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In Addition to Healthy Lifestyles, Certain Medications Slow Aging

On By ModernMedia
Photo by Barbara Olsen on Pexels

When Raghav Sehgal arrived at Yale as a graduate student several years ago, he wanted to explore the use of powerful computer science tools in cancer research. With an engineering background and a computational biology startup already under his belt, he was well prepared.

But as Sehgal began his Ph.D. studies, his thesis adviser at the Yale School of Medicine posed a larger question: If you want to solve cancer or any age-related disease, such as cardiovascular disease, why not solve aging itself? 

“That put me on a different path,” said Sehgal, an associate research scientist in psychiatry with specialties in computational biology and bioinformatics. “As researchers, we have a long way to go in understanding the aging process and whether the steps we take to manage it really work.

What works and what doesn’t

Improved blood-based DNA tests indicate that these interventions seem to be the most effective at slowing the biological aging process:

  •  Prescribed medications for metabolic control and weight management, including metformin and semaglutide.
  •  Healthy diet and exercise combined. Researchers looked at popular diets including, the Mediterranean, low-fat, and low-carb plans.

Additional research is needed to further validate the findings.

Today, Raghav’s research focuses on the biological systems that drive human aging and how to best measure aging, as well as why aging gives rise to diseases like cancer, diabetes, and dementia. And while his research might not necessarily solve aging, he does explore whether the aging process can be reversed through interventions.

Sehgal is the first author of a new paper from the lab of Albert Higgins-Chen, assistant professor of psychiatry in the Yale School of Medicine. In the paper, Higgins-Chen’s research team took a significant step toward determining which existing anti-aging measures have quantifiable impacts.

Using a new class of DNA-based blood tests, they found that lifestyle interventions and certain drug treatments indeed appear to slow the aging process, while over-the-counter supplements don’t have much effect. All members of the Higgins-Chen lab collaborated in the work, including researchers Daniel Borrus, Jenel F. Armstrong, John Gonzalez, Jessica Kasamoto, and Yaroslav Markov. The paper appears in the journal Nature Medicine.

“For the first time we’ve shown that certain therapies have measurable impacts,” said Sehgal. “This wasn’t previously possible, because we didn’t have enough data to say these biomarkers are consistently responsive to these interventions.” Biomarkers are measurable indicators that reflect a person’s functional or biological age rather than just the number of years lived.

For their analysis, the researchers primarily used a type of blood-based biomarker known as epigenetic clocks, which estimate epigenetic or biological age by measuring the pattern of methyl groups (basic chemical structures that act like tags) attached to a person’s DNA. As people age, these chemical tags change, previous research has shown. Successful anti-aging interventions can reverse the tags. Computer algorithms are then able to use the changes observed in these tags to estimate a person’s epigenetic “age.”

In their work, the researchers combined data from 51 anti-aging intervention studies – which examined a range of strategies, from supplements to medical procedures – and measured more than 110 DNA methyl biomarkers (including 16 major epigenetic clocks). They then compared participants’ biological ages before and after various interventions.

“What we did was pretty unique,” Sehgal said. “We already know that certain things might prolong health span and lifespan. There is data from retrospective analysis as well as from animal models. We took all that knowledge along with the real-world clinical studies to identify which interventions in humans were slowing down aging across the board in these known biomarkers.”

The researchers tested four categories of intervention: pharmacological drugs, lifestyle-based changes, over-the-counter supplements, and medical procedures. They found that lifestyle interventions, such as a combination of a healthy diet (whether it’s Mediterranean, low-carb, or low-fat) and exercise, consistently decreased epigenetic age.

Pharmacologic interventions – including metformin and semaglutide, prescription medications used for metabolic control and weight management, and anti-TNF therapies, which use biologic medications to target an immune system protein that triggers harmful inflammation –decreased epigenetic age the most. (TNF, or tumour necrosis factor, is an immune-system protein that helps fight inflammation-related injury.) 

On the other hand, over-the-counter supplements and certain medical procedures didn’t have an effect in decreasing epigenetic age, their analysis showed. Other key findings revealed that the newer biological age clocks outperformed older models, and that biomarkers changed more in people with diseases than in healthy volunteers.

Going forward, the next step would be expanded testing measuring interventions and impact in a widespread, diverse group of volunteers, Sehgal said.

“If these new biomarkers are eventually validated to predict long-term health, scientists will be able to evaluate anti-aging therapies much faster,” he added. “Instead of waiting decades for evidence from clinical trials, we’ll be able to see which interventions are effective and in which people in a few years or even months.”

Senior author Higgins-Chen warned that researchers need to be cautious in interpreting intervention studies. 

“We have developed a rigorous, systematic approach to evaluating and comparing how biomarkers change across a wide variety of interventions, and that is a critical step in the right direction,” he said. “However, the true meaning of that change must be fully understood.”

Which biomarker changes are due to the intervention, and which result from hidden confounders? What is the time course of the change during an intervention – and after the intervention ends? What are the biological mechanisms underlying the change?

“And most importantly – what does the change mean for our long-term risk of age-related disease and functional decline?” Higgins-Chen said. The lab is continuing to investigate these questions in additional studies led by researchers Borrus, Armstrong and Grace Zou. Chen’s lab is also affiliated with the Department of Pathology, the Computational Biology and Bioinformatics Program, and the Y-Age Yale Center for Research on Aging.

Source: Yale University

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Study Finds Long-Term Benefits of Stroke Thrombectomy

On By ModernMedia
Thrombophilia. Credit: Scientific Animations CC4.0.

A one-year follow-up analysis of a landmark clinical trial suggests that patients with severe strokes experienced better long-term outcomes after undergoing endovascular thrombectomy compared with medical management alone, according to findings published in JAMA.

