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Are Young Women Receiving Delayed Care for Breast Cancer?

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Study reveals that especially young patients and those with lower income are most likely to experience delays

Photo by Tima Miroshnichenko on Pexels

In an analysis of data on adolescents and young adults with breast cancer, lower income and younger age were linked with delays in care. The analysis published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, also found that women who experienced delays in cancer diagnoses tended to have later stages of disease.

Breast cancer diagnosed before the age of 40 years – which is before the recommended age of screening – often carries a poor prognosis, along with unique treatment and psychosocial challenges. Because younger women tend to not undergo screening and may face delays in response to breast cancer–related symptoms due to potential biases that they are not old enough to have cancer, investigators conducted a study to understand the impact of patient and tumour characteristics on delays in care and tie impact of delays on cancer outcomes.

In the analysis of data on 1071 individuals enrolled in the Young Women’s Breast Cancer Study, a multi-site prospective cohort of young women diagnosed with breast cancer by 40 years of age, the team identified 153 presentation delays, 120 diagnostic delays, and 228 treatment delays. Presentation delays were defined as ≥ 90 days from time of first patient-reported symptom(s) to presentation to a clinician, diagnostic delays were ≥ 90 days from first health care visit for symptom(s) to date of biopsy with a diagnosis with breast cancer, and treatment delays were considered ≥ 60 days between the time of diagnosis to time of first treatment.

After adjusting for influencing factors, lower annual income was associated with higher odds of presentation delay, while pregnancy at diagnosis, family history of breast cancer, and triple-negative breast cancer were associated with lower odds of presentation delay. Presentation delays were also associated with later stage disease in women with certain HER2-positive tumours. Odds of diagnostic delay were higher for younger patients and lower for those with triple-negative tumours. Those who experienced a delay in breast cancer diagnosis were more likely to have late-stage disease. Patients with more aggressive tumour types were less likely to have treatment delays.

Fortunately, delays were not associated with cancer-free or overall survival, but the authors noted that later stage at diagnosis may require more extensive surgery, radiation, or systemic therapy that can impact quality of life and other outcomes.

“Our study reveals continued issues in care delay among patients with young-onset breast cancer and emphasises a need to improve both patient and provider understanding of young-onset breast cancer risk factors and symptoms to decrease disease burden among these patients,” said senior author Kristen D. Brantley, PhD, MPH, of the Dana-Farber Cancer Institute.

Full Citation:
“Delays in breast cancer presentation, diagnosis, and treatment in young women.” Bessie X. Zhang, Tal Sella, Yue Zheng, Gregory J. Kirkner, Kathryn J. Ruddy, Shoshana M. Rosenberg, Virginia F. Borges, Lidia Schapira, Steven E. Come, Jeffrey M. Peppercorn, Laura Collins, Ann H. Partridge, and Kristen D. Brantley. CANCER; Published Online: October 12, 2026 (DOI: 10.1002/cncr.70594). 
URL: http://doi.wiley.com/10.1002/cncr.70594

Source: Wiley

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Safer Nurse Workloads Could Alleviate Emergency Department Crowding

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Credit: Pixabay CC0

A new study led by researchers from Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR) finds that improving hospital nurse workloads could alleviate delays in care contributing to emergency department crowding.

The findings, published in Medical Care, highlight a promising solution to emergency department (ED) crowding, a national crisis that occurs when the number of patients entering hospitals exceeds the number of available inpatient beds, causing bottlenecks in the emergency department.

In emergency departments where nurses reported staffing inadequacies, researchers identified significantly worse patient crowding. A 1 standard deviation increase in emergency department nurse staffing inadequacy was associated with an

  • 18-minute increase in ED length of stay for patients being observed for behavioural health
  • 9-minute increase in overall patient ED length of stay
  • 0.4 percentage point increase in patients leaving the ED before being seen by a provider.

The study also found that staffing inadequacy as reported by nurses working inpatient was associated with an 18-minute increase in ED length of stay for patients presenting with behavioural health conditions. Over 60 percent of emergency department nurses and 58% of inpatient nurses in the study reported that there were not enough staff to get work done in their hospital.

“Nurses are caring for more patients than they can safely manage, and our findings suggest that high nurse workloads are contributing to excessive delays in emergency department care,” said first author Jane Muir PhD MSHP RN (Assistant Professor, Department of Family and Community Health; CHOPR core faculty).

