defects in heterojunction photocatalysts as programmable chemical sockets for noble‐metal placement, establishing a general blueprint for atom‐economical and scalable solar hydrogen generation.

Expression of Concern: Molecular prevalence, phylogeny and hematological impact of Toxoplasma gondii and Plasmodium spp. in common quails from Punjab, Pakistan

PLoS ONE Jul 23, 2026 DOI: 10.1371/journal.pone.0354414

Altered postnatal chromatin development in the nucleus accumbens primes enduring stress sensitivity

Journal of Neuroscience Rebekah L. Rashford, Lisa Z. Fang, Michael DeBerardine et al. Jul 23, 2026 DOI: 10.1523/jneurosci.2217-25.2026

Early-life stress (ELS) sensitizes individuals to subsequent stressors to increase lifetime risk for psychiatric disorders. Within the nucleus accumbens (NAc) — a key limbic and reward-associated brain region — ELS sensitizes both cellular and transcriptional response to later stress, which are programmed by enduring epigenetic changes. Among the histone modifications persistently enriched by ELS in NAc is H3K4me1, which is associated with open chromatin and epigenetic priming of genomic enhancers. Here, we sought to determine whether H3K4me1 enrichment in NAc was sufficient to prime cellular and behavioral responses to adult stress. Viral-mediated overexpression of the histone H3 monomethyltransferase Setd7 in juvenile NAc of male and female mice induced persistent chromatin changes and predominately opened chromatin at long-range cis-regulatory elements predicted to enhance immediate early-genes and transcriptional regulators of mesolimbic development and synaptic activity. These epigenetic changes altered physiological properties of D2-type medium spiny neurons in NAc to resemble neurons of stressed mice, without significantly altering D1-type neurons. Finally, juvenile — but not adult — Setd7 overexpression and H3K4me1 enrichment in NAc enhanced behavioral sensitivity to future stress. Together, these data indicate that altered postnatal chromatin development in NAc by H3K4me1 enrichment is sufficient to prime long-lasting transcriptional, physiological, and behavioral stress sensitivity. Significance Statement Early-life stress enriches for H3K4me1 in the nucleus accumbens, which is sufficient to open chromatin, alter medium spiny neuron physiological properties, and prime behavioral response to future stress. This work links multiple levels of analysis and provides neurobiological evidence that altered maturation of the juvenile epigenome encodes long-lasting stress sensitivity.

Bioorthogonal Anchor‐and‐Lock of Probiotic Biofilms on Diverse Biomaterials to Combat Delayed Implant‐Associated Infection

Advanced Materials Meng Zhang, Silin Ye, Weichang Li et al. Jul 23, 2026 DOI: 10.1002/adma.74083

ABSTRACT Bacterial adhesion and biofilm formation on implants remain a leading cause of device failure, and delayed‐onset infections become refractory to antibiotics once mature biofilms form. Probiotic biofilms offer a promising alternative to conventional antimicrobial coatings, but clinical translation is hindered by the lack of a stable, substrate‐generalizable immobilization method. Here we presented a broadly applicable “anchor‐and‐lock” strategy that covalently tethered probiotic biofilms to diverse implants via bioorthogonal SPAAC reaction. A mussel‐inspired adhesive peptide functionalized with DBCO served as the surface anchor, while L. casei metabolically labeled with azide groups became the click‐ready lock. The resulting coatings formed uniformly on titanium, polyurethane, silicone rubber, and polypropylene, exhibiting long‐term stability. The biofilm operated through a dual‐phase antimicrobial mechanism, including an initial bactericidal phase (≥96% killing of S. aureus ) mediated by lactic acid and hydrogen peroxide release, followed by a sustained anti‐adhesive phase that prevented pathogen colonization. RNA‐sequencing revealed that the coating downregulated S. aureus adhesion‐associated genes while suppressing carbohydrate transport and metabolic pathways. In clinically relevant delayed‐infection models in bone and bladder, functionalized implants prevented infection, mitigated inflammation, and promoted tissue integration, effects absent on unmodified controls. This SPAAC‐mediated strategy offers a broad approach to mitigating implant‐associated infections.

Identification of Candidate epitopes from nation-enriched sequences in the African swine fever virus genomes

PLoS ONE Sieun Kim, Eun Bae Kim Jul 23, 2026 DOI: 10.1371/journal.pone.0354143

African swine fever virus (ASFV) is a highly lethal pathogen that causes African swine fever (ASF) and is found in Africa, Europe, and Asia. In addition, extensive regional genetic variation poses significant challenges for vaccine development. In this study, we aimed to identify amino acid sequence fragments that are commonly enriched within ASFV strains from each country and evaluate their potential as epitopes. Amino acid sequences of genomes were segmented into overlapping 9-, 12-, 15-, and 20-mer peptides; selected fragments enriched in countries with at least ten available genomes; and cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL), and linear B lymphocyte (LBL) epitope predictions, followed by antigenicity assessment. Genomes from Italy yielded the highest number of fragments across all peptide lengths, whereas those from Russia showed a unique pattern in which fragment counts decreased as peptide length increased. From the five countries analyzed, 136 CTL, 95 HTL, and 97 LBL candidate epitopes were identified, of which 39 CTL, 18 HTL, and 75 LBL epitopes were predicted to be antigenic. The identified epitopes originated from structural ( n  = 24), replication/transcription ( n  = 11), and multigene family ( n  = 38) proteins. The resulting epitope library provides a comprehensive resource for the selection of multi target vaccines and diagnostic candidates. These findings provide a foundation for the design of region-specific vaccines and can be broadly applied for the future development of ASFV vaccines and diagnostic tools.