The study evaluated ischemic stroke patients presenting with large-core infarcts, meaning a significant amount of brain tissue had suffered damage. These patients are historically considered less likely to benefit from mechanical clot removal because of the amount of brain damage that has already occurred by the time treatment begins, said Sameer A. Ansari, MD, PhD, professor and chief of Interventional Neuroradiology in the Department of Radiology, who was a co-author of the study.

While the original trial did not show meaningful benefit at 90 days, the newly reported one-year data show functional gains among patients who received thrombectomy. The results of the current study suggest longer-term follow-up was needed to fully understand the benefits of the procedure, Ansari said.

“At one year, it’s quite evident based on the statistical analysis that there’s significant benefit with thrombectomy,” said Ansari, also a professor in the Ken and Ruth Davee Department of Neurology and of Neurological Surgery.

In the study, investigators found that 23.6 percent of patients treated with endovascular thrombectomy achieved functional independence one year after their stroke, compared with 6.8 percent of patients who received medical management. Patients in the thrombectomy group were also significantly more likely to regain the ability to walk independently, with 35.4 percent achieving independent walking versus 18 percent in the medical-management group.

The multicentre trial enrolled patients at 47 US stroke centres who presented within 24 hours of symptom onset and had large strokes identified using noncontrast computed tomography (CT) imaging.

Patients who underwent thrombectomy also reported better quality of life one year after stroke, while one-year mortality rates were similar between the treatment groups.

The findings add to growing evidence from other large core interventional stroke trials that patients with extensive brain injury can still benefit from rapid thrombectomy to restore blood flow.

One possible explanation for the delayed benefit, Ansari said, is that recovery from severe stroke continues long after the standard 90-day assessment period used in most clinical trials.

“We know that people continue to improve after a stroke for the next one to two years,” Ansari said. “Three months has been an arbitrary standard used in prior stroke trials to assess benefit and functional outcomes after targeted interventions.”

Restoring blood flow may also support long-term neuroplasticity, the brain’s ability to reorganise and form new neural connections after injury, Ansari said. The study reported that patients who received thrombectomy continued to improve between 90 days and one year, while outcomes remained static or declined in the medical-management group.

While more research is needed to fully understand which large core stroke patients benefit most from thrombectomy, the results of the study may provide additional confidence that aggressive intervention can yield meaningful recovery for patients, even when improvement is not immediately apparent.

“What we’re seeing across multiple randomised controlled trials, endovascular thrombectomy remains a powerful intervention across a spectrum of stroke presentations,” Ansari said. “It gives clinicians more confidence to treat patients even with severe brain injury and to counsel their loved ones that the outcome benefit may require time to heal, hard work with physical therapy/rehabilitation, and family support.”

The study was supported by unrestricted grants from Medtronic, Cerenovus, Penumbra, Stryker and Genentech.

Original written by Olivia Dimmer

Source: Northwestern University

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Accreditation Brings NWU’s Medical School Closer to Reality

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The North-West University (NWU) has reached a decisive milestone in establishing the Desmond Tutu School of Medicine following the accreditation of its Bachelor of Medicine and Bachelor of Surgery (MBChB) programme by the Higher Education Quality Committee (HEQC) of the Council on Higher Education (CHE).

The CHE confirmed the accreditation in correspondence dated 21 August 2026. The six-year, 940-credit programme will be offered in contact mode at the Potchefstroom Campus.

For Prof. Binu Luke, inaugural chief director of the Desmond Tutu School of Medicine, the decision represents both an institutional achievement and the culmination of an immense collective effort.

“The accreditation of our MBChB programme by the Council on Higher Education is a major milestone in the development of the programme,” he says.

“More than excitement, there is a sense of relief because accreditation by the CHE is a crucial step in our progress towards establishing the school.”

The achievement follows an extensive process of planning, coordination and documentation involving teams across the university. According to Prof. Luke, the application required detailed evidence of how the school and its medical programme would function, covering everything from its curriculum and governance to its clinical training arrangements, staffing, finances and infrastructure.

“There is certainly excitement because this is the result of extensive hours of planning, organisation and implementation across our five workstreams,” he says.

“These workstreams cover defining the ‘North-West doctor’, preparing the clinical training platform, human resources and financial matters, infrastructure, governance, and curriculum development and mapping.”

Translating years of preparation into a comprehensive accreditation application was itself a demanding undertaking.

“Documenting all these activities, completing the relevant forms and providing the required portfolio of evidence was no mean feat,” says Prof. Luke.

“Credit must go to the core team, as well as to all the relevant entities within the university that supported this project.”

The CHE’s correspondence confirms the programme’s full accreditation and that all stipulated conditions have been met. The process of registering the qualification with the South African Qualifications Authority (SAQA) on the National Qualifications Framework (NQF) is now under way.

The accreditation process included the submission of detailed information about clinical rotation modules, assessment practices, exit-level outcomes and opportunities for articulation within and across the university.

Prof. Luke compares the establishment of the medical school to the journey from conception to birth, with accreditation representing the point at which the vision has become viable and the university must carry it through to completion.

“If we compare this process to pregnancy and delivery, from conception to a full-term birth at approximately 40 weeks, this milestone represents the point of viability, which we would regard as about 28 weeks,” he says.

“From now on, there is no turning back. We must continue and deliver the fully developed school in January 2028.”

The Desmond Tutu School of Medicine is set to become South Africa’s 11th medical school and plans to welcome its first cohort of students in 2028. Its development forms part of the NWU’s commitment to addressing the country’s healthcare workforce needs and strengthening healthcare delivery, particularly in underserved communities.