“Crowding occurs when hospitals don’t have enough resources to admit patients into a bed, whether in the ED or inpatient units,” Muir added. “We find that having enough nursing positions to appropriately staff high-stakes hospital care is one of the most important resources for ensuring the public experiences safe, timely care. A hospital bed without a nurse to staff it is not an available bed.”

The average study hospital was performing worse than the Joint Commission recommendations for ED care (recommendation: less than 2% of patients leave the ED without being seen and less than 4 hours length of stay for patients with behavioural health conditions). In this study, the average ED had 2.8% of patients leave without being seen and 5.5 hours length of stay for behavioural health patients.

Improving nurse staffing adequacy could result in more accessible ED care. In this study, researchers projected that funding more positions for bedside nurses in the 410 study hospitals would be associated with over 5000 more patients treated due to shorter ED lengths of stay, and over 250 patients retained in care due to fewer people leaving waiting rooms before being seen.

“Hospitals can create more funded positions for bedside nurses to alleviate chronic understaffing conditions and solve long wait times in emergency departments,” Muir stated. “Our study emphasises that safe nurse staffing matters to move the needle on safer, timelier care for the public.”

Source: Penn Nursing

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The Ovary Doesn’t Retire After Menopause

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Postmenopausal human ovaries show progressive molecular remodelling and inflammatory shifts

Female reproductive system. Credit: Scientific Animations CC4.0 BY-SA

Contrary to popular belief, the postmenopausal ovary is not defunct.

In a new, paradigm-shifting study of ovaries from 28 women, scientists at Northwestern University and the Buck Institute for Research on Aging found that in the decades after menopause the ovary remains biologically active and continues to remodel with age, showing increased inflammation and changes in tissue structure. The study also identified a molecular link between ovarian ageing and cancer.

The study was published on 14 October in Aging Cell.

“In the ovary, we reach a point of no return with respect to fertility in which it’s no longer producing eggs, and I would venture to say most people assume those ovaries are just sitting there doing nothing, similar to the appendix,” said co-corresponding author Francesca Duncan (associate professor of reproductive science in medicine, Northwestern University Feinberg School of Medicine; associate professor in residence, Buck Institute). “But that’s what makes this study very different.”

The findings challenge the notion that the ovary is an innocent bystander after reproduction ends, raising questions about whether it could play a more active role in ageing and chronic disease in women.

“The ovary is not just a reproductive organ,” said co-corresponding author Birgit Schilling (professor and director of the Mass Spectrometry Center, Buck Institute). “It really influences how somebody ages because it speaks to all these other organs, such as the brain, and also to the bone, and women after menopause experience often a lot of bone problems. So, we think there is a connection between all these organs.”

Women now routinely live for decades after menopause, making it increasingly important to understand what the ovary is doing during this long post-reproductive period, Duncan said.

“Is the ovary the canary in the coal mine in women?” said Duncan. “Could ageing in the ovary set off a cascade of changes that continues throughout the body as women get older?”

Duncan’s group previously found similar evidence of continued remodelling in postmenopausal ovaries of mice. When she embarked on that research and the current study in humans, she expected to see very little activity in the postmenopausal ovary.

“I was predicting that if we took a 50-year-old ovary, a 60-year-old ovary, a 70-year-old, an 80-year-old ovary, they would all look exactly the same, have no eggs, and basically be non-functional,” Duncan said. “The fact that across species we’re seeing this gives us confidence that this isn’t just some random event, but something truly meaningful is happening in the biology.”

What remains unknown is exactly what the ovary is doing after menopause and whether those changes are beneficial or harmful, Duncan said.

“Our data points to progressive ageing features in which the ovary appears to lose its original identity and ends up doing something different,” Duncan said. “We do not yet know if there’s ever a point in a woman’s life when this organ is no longer beneficial and it’s actually harmful. These results really point to the need to ask this question.”

To characterise the changes, Schilling’s team – spearheaded by Buck Institute staff scientist Mark Watson – used advanced proteomic technologies to analyse 5,812 protein groups in normal ovarian tissue from postmenopausal women aged 50 to 75.

Human ovarian tissue is difficult to obtain, making the 28 ovaries an unusually valuable collection. By focusing exclusively on women within a relatively narrow 25-year age range after menopause, the researchers examined molecular changes that continue during the postmenopausal years. The technology allowed examination of thousands of proteins across every sample and identification of patterns using multiple statistical approaches.

Those analyses showed that the ovary continues to change well after its reproductive life ends.