Engineering Mesoporous Composite Nanospheres With Metal Core and Metal Oxide Shell for Plasmonic Promoted Gas Sensing

Advanced Materials Tianming Hu, Keyu Chen, Xin‐Yu Huang et al. Jul 23, 2026 DOI: 10.1002/adma.74251

ABSTRACT Nanoengineering of core‐shell nanostructures integrating plasmonic metal cores and mesoporous semiconducting metal oxide (SMO) shells hold significant promise across catalysis, chemical sensing, diagnosis, micro–nano robots, and smart optics. However, their practical implementation is hindered by synthetic challenges such as poorly controlled hydrolysis kinetics of shell precursors and excessively high surface energy of core seeds. Herein, a versatile sequential active colloidal interfacial assembly strategy is developed to construct a library of uniform and core‐shell nanospheres featuring mesoporous SMO (e.g., SnO 2 ) shells precisely coated on functional nanocores (e.g., Au NPs). As a representative core‐shell material, the as‐synthesized Au@mSnO 2 nanospheres combine localized surface plasmon resonance (LSPR) with a mesoporous catalytic matrix, thereby enabling excellent photoresponsive properties that are particularly favorable for catalysis and chemical sensing. The Au@mSnO 2 nanospheres are used as a catalytic sensing layer matrix for fabricating custom MEMS‐based sensing nanodevices that can couple with micro‐LED to serve as chemiresistive sensors for gas detection. The as‐fabricated sensors exhibit 6‐fold enhancement of sensitivity toward low concentration NO 2 at room temperature under low‐power green light illumination. Mechanistic investigations systematically elucidate the LSPR‐induced charge carrier dynamics, revealing that the superior sensitivity originates from ultrafast hot‐electron injection, which accelerates surface catalytic activation and target gas redox conversion. This work presents a rational paradigm for precisely engineering multifunctional core‐shell structures with spatially separated components tailored heterogeneous interfaces, opening new avenues for intelligent sensing and nanophotocatalysis, and so forth.

Towards a behavioral profile of degree adverbs in Mainland and Taiwan Mandarin news language

PLoS ONE Yan Xiao, Qiurong Zhao Jul 23, 2026 DOI: 10.1371/journal.pone.0348273

The major difference between Mainland Mandarin and Taiwan Mandarin in adverb usage lies in degree adverbs. Exploring the similarities and differences in degree adverbs across both sides of the strait not only helps reveal the subtle differences between Chinese dialectal varieties, but also helps broaden the path for computer-assisted compilation of language dictionaries, and enlighten the research method used by language variation studies, comparative language studies and other applied linguistics. This paper compares degree adverbs in Mainland Mandarin and Taiwan Mandarin based on self-built news corpus by using BP (behavior profile) approach and finds that: (1) Degree adverbs with high and medium intensification/mitigation level are more commonly used while degree adverbs with extreme and low intensification/mitigation level are avoided on both sides. In addition, Taiwan uses more extreme degree adverbs than Mainland. (2) The usage of degree adverbs in Mainland and Taiwan Mandarin is significantly related to the semantic prosody, word class, and syntactic function of the words they modify. Specifically, in terms of the semantic prosody of the words they modify, degree adverbs in Mainland modify more positive semantic prosody than those in Taiwan. In terms of the word class of the words they modify, degree adverbs in Mainland mostly modify verbs while degree adverbs in Taiwan corpus mostly modify adjectives. In terms of the syntactic function of the words they modify, degree adverbs in Mainland mostly modify predicates while degree adverbs in Taiwan mostly modify attributives. (3) Cluster diagram analysis shows that the unique degree adverbs on both sides can be substituted with degree adverbs that have similar behavioral profile by each other, which reflects the openness and flexibility of language. This article further points out that the similarities and differences between degree adverbs in Mainland and Taiwan are mainly influenced by news language norms, regional socio-cultural differences, and language change and contact. This paper aims to provide new insights for language users regarding the subtle differences between dialectal varieties in news language and beyond, thereby facilitating more effective communication and the appropriate language use.

Polio should have been eradicated by now. What’s plan B?

Nature Aisling Irwin Jul 23, 2026 DOI: 10.1038/d41586-026-02229-6