Several important steps must still be completed before the first students begin their studies. Among these is professional accreditation by the Health Professions Council of South Africa (HPCSA).

“There are still several activities that we need to complete. The next major milestone is accreditation by the HPCSA, which is essential for our graduates ultimately to enter professional practice,” says Prof. Luke.

“We have planned the HPCSA accreditation visit for February 2027, and we hope to receive its approval so that we can begin enrolling students in the middle of 2027, with the first cohort commencing its studies in 2028.”

The university will also finalise agreements with the University of the Witwatersrand and the National Health Laboratory Service. These partnerships will support the academic, clinical and laboratory components required to train future doctors.

The school’s curriculum and clinical training model are being designed to produce doctors who are clinically competent, ethically grounded and responsive to the realities of South Africa’s healthcare system. Its approach will be guided by the values associated with its namesake, Archbishop Desmond Tutu, including compassion, justice, integrity and service.

For Prof. Luke, the CHE’s decision is not the end of the journey, but confirmation that a vision years in the making has entered a new and irreversible phase.

“This is a crucial step forward,” he says. “There is no going back. We must now continue the work and deliver the school in January 2028.”

According to Prof. Awie Kotzé, executive dean of the Faculty of Health Sciences, the milestone ushers in a new era for both the NWU and the faculty.

His work towards establishing the medical school began in 2017. It will become the sixth school within the faculty and enable the NWU to offer a comprehensive range of clinically oriented qualifications, with several additional programmes expected to be introduced in the near future.

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Spouted Baby Food Pouches More Like Sugary Drinks/Smoothies than Nutritious Food

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They are high in sugar, low in nutrients, and too thin, finds analysis of UK products.
Current labelling as complementary food source needs regulatory review, say researchers.

Image made with AI

Commercial baby foods in spouted pouches – intended to boost nutritional intake from the age of 6 months onwards – are often more like sugary drinks and smoothies than nutritious food, finds an analysis of UK products, published online in Archives of Disease in Childhood.

They are often higher in sugar and lower in nutrient density than breast milk or formula, as well as frequently lacking the texture needed to help babies learn to eat solid foods, the analysis shows.

These pouches are currently labelled as a complementary food to be used alongside breast milk or formula, but the findings prompt the researchers to question whether this labelling is appropriate and to call for a regulatory review of these products.

Breast milk alone supplies all the key nutrients needed up to the age of around 6 months. After that, complementary foods are essential for establishing healthy food preferences, optimal growth, and long term health, as well as for helping babies learn how to eat solid foods, explain the researchers.

Complementary foods should have an increasingly solid texture and be more energy and nutrient dense than breast milk, they add. But while spouted pouches have become the dominant packaging for commercial baby foods, it’s not clear if their content fulfils these criteria, particularly as the contents need to be thin enough to pass through the spout.

To find out, the researchers reviewed the commercial baby foods available in 6 large hypermarkets, serving families in Glasgow, Scotland in October and November 2024.

In all, they found 298 products from 16 manufacturers, of which 178 (60%) were spouted pouches.  

All these pouches were labelled as suitable for children under 12 months; two-thirds were aimed at babies aged 6 months or younger—counter to official recommendations. Of the other products, 46 (38%) were aimed at infants aged 12 months or more.  

Foods were categorised relative to breast milk for energy, protein, and sugar content, and defined as suitable for complementary feeding if they were: a purée or solid food which would enable weaning; more energy and protein dense than breast milk; had a sugar content no higher than breast milk.  

Food texture was rated by two assessors for 284 (95%) of all the products. Half of the spouted pouches (49%) were liquids (score 1–3, where 0 is thin, and 4 is very thick) compared with 7% of the other products.

Only 10% of the spouted pouches were soft foods, compared with more than three-quarters (77%) of the other products.  

“The texture and manner of complementary feeding is important,” emphasise the researchers. “While suckling is an innate characteristic, the oromotor skills required for the manipulation of solid food in the mouth must be learnt experientially.  

“For that reason, recommendations suggest that first foods offered should progress from purées to lumpy, mashed, and finger foods. For pouches specifically, not only do they deliver a thin food that can be swallowed with little oromotor manipulation, but they are also often consumed by sucking from the spout, rather than from a spoon,” they add.

Overall, the available baby foods had an average energy content of 66.5 kcal/100 g, with only 35% above that for breast milk (65–70 kcal/100 g).

Only half (52%) of spouted pouches had a protein content higher than the range for breast milk..

In common with most of the other baby foods, only around a third of the spouted pouches had more energy per weight than breast milk, even though  61% had higher sugar content than breast milk. This compares with only 8% of the other baby foods.

“High sugar intakes in early childhood have long-term health implications, both in terms of dental health and overweight,” point out the researchers. 

In all, only 14 (8.5%) of the spouted pouches were defined as being completely suitable for a complementary food in that they met all the desired criteria; 48 (29%) met none. By contrast, 37 (32%) of the other wet baby foods met all the desired criteria; only 2 (2%) met none.

The researchers acknowledge various limitations to their findings. For example, they had no data on actual consumption, and the assessment of nutrient content was limited to the information provided by the manufacturers, with iron content, which is a key nutrient, rarely stated.

But they nevertheless conclude: “Products delivered in [spouted] pouches generally do not meet the desired characteristics of complementary foods. Many are more similar to sweet fruit smoothies, which are not recommended at all for babies or preschool children.

“Our findings suggest that regulators should consider whether a change in product categorisation and labelling is needed to make clear which products are foods and which are drinks, to discourage the use of [these pouches] and to enable parents to make informed choices in line with public health recommendations for feeding infants and young children.”