Ovaries from younger postmenopausal women had more proteins involved in maintaining cells and tissue structure, while older ovaries had more proteins associated with inflammation, immune activity and the ongoing breakdown and rebuilding of the extracellular matrix. The differences were most pronounced between ovaries from women in their 50s and those from women 70 and older.

“When we analysed the data in multiple different statistical ways, what became clear across all these methodologies is that the ovary was not stagnant,” Schilling said. “In fact, over the decades, there were quite dramatic differences in terms of some proteins’ levels would go up with age and some proteins’ levels would go down, which tells us this organ is quite dynamic.”

The ageing ovaries also showed some of the same molecular patterns seen in cellular senescence.

The findings build on a discovery Duncan’s lab made a decade ago. In 2016, the lab was the first to report that as ovaries age they become increasingly inflamed, fibrotic and stiff. Because cancer cells can thrive in collagen-rich, stiff environments, the scientists have been investigating whether these age-related changes could make the ovary more hospitable to cancer cells.

The new study provides a molecular view of that remodelling process later in life. As postmenopausal ovaries aged, proteins involved in maintaining tissue structure declined, while proteins involved in inflammation and reshaping the tissue environment became more prominent.

Although all the ovarian tissue in the study appeared normal and cancer-free, some proteins previously associated with ovarian cancer were more abundant in ageing ovaries, with the strongest signal among women in their 60s. The finding does not mean the ovaries were cancerous or precancerous, but suggests healthy ovarian ageing and ovarian cancer share some biological processes.

“It’s not that all postmenopausal women get ovarian cancer, but we know that that fibrotic inflammatory environment is certainly an environment that cancer cells prefer to home in on,” Duncan said. “This is all consistent with the idea that the ageing ovary is a potential third hit for ovarian cancer, with the first hit being genetic and the second hit being environmental. So can we target the ageing ovary therapeutically to lower the risk of ovarian cancer, or can we develop novel biomarkers of ovarian cancer?”

The findings do not answer whether healthy ovaries should ever be removed after menopause. Rather, they raise new questions about how the biological activity of the postmenopausal ovary might influence women’s health systemically and whether the observed changes contribute to disease or are features of normal ageing.

Source: Northwestern University

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UP Researchers Call for More Personalised Radiation Dosing in Cancer Treatment

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Two cancer patients can receive exactly the same amount of a radioactive medicine, yet their bodies may absorb very different radiation doses.

University of Pretoria (UP) nuclear medicine researchers argue that this is one of the next big challenges precision cancer treatment needs to address.

In a paper published in the inaugural volume of The Lancet Medical Imaging & Theranostics, Prof Mike Sathekge and Dr Kamo Ramonaheng call for greater use of patient-specific dosimetry, which measures how much radiation actually reaches a patient’s tumour and healthy organs.

Radiopharmaceutical therapy uses medicines containing small amounts of radioactive material to seek out and attack cancer cells. But treatment is still commonly based on a standard amount of radioactivity, sometimes adjusted for factors such as body weight.

The researchers argue that knowing how much is given is not the same as knowing how much radiation the cancerous cell actually receives.

“Two patients can receive the same treatment, but their bodies may handle it very differently,” explains Prof Sathekge, Head of Nuclear Medicine at UP and Steve Biko Academic Hospital and CEO of the Nuclear Medicine Research Infrastructure (NuMeRI).

“Precision medicine should ultimately mean precision for the individual patient. If we can measure how much radiation reaches the cancer and how much reaches healthy tissue, we have much better information to guide treatment.”

From standard treatment to individual treatment

This measurement is known as dosimetry. The principle is similar to asking not only how much medicine was prescribed, but how much of the treatment reached its intended target.

The researchers propose a practical first step which is to measure the radiation absorbed by the tumour and healthy organs after treatment. This could help doctors understand whether the cancer received enough radiation while limiting unnecessary exposure to healthy tissue.

For patients receiving several treatment cycles, information from the first cycle could eventually help doctors decide whether later treatment should be adjusted or whether continuing the therapy is likely to benefit the patient.

Dr Kamo Ramonaheng elaborates that, “The question should not only be, ‘How much did we give the patient?’ It should also be, ‘How much did this patient actually receive where it mattered?’ Dosimetry brings us much closer to answering that question.”

This could become increasingly important as these therapies are used earlier in cancer care, where patients may live for many years after treatment and reducing long-term side effects becomes particularly important.

New technology is opening the door

Sathekge and Ramonaheng say advances in medical imaging and artificial intelligence are making personalised dosimetry increasingly practical.

More sensitive scanners can provide better information about where radioactive medicines travel in the body, while AI could eventually help analyse images faster and predict how individual patients may respond. The researchers stress that these technologies must be carefully tested before becoming part of routine clinical decision-making.

The ultimate possibility is to use imaging before treatment to predict the radiation dose a patient’s tumour and organs are likely to receive, allowing doctors to plan treatment more precisely before it begins.

Why NuMeRI matters

Much of the infrastructure needed to investigate these approaches already exists at NuMeRI, based at Steve Biko Academic Hospital.

The national research facility brings together advanced PET and SPECT imaging, radiopharmaceutical development, medical physics, radiobiology and clinical research. It is designed to help move discoveries from the laboratory into patient care and to strengthen research and training in personalised nuclear medicine.

Dr Ramonaheng is Head of Medical Physics and Radiobiology at NuMeRI and winner of the prestigious Saul Hertz Award at the Theranostics World Congress 2026. Her research includes patient-specific dosimetry.

Prof Sathekge explains that, “NuMeRI gives us a place where we can develop the science, test it, image patients and build the evidence needed to improve treatment. That is important for dosimetry because personalised treatment depends not only on an idea, but on having the technology, expertise and clinical environment to make it possible.”

The researchers caution that technology alone will not be enough. Wider use of personalised dosimetry will require trained specialists, consistent standards, appropriate funding and stronger clinical evidence.

Their paper describes dosimetry as the “compass” that could guide radiopharmaceutical therapy towards truly personalised cancer treatment.

For Prof Sathekge, the destination is clear, “We want to get closer to giving the right treatment, at the right radiation dose, to the right patient at the right time.”

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Skin Sensors Show Link Between Insomnia and Fear Responses

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A small study measuring stress-related skin signals found differences in the learned fear and safety responses of adults with and without insomnia.  

Demonstration of skin conductance sensors attached to the palm, used for estimating physiological arousal. Image credit: Revanth Reddy, CC-BY 4.0

A new computational model using skin conductance measurements to estimate stress-related emotional arousal found a significant difference in learned fear and safety responses over time between adults with and without insomnia. The new study from Dr. Rose T. Faghih of New York University Tandon School of Engineering, US, and collaborators at Harvard Medical School, US, describing the work was published this week in the open-access journal PLOS Mental Health.

Insomnia Disorder, affecting an estimated 10% of the population, has been widely conceptualised as a disorder of chronic hyperarousal linked to emotional and autonomic dysregulation. Sleep is thought to help consolidate fear extinction, the process of learning that a previously threatening stimulus no longer signals danger, forming a new, inhibitory “safety memory” to override an established “fear memory.” 

 Skin conductance, changes in the skin’s electrical properties driven by sweat gland activity, is a well-established marker of stress and emotional arousal. Previous studies looking at skin conductance and fear extinction have focused primarily on sharp, isolated incidences of stress activity.

 In the new study, researchers designed two statistical models estimating stress and arousal from skin conductance: one model using only isolated stress spikes, and one model that also incorporated the signal’s continuous background levels. Both models were applied to skin conductance recordings from an initial cohort of 24 adults with insomnia and 24 good sleepers who completed a task in which they were temporarily conditioned to fear a visual stimulus, then learned it was no longer dangerous.

 Only the model including the tonic background signal detected a significant difference between the two groups. From the conditioning phase, when the visual stimulus was paired with a mild shock, to the extinction phase, when it no longer was, the average ‘high-arousal index’ increased in people with insomnia but slightly decreased in good sleepers. Other differences between the groups — including lower average arousal during conditioning and higher average arousal when the fear and safety memories were recalled on the second day — followed a similar pattern but did not reach statistical significance.

 These findings suggest that because people with insomnia failed to fully acquire the safety memory on the first day or retain it until the second day, the new extinction memory was too weak to oppose the original fear memory during recall. Lead author Tianyu Hwang summarises the experiment as follows: “Our study shows that insomnia isn’t just about poor sleep – it directly relates to the body’s ability to learn and remember that a threat is gone.” 

 “Hyperarousal is thought to be an underlying risk factor for developing insomnia, and we were excited to see that sophisticated mathematical parsing of skin conductance revealed the same effect we had previously observed using fMRI,” co-author Dr Edward Pace-Schott writes. “This hyperarousal could oppose subsequent learning that a stimulus has become safe, which may explain why anxiety treatments like exposure therapy are more successful in people with good sleep.”