Source: The BMJ Group

Categories : Healthcare Politics and Regulations HIVTags : Leave a comment

Some Pharmacists Can Now Apply for Permits to Provide HIV Prevention Pills Without a Doctor’s Script

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Specially trained pharmacists will be allowed to dispense HIV treatment and prevention medicines without a doctor’s script. (Photo: Unsplash)

By Catherine Tomlinson for Spotlight

Ten months after an enabling court judgment, some pharmacists in South Africa can finally start applying for permits that allows them to dispense HIV prevention pills without a script from a doctor.

Specially trained pharmacists can now begin applying for permits to dispense antiretroviral medicines for HIV prevention without a doctor’s prescription. The long-awaited permitting process was announced to pharmacists in a South African Pharmacy Council (SAPC) e-Note on 13 August.

The announcement came 10 months after the Supreme Court of Appeal cleared the way for the implementation of pharmacist-initiated management of antiretroviral treatment (PIMART) in South Africa.

What is PIMART?

PIMART is a form of task-shifting that allows pharmacists to provide some limited HIV services that are currently only provided by doctors and nurses.

It is intended that, under the PIMART programme, pharmacists that have completed a dedicated training programme and have received a special permit from the Director-General of Health will be authorised to provide first-line antiretroviral treatment to people with uncomplicated HIV without a doctor’s script.

They will also be allowed to dispense HIV prevention medicines without a doctor’s script – this includes both pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). PrEP is taken prior to sex to prevent potential infection while PEP is taken shortly after a possible HIV exposure to prevent infection.

PIMART’s long road to implementation

The SAPC first proposed PIMART to the health department in 2018. The proposal was in response to a request from the department for pharmacists to take on a larger role in the country’s HIV response.

In 2021, Spotlight reported the imminent launch of PIMART services in South Africa’s pharmacies, but then a court challenge against PIMART by a group of general practitioners blocked the programme’s implementation.

Four years later, in October 2025, a ruling by the Supreme Court of Appeal finally cleared the way for SAPC to launch PIMART. Following the court ruling, Vincent Tlala, CEO and Registrar of the SAPC, told media that the SAPC would issue a memo in November 2025 inviting pharmacists to apply for PIMART permits. But this would in fact only materialise in August 2026.

The SAPC’s 13 August memo to pharmacists, said that certain pharmacists can now begin to apply for temporary PIMART permits to provide PEP, PrEP, and HIV testing services – but not yet HIV treatment services. The temporary permits will be valid for 24 months.

Also, only pharmacists that completed the South African HIV Clinicians Society’s (SAHCS) previous PIMART training course can apply for the limited-scope, temporary PIMART permits.

Pharmacists that have not completed this course will have to wait for a new training course to be accredited and launched before they can apply for permits to provide PIMART services.

How long will it take to get a permit?

Tlala told Spotlight that the granting of the limited-scope, temporary PIMART permits by the Director-General and their recording by the SAPC may take a few months.

“The Department of Health processes applications for permits within 90 days (maximum),” said Tlala, adding that “[t]he PIMART permit recording process with the South African Pharmacy Council then takes between 72 working hours and 14 days, depending on the completeness of the application.”

The permits will only be granted to pharmacists who have already completed the Southern African HIV Clinicians Society’s (SAHCS) continuous professional development (CPD) PIMART course. Pharmacists that did not complete this course will need to wait for an updated PIMART course to become available before they can undertake the required training to be permitted.

Fiona Story, CEO of SAHCS, told Spotlight that nearly 800 pharmacists have completed the course.

Taken together, all of this suggests that toward the end of the year, a few hundred pharmacists in South Africa might be dispensing HIV prevention medicines without doctors’ scripts.

When will the updated training course be available?

Currently, there is no PIMART training course available for pharmacists, as the previous PIMART training course provided by SAHCS is on pause, while the updated course awaits accreditation. Based on dates provided by SAHCS, the updated course might only be available early next year.

However, once the updated course is available, it is anticipated that pharmacists that complete it will be able to apply for full-scope PIMART permits that allow them to dispense first-line antiretrovirals to people with uncomplicated HIV without a doctor’s script, in addition to PEP and PrEP.

“The CPD-accredited PIMART course is no longer available as it was reviewed and updated in line with the requirements for accreditation as a supplementary training course,” Story told Spotlight.

She said that the SAHCS is seeking accreditation of its updated PIMART training course from the SAPC. “SAHCS anticipates the PIMART supplementary training course accreditation process will conclude before the end of 2026,” said Story. She added: “SAHCS has prepared to launch the PIMART supplementary training course as soon as accreditation has been received.”

When will pharmacists be able to dispense HIV treatment without a doctor’s script?

The timeline for when pharmacists will be able to provide the full scope of services intended under PIMART, including HIV treatment for uncomplicated cases, remains unclear. Before this can happen, the SAPC must accredit the SAHCS’ updated supplementary training course and the SAHCS must launch this course.

After this, the permits granted to pharmacists by the Director-General will need to be expanded to include the provision of first-line antiretroviral therapy for treatment of uncomplicated HIV.

In the meantime, the around 800 pharmacists who completed the SAHCS’s previous PIMART training course can now start applying for permits to provide PrEP, PEP, and HIV testing services.

This article was first published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.