 Senior author Dr Rose Faghih adds: “Using our previously developed sympathetic arousal virtual sensors based on microfluctuations in sweat activity, we compared insomnia patients and healthy controls during fear extinction and observed that insomnia is associated with a reduced capacity to extinguish physiological threat responses.” 

 Dr Ryan Bottary, co-author, notes: “In our study, people with insomnia, compared to their good sleeping peers, became more aroused once the danger was taken away. For patients, this may help explain why the fear that ‘a bad night will ruin tomorrow’ survives so many tomorrows that turn out just fine.”

 Co-author Dr Saman Khazaei concludes: “I find it interesting to see that decoded arousal from certain components of skin conductance reflects a signature of a disrupted fear response in people diagnosed with insomnia. This finding may motivate further research on skin conductance and the use of wearable devices that measure it to improve sleep in everyday-life settings.”

Provided by PLOS

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Pope Leo XIV’s Lung Cancer Highlights Growing Number of Nonsmokers Diagnosed with the Disease – And Younger People Too

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By Edgar Beltrán, The Pillar – Own work, CC BY-SA 4.0, Link

Estelamari Rodriguez, University of Miami

When many people think of an average lung cancer patient, they often imagine an older man smoking. But the face of lung cancer has changed. Over the past 15 years, more women, never smokers and younger people are being diagnosed with lung cancer.

In fact, lung cancer is the leading cause of cancer death among women, and more women die from lung cancer than breast, ovarian and colorectal cancer each year. The American Lung Association reports that while lung cancer rates have risen by 79% for women over the last 44 years, they decreased by 43% for men. And for the first time in history, there are more young women than men diagnosed with lung cancer.

News about Pope Leo XIV’s lung cancer diagnosis on Oct. 13, 2026, sparked discussion about increasing rates of the disease among people who have never smoked. Leo reportedly is not a smoker. Potential causes for the disease include environmental exposures and genetics, and recognising the diverse factors that can increase someone’s risk of lung cancer – regardless of their smoking history – is essential for timely and appropriate screening and treatment.

Cancer that is found at the earliest stages, like that of the pope, can be treated with surgery and cured for both smokers and nonsmokers. The challenge is that people who have never smoked are not currently included in lung cancer screening guidelines, and tumours are often only found by chance.

As a thoracic oncologist, I have seen many younger women and never smokers walk into my clinic with a new diagnosis of lung cancer. Particularly for never smokers, lung cancer is unexpected for both patients and their doctors, which can often lead to delays in diagnosis. Researchers have described this trend of increasing lung cancer rates among women in different parts of the world and are starting to understand why cases are on the rise.

Lung cancer in women

The first explanation of why rates of lung cancer in women have increased is that many started smoking later than men, pushing back their peak in smoking-related lung cancer diagnoses.

Women also started smoking in the years when filtered cigarettes were most commonly used. This led to an increased risk of a type of cancer called adenocarcinoma due to the way cigarette filters distribute tobacco smoke to the outer parts of the lungs. Some studies suggest that women are more susceptible to the carcinogenic effects of exposure to tobacco and cigarette smoke, including second-hand smoke, and may develop lung cancer after fewer years of smoking compared to men.

However, it is important to note that most people diagnosed today with lung cancer are not active smokers. About 20% of women with lung cancer have never smoked – higher than for men with lung cancer who’ve never smoked. An increasing number of lung cancer diagnoses are among people who never smoked.

Lung cancer risk factors

Besides smoking and secondhand smoke, there are several other lung cancer risk factors. These include a family history of cancer and exposure to asbestos, radon and air pollution.

Exposure to carcinogens in the workplace in the form of inhaled chemicals such as arsenic, beryllium, cadmium, silica and nickel is still a concern in some parts of the world. The potential lung cancer risk of e-cigarette and marijuana smoke is still under study but of potential concern.

Recently, researchers have also found that genetics can play a role in lung cancer risk in some patients with a strong history of lung cancer. Studies of these families have helped identify potential susceptibility genes for lung cancer and environmental risk factors.

Like BRCA1 and BRCA2 in breast cancer, alterations in genes that promote or protect against tumour development can contribute to lung cancer development. Researchers have yet to identify specific mutations that may predispose individuals to lung cancer. However, studying familial genetic predispositions can help elucidate how lung cancer develops and lead to new biomarkers for early cancer detection in high-risk groups.

Lung cancer screening

In 2021, the United States Preventive Services Task Force updated its lung cancer screening guidelines to include younger patients with less smoking history. Now, lung cancer screening is recommended for adults ages 50 to 80 who have smoked at least one pack per day for 20 years, current smokers and former smokers who quit smoking within the last 15 years. Women at risk for lung cancer can talk to their doctors about ordering a low-dose CT scan for lung cancer screening.

Nationwide, more than 70% of eligible women undergo breast cancer screening but less than 6% of all eligible smokers pursue lung cancer screening. Researchers estimate that these new screening guidelines will increase the number of women eligible for lung cancer screening by 40% by including those at a younger age who have less smoking exposure.

A low-dose CT scan can help with early detection of lung cancer. In this image, the tumour is the white nodule in the upper right corner of the black space. Atlas of Pulmonary Pathology/Flickr, CC BY-SA

Lung cancer diagnosis

In recent years, increasing understanding of the genetic changes that can lead to cancer and how to harness the immune system to treat cancer has led to new targeted therapies and immunotherapies that have improved the prognosis of patients with lung cancer. Women tend to have a better lung cancer prognosis than men, especially if they never smoked and have tumours with molecular changes that can be treated with targeted therapies.

However, lung cancer symptoms may go unrecognised in women. Symptoms of lung cancer can include coughing, shortness of breath, overwhelming fatigue and pain in the back, chest or shoulder, which could be confused for other ailments. Because women tend to be slightly younger when diagnosed than men, patients may be able to tolerate symptoms longer and delay seeking medical attention. Physicians also might not attribute these symptoms to lung cancer due to a patient’s younger age.

Recognising the early symptoms of lung cancer, expanding lung cancer screening eligibility and testing for genetic biomarkers to select the best therapy are some of the steps that could help address the global epidemic of lung cancer in women.

This is an updated version of an article published on Feb. 1, 2023.

Estelamari Rodriguez, Associate Director of Community Outreach in Thoracic Oncology, University of Miami

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Researchers Explore Gut & Brain Health Link for People with HIV

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Irritable bowel syndrome. Credit: Scientific Animations CC4.0

Oregon Health & Science University researchers have secured a $5.8 million, five-year federal award to investigate whether damage to the gastrointestinal tract contributes to neuroinflammation in people living with HIV – raising the potential for new treatments to preserve brain function in people with HIV and older adults.

“Even though antiretroviral drugs are very successful at suppressing the virus, we’ve seen people living with HIV have neurocognitive disorders similar to what happens when people age,” said co-lead investigator Afam Okoye PhD (professor, OHSU Vaccine & Gene Therapy Institute). “If we can show a dynamic relationship between inflammation in the gut and the brain, this line of research could then lead to new treatments to reduce neuroinflammation.”

The award from the National Institute of Mental Health of the National Institutes of Health will enable researchers to align nonhuman primate models with human autopsy tissues to better understand the interplay between inflammation in the gut and brain health among people living with HIV.

Scientists have long associated inflammation in the gastrointestinal tract with impaired cognition in the brain. People with inflammatory bowel disease are at increased risk for Parkinson’s and Alzheimer’s disease, for example.

This problem disproportionately affects people living with HIV.

Researchers surmise this may be related to the fact that the initial infection of the virus – even when it’s subsequently held in check by antiretroviral therapies – causes lasting damage to immune cells in the GI tract. The research team will include pathologists at OHSU and infectious disease specialists at the NIH to better characterise how exactly inflammation in the gut is linked to brain function.

The research also will involve nonhuman primates at OHSU’s Oregon National Primate Research Center.

“Neuroinflammation in people with HIV is very hard to study,” said Okoye (also Division of Pathobiology and Immunology, ONPRC). “These are very challenging studies to do, but we have expertise and experience in the nonhuman primate model. It’s high risk but also high reward.”

Ultimately, it may be possible to develop targeted therapies that tamp down harmful or runaway inflammation while retaining the beneficial effects of a strong immune system.

“Inflammation in and of itself is not bad,” said co-lead investigator Jacob Estes PhD (professor and director of the VGTI). “It’s part of the immune system’s response to mediate infection. Ultimately, this research could lead to precision targets that would limit pathology that harms brain function but doesn’t completely shut off the immune system’s ability to do the things it needs to do to promote health.”