Categories : Obstetrics & GynaecologyTags : Leave a comment

The Silent Epidemic in Maternal Health: Why More Pregnant Women Need Hepatitis B Screening

On By ModernMedia
Photo by ManuelTheLensman on Unsplash
  • Hepatitis B remains one of the world’s most underdiagnosed infections.[1]
  • Untreated hepatitis B can remain silent for years while increasing the risk of severe liver disease and preventable infant infection.[1,2]
  • Integrated point-of-care testing during antenatal care visits presents an important opportunity to identify undiagnosed infections and support measures aimed at reducing transmission to newborns.[2,3] 

A pregnant woman attending her first antenatal care (ANC) appointment will often be screened for conditions that could affect her health and the health of her unborn child, including HIV and syphilis, but not always for hepatitis B virus (HBV) infection. This is not because hepatitis B is rare; in fact, quite the opposite. Millions of people worldwide are living with chronic hepatitis B infection, yet many remain unaware of their infection because the disease can progress silently for years without symptoms.[1] As a result, infection is often diagnosed only after serious liver complications develop.[1]

Late diagnosis increases healthcare costs, may limit treatment options and contributes to preventable illness and death.[1] For pregnant women, delayed diagnosis creates an additional risk of vertically transmitting the virus to their babies during childbirth.[2] That missed opportunity is why hepatitis B needs to be seen not only as a liver disease, but as a maternal and child health priority. For healthcare companies such as Abbott, there is an opportunity to help health systems make every ANC touchpoint work harder by bringing reliable, rapid and integrated testing closer to the point of care.

The central question is no longer whether hepatitis B can be detected, prevented or managed. It can. The question is whether health systems are using routine moments of care, especially pregnancy, to find the infection early enough to enable interventions that can improve outcomes for mothers, infants and families.

  • Hepatitis B is often silent, but its consequences are not.[1]
  • ANC offers a critical window to prevent mother-to-child transmission through timely immunoprophylaxis.[2,3]
  • Integrated testing can help expand access while reducing practical barriers for patients and frontline healthcare workers.[3]
  • Africa has the tools to change the trajectory; now systems must scale them.[1,3]

The cost of not knowing

Hepatitis B remains one of the world’s most significant infectious diseases despite being preventable and treatable. According to the World Health Organization’s (WHO) Global Hepatitis Report 2026, an estimated 240 million people were living with chronic hepatitis B in 2024, and the WHO African Region accounted for 68% of new hepatitis B virus infections globally.[1]

Behind these numbers are people who may be asymptomatic for years while the virus quietly damages the liver. When hepatitis B is not detected, the first sign of illness may be cirrhosis, liver cancer or liver failure.[1] For families, delayed diagnosis may contribute to repeated clinic visits, rising treatment costs, lost income and the emotional burden of managing a condition that could have been identified much earlier.

“Hepatitis B challenges health systems because it is often invisible until the consequences are severe,” says Dr Evans Mathebula, Senior Medical Affairs Manager at Abbott’s rapid diagnostics business in Africa. “If we wait for symptoms, we have waited too long. The priority should be to make hepatitis B screening routine, accessible and connected to care, particularly at moments when people are already engaging with the health system.”

This is especially important in maternal care. Pregnancy represents one of the most important opportunities to identify previously undiagnosed hepatitis B infection. For many women, ANC is among the few periods of regular engagement with the healthcare system.[2] This visit already serves as an important screening and health education opportunity and can facilitate preventive interventions. Many African countries have made important progress in preventing mother-to-child transmission of HIV. That progress shows what is possible when testing, treatment, policy and community trust are aligned. Hepatitis B now needs the same systems discipline, because the antenatal care clinic may be one of the few reliable points of contact between a pregnant woman and the health system.

This approach aligns with the WHO’s triple elimination initiative, which encourages countries to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B together, rather than through fragmented disease-specific programmes.[3] It recognises a simple reality: healthcare systems across Africa continue to face constraints, workforce pressures and laboratory challenges. In this context, adding new screening priorities must be practical and sustainable. Additionally, pregnant women should not have to navigate three separate pathways when one integrated screening moment can support identification of multiple risks and enable timely care during a single encounter.[3]

An integrated antenatal panel that screens for HIV, syphilis and hepatitis B from a single finger-prick is one example of how health systems can simplify access while maintaining a comprehensive standard of care.[3] For mothers, it can help reduce the risk of missed results and clarify next steps. For healthcare workers, it can support faster decision-making at the point of care when linked to appropriate follow-up pathways. For newborns, timely identification of maternal hepatitis B can support measures that reduce the risk of exposure and enable timely preventive action.

“The most powerful public health interventions are those that fit naturally into the realities of existing care,” adds Mathebula. “The easier it is for healthcare workers to identify hepatitis B during a single antenatal visit, through the use of an integrated panel, the sooner patients can be considered for appropriate follow-up care. We are not only improving diagnosis; we are giving clinicians the information they need to support mothers, help reduce the risk of infant infection and strengthen confidence in the health system.”

A hopeful path to elimination

For too long, hepatitis B has remained overshadowed by other infectious diseases despite its scale and impact. The tools needed to prevent transmission, diagnose infection and support long-term management already exist.[1] What remains is the challenge of finding the millions of people who are living with this virus without knowing it, starting with those accessing maternal and primary healthcare.

To move from awareness to action, policymakers and healthcare leaders should prioritise routine hepatitis B screening in antenatal care, support point-of-care testing in decentralised settings, strengthen linkage to treatment and ensure newborns receive timely protection.[1,3] These are practical steps that can turn a silent infection into a manageable health issue and help prevent transmission to the next generation.

Eliminating hepatitis B as a public health threat will require more than technology alone. It will require political will, domestic investment, continued education to increase awareness, trusted community engagement and health systems designed around people’s real lives. But the path is clear: if one antenatal care visit can identify risk, enable timely care and support measures that help reduce a child’s risk of infection, then it is one of the most powerful opportunities public health has to change two lives at once.

References: 

[1] World Health Organization. (2026). Global hepatitis report 2026. Geneva: World Health Organization.

[2] Afolabi, I. B., Phillips, J. C., El-Chaar, D., Bainbridge, S. A., & Phillips, K. P. (2026). Preventing vertical transmission of hepatitis B in sub-Saharan Africa: protocol for a systematic review and meta-analysis on vaccination uptake and determinants among pregnant women. BMJ Open, 16(1), e113229. https://doi.org/10.1136/bmjopen-2025-113229

[3] World Health Organization & United Nations Children’s Fund. (2025). Country guidance for planning triple elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus programmes. Geneva: World Health Organization.

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Indoor Airflow in Tuberculosis Spread Has Been Underestimated

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Researchers explore how a key factor can mitigate or promote tuberculosis transmission.

Tuberculosis bacteria. Credit: CDC

Tuberculosis (TB) is a leading cause of infectious disease deaths, claiming over 1 million lives every year. It spreads through the air when an infected person coughs, sneezes, or exhales, and drug-resistant strains and asymptomatic spreading are growing concerns. Curbing TB transmission is an urgent public health challenge, yet scientists still don’t understand how airflow and other environmental factors influence that spread.

One problem is that studies of infectious disease transmission have focused mainly on population-level assessments or individual immune responses. But understanding how airflow and mixing influence transmission in indoor spaces requires expertise in fluid physics and computational modelling.

An interdisciplinary team including researchers at MIT and the University of Texas Southwestern Medical Center has now combined animal transmission experiments with quantitative particle tracking and flow modelling to understand how some lab-based environments can promote the spread of respiratory infectious diseases such as TB, while others mitigate that spread.

A key factor in predicting infectious transmission was not just the total ventilation rate but, more importantly, the local pattern of airflow driven by the design – such as air leakage, inflow and outflow locations, and forces created by an infected individual.

“The local airflow patterns turn out to be pivotal,” says Lydia Bourouiba, the Japan Steel Industry Chair Professor at MIT and faculty lead of the Fluid Dynamics of Disease Transmission Laboratory, part of the Fluids and Health Network within the Institute for Medical Engineering and Science (IMES). “Our team’s findings provide some of the clearest evidence I’m aware of showing the importance of accounting for [airflow] inhomogeneity and its effects when designing for airflow detailed patterns. This insight is critical when building or retrofitting an indoor space to mitigate airborne transmission, or when designing an airborne transmission study.”

The research is an important step toward connecting laboratory infectious disease studies with how people spread such diseases in the real world. The team hopes their insights can extend beyond their model system and show the importance of flow physics in building designs to prevent the spread of airborne diseases indoors.

“Despite recent pandemics and epidemics, there is still resistance to incorporating airflow in routine infectious disease prevention tools,” Bourouiba says. “Infrastructure could be retrofitted at relatively low cost, but the paucity and difficulty of gathering direct evidence prevents broader adoption of flow physics as a tool for indoor health. This study helps provide such evidence.”

Joining Bourouiba on a paper about the work are Yash Kulkarni, a postdoc at IMES, who led the fluid and aerosol physics components; Kubra Naqvi, lead author and a postdoc at UT Southwestern; Michael Shiloh, a professor at UT Southwestern, who led the multiyear effort to reestablish a classic tuberculosis transmission model; Hui Ouyang, an assistant professor of aerosol engineering at UT Dallas; Yuhui Guo, Deepak Sapkota, and Arabella Martin, all UT Southwestern PhD students; Pei Lu and Victoria Ektnitphong, research associates at UT Southwestern; Shibo Wang, a University of Minnesota researcher; Beatriz Dias, a UT Southwestern instructor; Bret Evers, an associate professor at UT Southwestern; and Lenette Lu, assistant professor at UT Southwestern.

Opening the black box

When people exhale, talk, cough, or sneeze, tiny microdroplets and bioaerosols launch from their mouths, carried forward by a cloud. If infected by a respiratory disease, these bioaerosols can contain pathogens that can infect others. Disease transmission depends on pathogen survival in the air, which is influenced by temperature, humidity, and ventilation.

In 1882, German physician and microbiologist Robert Koch first established an animal model for the study of tuberculosis pathogenesis. Decades later, researchers demonstrated airborne transmission of tuberculosis between people and animals.

These early experiments have proven difficult to replicate in today’s modern, biosafety-grade facilities. This new study reveals the difficulty comes from stringent containment and ventilation requirements, which can dramatically influence airflow in experiments.

“Host-to-host transmission is an obligatory evolutionary phase of respiratory pathogens, yet it has been considered too intractable or complex to be amenable to systematic investigation, hence is commonly relegated to a black box. Our work opens that black box,” says Bourouiba, who is professor in MIT’s departments of Mechanical and Civil and Environmental Engineering, and an IMES core faculty member.

To quantify how local airflow patterns impact infectious disease transmission, the researchers redesigned and modelled the early studies for modern high-containment lab facilities — including their seal, inflow, outflow, and exhaust pathways — and quantified particle and bacteria-laden particle release and dispersal. They released tracer particles and bacteria into a compartment and modelled recovery from air sampled on the other side under differing airflow rates, designs, and leak configurations.

The MIT team carried out computations, benchmarked against particle release experiments. The results revealed how important seemingly small details such as leakage paths could be.

“Even a small leak could short-circuit the airflow by drawing fresh air directly toward the exhaust, rather than drawing contaminated air across the containment chambers,” says Kulkarni. 

Advancing TB research

To date, uneven indoor airflow patterns have not been fully harnessed as part of a risk mitigation strategy. 