Source: Oregon Health & Science University

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New Research on Botticelli’s Venus Uncovers a Pituitary Tumour

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By Sandro Botticelli – Adjusted levels from File:Sandro Botticelli – La nascita di Venere – Google Art Project.jpg, originally from Google Art Project. Compression Photoshop level 9., Public Domain, Link

New evidence supporting the theory that Botticelli’s Venus died from a pituitary tumour was published on Monday.

The Medical Humanities paper published by the BMJ is the third in a series of papers led by Professor Paolo Pozzilli, in which he has set out his research on the Renaissance aristocrat Simonetta Vespucci, Sandro Botticelli’s muse, who died at just 23 from suspected tuberculosis.

Simonetta Vespucci (c. 1453–1476), born Simonetta Cattaneo in Genoa, was a Renaissance beauty dubbed “La Bella Simonetta.” Married at 16 to Marco Vespucci, she captivated Florence’s elite, including the Medici family.

Botticelli painted her in both The Birth of Venus and Primavera, and was so devoted to her that he asked to be buried at her feet. The “Venus squint” made famous in her paintings was copied by other artists and became a hallmark of Renaissance beauty.

Professor Paolo Pozzilli’s previous examination of documents about her death, and of the portraits, suggested an expanding pituitary tumour led to pituitary apoplexy, an acute condition ending in bleeding and death. This may have been sparked by dancing, or a violent rape – both suggested by the historical record.

In the latest paper, Pozzilli’s team examines Botticelli’s depiction of Vespucci’s eyes in the famous Birth of Venus, and in other portraits of her.

The findings support the original hypothesis. They describe swelling around the woman’s eyes, particularly her left eye. The tissue covering the white part of the eye is loose or folded, and the tissue underneath is swollen with fluid.

These changes, together with a squint (where the eyes do not point in the same direction), may be associated with a large tumour of the pituitary gland. There is also some swelling around her right eye.

Paolo Pozzilli (Honorary Professor of Diabetes and Clinical Research, Queen Mary University of London) said: “Sandro Botticelli was a brilliant artist who depicted his subjects with great realism. So it is not surprising that he’s left medical evidence in his paintings that we are able to read centuries later. The squint (‘strabismus’) of Venus in Simonetta Vespucci’s portraits embodies a poignant paradox: once exalted as the epitome of divine allure in Renaissance art and copied by artists like Bronzino, it now reveals itself as a subtle harbinger of her doom.”

Source: Queen Mary University London

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Prescriptions for Nature Could Fight the ‘Epidemic of Loneliness’

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Photo by Henry Xu on Unsplash

About one in three Americans and one in six people worldwide feel lonely on a regular basis, a troubling reality that has prompted some public health officials to declare an ‘epidemic of loneliness’.

A new global study presents a novel remedy. It found that nature-based social prescribing – clinicians literally prescribing things like gardening, hiking or birdwatching – can significantly reduce loneliness. Spending time in nature with others works even better, particularly for the loneliest among us, the study found.

“There has been a lot of passion about nature-based prescriptions, but not a lot of evidence,” said corresponding author Jill Litt (professor of environmental health, CU Boulder; principal investigator, RECETAS project).

Thus far, all the trials have shown promising results. The latest findings, looking at 320 lonely adults in Barcelona, appear in the October issue of Lancet Regional Health.

“We now have randomised controlled trials showing this works and the impacts last,” said Litt.

Loneliness is not about being physically isolated. Rather, it is a “subjective disconnect between one’s expectations of their social relationships and one’s reality.”

“I’ve heard people describe it like a knot in their stomach, like something is just not right,” said Litt. “You could be in a room full of people and still feel lonely.”

Chronic loneliness can increase risk of cardiovascular disease, dementia, stroke, depression and anxiety. It can also burden the healthcare system, as people suffering from loneliness tend to visit their doctor more and are more likely to visit the emergency department with vague complaints on Friday afternoons – a phenomenon known as “Friday afternoon syndrome.”

Due to stigma, people are often reluctant to admit or don’t recognise they are lonely and assume the physical symptoms they feel are due to something else.

“Once clinicians really start to drill down to the root causes, they discover that loneliness is a big factor and the solutions may lie outside the traditional medical system,” said Litt (also a researcher with the Barcelona Institute for Global Health).

RECETAS (Re-imagining Environments for Connection and Engagement) was launched in 2021 with a $5.6 million grant from the European Union. It has since conducted randomised controlled trials in Barcelona, Spain; Prague, Czech Republic; and Helsinki, Finland; and quasi-experimental studies in Marseille, France; Cuenca, Ecuador; and Melbourne, Australia.