“By systematically defining how airflow and design influence biological exposure, we were ultimately able to restore transmission and create a system that can now be used to ask fundamental questions about the bacterial, host, and environmental factors that determine tuberculosis spread,” says Naqvi.

“I began working to reestablish this seminal TB animal transmission model nearly 10 years ago, and it proved far more challenging than I anticipated,” says Shiloh. “I hope this work serves as a reminder that meaningful scientific advances often require patience and perseverance.”

“This work illustrates how crucial it is to support synergistic collaborations integrating complementary disciplines to tackle research bottlenecks – and to standardise reporting norms across laboratories,” Bourouiba says. “If different labs have varying airflow patterns from uncontrolled leaks or seal details, that physical variability can overwhelm the biological signals researchers seek. Beyond its foundational impact for TB transmission studies, our work shows that opening the black box of transmission provides mechanistic insights: Detailed airflow pattern control can enhance or mitigate airborne transmission – making it exploitable as a prevention measure in crowded gathering spaces.”

This work was supported, in part, by the National Institutes of Health, the National Science Foundation, the Burroughs Wellcome Fund, MathWorks, and the Translational Research Institute for Space Health.

by Zach Winn, Massachusetts Institute of Technology

This story is republished courtesy of MIT News (web.mit.edu/newsoffice/), a popular site that covers news about MIT research, innovation and teaching.

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Scientists Are Discovering Something Surprising About Obesity in Teenagers

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Adolescent metabolism may remain flexible enough for early weight loss interventions to prevent lasting health damage

Photo by Andres Ayrton on Pexels

Obesity doesn’t look the same at age 15 as it does at age 45 and Duke University School of Medicine researchers are learning why.

A study published in the Journal of Clinical Investigation showed teenagers retain a degree of metabolic flexibility that’s largely lost in adulthood. The study suggests that the way teenage bodies respond to excess weight is fundamentally different and potentially more reversible.

By showing that obesity’s biology changes with age, the discovery points to a potential window when the metabolic damage linked to obesity can be halted, or even reversed, before it becomes a lasting health burden.

“For a long time, medicine has tended to treat adolescents as little adults,” said John Rawls, PhD, a professor of molecular genetics and microbiology and member of the Duke Microbiome Center. “But teenagers are still growing, building muscle and bone, and using energy in ways that are very different from adults. We wanted to understand how those differences shape obesity.”

Nearly 1 in 5 U.S. children has obesity, a condition associated with higher risk for heart disease, diabetes, asthma, and some cancers later in life.

Without intervention, most children with obesity will continue to have obesity into adulthood, said study co-author Sarah Armstrong, MD, a pediatrician and medical weight management specialist at Duke Health.

The change from adolescence to adults happens in late teens to early 20s for women and early-to-mid 20s for men.

But researchers are increasingly asking when those risks become biologically embedded and whether adolescence offers a chance to change course.

The microbiome tells a different story in teens

The Duke team focused on two systems often linked to obesity: the gut microbiome which is the community of microbes living in the digestive tract, and the metabolome, the collection of chemicals produced as the body and microbiome process food and energy.

First, using gut microbes collected from 287 teenagers in the Pediatric Obesity Microbiome and Metabolism Study, they confirmed that teens with obesity have microbiomes that differ compositionally from those of teens at a healthy weight.

Next, Jessica McCann, PhD, a senior research associate in molecular genetics and microbiology, transplanted microbiome samples from adolescents with and without obesity into germ-free mice.

Unlike what researchers often see in adult obesity studies, the mice did not gain extra weight after receiving microbiota from adolescents with obesity.

The findings indicate that while obesity-related differences in the microbiome are beginning to emerge during adolescence, those microbes may not be driving disease the waythey do in adults.

“This suggests there’s a developmental window in which the microbiome becomes involved in obesity,” McCann said. “The relationship between the host and the microbiome may still be developing during adolescence, which means there may be an opportunity to change its trajectory.”

Warning signs appear, but so does resilience

Working in collaboration with the Duke Molecular Physiology Institute, the research team also found differences in how adolescents process nutrients. Adults with obesity often have elevated levels of branched-chain amino acids, as well as related compounds called branched-chain keto acids (BCKA), which are linked with insulin resistance and Type 2 diabetes.

The adolescents showed a different pattern. While branched-chain amino acids were elevated, BCKA levels remained relatively low.

The warning signs are there, McCann said, but teens’ bodies still appear capable of adapting to the metabolic strain of excess weight. “The metabolome is showing early signs of disease progression, but it’s also showing evidence of adaptive plasticity.”

At this stage they may be more responsive to weight management through diet, medication or microbiome-based therapies.

“The evidence increasingly supports intervening as early as possible,” said Armstrong, a professor of pediatrics at Duke.

Researchers hope the work would eventually lead to more personalised obesity treatments, using a child’s microbiome or metabolic profile, to help determine which weight loss therapies are most likely to succeed.

The study was supported by the American Heart Association and the National Institute of Diabetes and Digestive and Kidney Diseases.  

Source: Duke University School of Medicine

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Longer Meal Intervals Linked to Faster Disease Accumulation in Older Adults

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Photo by Gustavo Fring

Older adults who typically had longer intervals between meals accumulated chronic diseases more rapidly over time than those with shorter intervals, according to a study from Karolinska Institutet published in the Journal of Internal Medicine. The association was most pronounced among people aged 78 years and older.

Interest in fasting has increased in recent years, but relatively little is known about how meal timing affects health in older adults. In this new study, researchers investigated whether the duration of the longest daily interval between meals was associated with the accumulation of chronic diseases over time. 