The newest findings centre around the site in Barcelona.

The study included 320 lonely older adults from 12 low-income neighbourhoods. Half were placed in a group of 8–10, which spent two hours weekly for nine weeks together doing things like gardening, birdwatching or nature-based art programmes along with two trained facilitators. The other half were provided the same menu of free, easily accessible nature-based activities that they could do on their own. Both strategies worked. Participants on average showed an 11% reduction in loneliness scores at three months; 12% at six months; and 17% at one year. For those who started with lower emotional wellbeing, the group intervention worked better.

Litt said that nature, with its vivid sounds, smells and sights, can act as an “additional facilitator,” augmenting therapeutic benefits.

Even being in nature alone can alleviate loneliness, the research suggests.

“Being out in nature forms this kind of reservoir of calm that we can return to later in life during stressful times,” said Louise Chawla (environmental psychologist and professor emerita, CU Boulder), who recently co-authored another paper with Litt about the role that nature can play in fostering social connections. “It’s not just restorative when you are in a place but also when you go back to it in memory.”

Public health agencies in Spain have already begun to recognise the Friends in Nature model as a best-practice for addressing the loneliness epidemic. Litt is now working to bring similar trials to the US in hopes that someday, insurers might cover things like a membership in a community garden or birdwatching club.

“We have nature in our cities and investment in our green infrastructure,” she said. “Now we need a mechanism to bridge these resources with our health systems to offer person-centred care that leverages the power of nature for healing and wellbeing.”

RECETAS project: https://www.recetasproject.eu/

Source: University of Boulder Colorado

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Smoking May Affect Fertility in Both Men and Women, New Study Finds

On By ModernMedia
Photo by Sara Kurfess on Unsplash

New research has shed light on how exposure to cigarette smoke could affect reproductive health in both men and women, identifying changes in biological processes involved in ovarian function and sperm production.

The study, led by researchers from the Universities of Nottingham and Sheffield and published in Frontiers, provides new insight into potential mechanisms linking smoking with reproductive health.

Infertility affects a significant proportion of people of reproductive age worldwide. According to the World Health Organization, approximately one in six people globally experience infertility at some point during their reproductive years.

In this study, researchers used a mouse model to examine the effects of different levels of cigarette-smoke exposure on the ovaries and testes, focusing on changes to reproductive tissues and the activity of genes involved in their normal function.

In females, the number and structure of ovarian follicles showed relatively little change following exposure, even at higher levels. However, researchers identified clear changes in the activity of numerous genes.

Genes involved in cell division and metabolism became less active, while genes associated with protein production became more active. The pattern of gene activity showed similarities with biological processes previously associated with ovarian ageing and reduced ovarian function.

In males, higher levels of smoke exposure were associated with changes to structures within the testes, including enlargement of the seminiferous tubules. Researchers also identified changes in the activity of genes involved in sperm production, immune responses and cell signalling.

Some genes associated with sperm production became more active, while others involved in immune function became less active. The findings suggest that cigarette-smoke exposure may alter biological processes important for normal testicular function and sperm development.

The researchers say the findings add to existing evidence about the potential impact of smoking on reproductive health and highlight the need to better understand the biological mechanisms involved.

Professor Lucy Fairclough (School of Life Sciences, University of Nottingham), co-author, said: “Our study has identified potential biological mechanisms that could help explain the link between smoking and reproductive health in both men and women.

“In females, we identified changes in gene activity associated with biological processes that have previously been linked to ovarian ageing and reduced ovarian function. In males, we found changes in genes involved in sperm production and testicular function.

“These findings are important because they help us understand how exposure to cigarette smoke could affect reproductive health. Further research will be needed to establish how these biological changes relate to fertility in humans.”

Dr Adam Watkins (University of Sheffield) said: “While it is well-established that smoking is harmful for your reproductive health, the exact mechanisms are not fully understood. Our mouse study has enabled us to explore how the ovaries and testes respond following exposure to cigarette smoke. Interestingly, our study shows that the ovary and testis respond differently to the cigarette smoke. We observed that while the structure of the ovary was unaltered, the testis showed measurable changes in its morphology. Within the ovary, we identified changes in genes that regulate cell proliferation and the synthesis of proteins, while in the testis, genes regulating sperm production were altered.

“While our study only assessed the effects of cigarette smoke on the ovaries and testes, it does provide new mechanistic insight into how parental smoking shapes their reproductive health.”

Source: University of Sheffield