The researchers used data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), which includes 2,981 people in Stockholm who were aged 60 years or older at the start of the study. Participants were followed for up to 15 years. The duration of intervals between meals was estimated from participants’ self-reported information about when they typically ate during a 24-hour period. 

Association seen across disease types

Longer intervals between meals were associated with faster accumulation of chronic diseases over time. In particular, people whose longest interval between meals during a typical day was 14 to 24 hours accumulated chronic diseases more rapidly than those whose longest interval was 6 to 11.5 hours. The association was observed for the total number of chronic diseases, as well as for cardiovascular and neuropsychiatric diseases, but not for musculoskeletal diseases. 

“Much of the research on fasting has been conducted in younger or middle-aged populations. Our findings suggest that the associations may be different in older adults, particularly among the oldest age groups”, says Adrián Carballo Casla, last author of the study and postdoctoral researcher at the Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.

The researchers emphasise that the study cannot determine cause and effect. Although longer intervals between meals were linked to faster disease accumulation, the study cannot establish whether the fasting pattern independently contributed to this outcome.

For information on funding and any potential conflicts of interest, please see the study.

Source: Karolinska Institutet

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Digital Wellness Program Eases Anxiety and Depression in Adults with Chronic Health Conditions

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A controlled trial across 13 countries found that a self-guided digital program and a version paired with telephone support both outperformed usual care for anxiety and depression

Photo by RDNE Stock project: https://www.pexels.com/photo/an-elderly-man-standing-on-one-leg-on-a-yoga-mat-8173497/

A digital program combining guided movement, breathing and meditation exercises, and coping-skills training reduced anxiety and depression symptoms in adults with chronic medical conditions, according to a new study published August 20th in the open access journal PLOS Medicine by Puneeta Tandon of the University of Alberta, Canada, and colleagues.

More than half of adults living with chronic physical conditions experience anxiety, depression, or fatigue, which can significantly reduce quality of life. Access to effective symptom management support is limited by mobility barriers, geography, cost, and shortages of trained clinicians. Digital programs may offer a scalable way to address this burden, but clinical trial evidence backing these interventions has been limited, and the role of human support in their efficacy is unclear.

Researchers conducted a fully remote, three-arm randomised controlled trial across 13 countries, involving 825 adults with self-reported chronic medical conditions including Primary Biliary Cholangitis, chronic digestive diseases, cirrhosis, and heart failure. Participants were assigned to a waitlist control group, a self-directed digital program (eMPower), or the same program supplemented with weekly telephone check-ins from trained non-clinicians. The program included movement, breathwork/meditation, coping skills, and disease education. Anxiety and depression symptoms were measured using a standard symptom scale ranging from 0 to 42.

At 12 weeks, participants receiving the digital program with telephone support showed significantly greater improvement in anxiety and depression scores than the control group (2.9-point greater improvement; 95% CI, 2.0–3.8). They also reported improved quality of life and less fatigue. In exploratory analyses, the self-directed program alone also significantly improved symptoms compared with control (2.6-point greater improvement; 95% CI, 1.8–3.5), and no significant difference was found between the two program formats, although the trial was not designed or powered to directly compare them.

The study primarily included women with higher education and only measured outcomes for 12 weeks, so longer-term impact and generalisability to other populations remain unclear. However, the authors say the data suggest a path forward for digital mental health interventions.

“Taken together, the eMPower clinical trial provides robust evidence that a fully digital, multicomponent intervention reduced anxiety and depression symptoms and was associated with improvements in fatigue, and quality of life across a range of chronic disease populations,” the authors say. “Rather than developing separate digital programs for each condition, a single cross-condition approach with tailoring for disease-specific education is effective in addressing shared symptoms.”

Corresponding author Dr. Puneeta Tandon states, “As clinicians, we are good at treating organ-specific problems, but the whole-person burden of chronic illness – the anxiety, low mood and exhaustion – that is often where patients have fewer practical options. People often leave the clinic without much they can try, but it doesn’t need to be that way. While these skills don’t replace medication or mental health care when those are needed, they do give people a practical place to start at home.

“What was surprising was that, in an exploratory analysis, we did not find a significant difference between the fully self-directed program and the program with brief weekly check-ins from a trained team member. This does not prove that the two approaches are equal, but it suggests that a program like this may be able to reach far more people without requiring one-to-one support for everyone. Support could then be focused on those who need it most.

“Because the study was entirely online, people could take part from home. The average age was 56, almost one in four participants was over 65, and 84% completed the 12-week follow-up – a strong result for a fully online study. We’re very grateful to the patient partners and organisations representing heart, kidney, liver, transplant and digestive communities who helped shape the program from the beginning. Their involvement was an important part of the study’s success.”

“The 12-Week eMPower program has demonstrated meaningful improvements in quality of life for people living with primary biliary cholangitis (PBC), the largest group enrolled in the eMPower study,” said Gail Wright, a PBC patient and President of the Canadian PBC Society. “Participants living with a significant symptom burden reported clinically meaningful improvements in fatigue and overall quality of life. The success of this program represents an important milestone for the PBC community, providing clinicians with evidence to support more personalised care that combines pharmaceutical treatment with an evidence-based self-management program for people living with PBC.”

First author Emily Johnson, MD/PhD Candidate, notes, “Running the trial entirely online meant we could reach people who are often left out of research – including people managing severe fatigue or mobility limitations, people living far from a specialist centre, and people who can’t add another appointment to their week. What struck me most was that they stayed. Patient partners shaped this program from the first draft, and I think that’s why it held people’s attention for 12 weeks. I look forward to continuing with this work and helping even more people.”

Provided by PLOS