Sleepiness at the wheel is a significant contributing factor to motor vehicle accidents. A new analysis published in Otolaryngology–Head and Neck Surgery reveals that for people with sleep apnoea, getting surgery for their condition may lessen their risk of such accidents compared with using a Continuous Positive Airway Pressure (CPAP) device at night or receiving no treatment.
In the analysis of data on 2 832 437 patients with obstructive sleep apnoea, 3.4% of patients who underwent surgery were in a car accident at any point following their diagnosis, compared with 6.1% of those using a CPAP and 4.7% of those not receiving any treatment.
Patients receiving no treatment had 21% higher odds of motor vehicle accidents compared with the surgery group. The surgery group had 45% lower odds compared with the CPAP group.
Patients with obstructive sleep apnoea who experienced accidents were more likely to have comorbidities such as hypertension, diabetes, and heart failure following the accident.
“Our findings underscore the profound impact that inadequately managed obstructive sleep apnoea can have on individual health and public safety,” said corresponding author Elliott M. Sina, BA, a medical student at the Sidney Kimmel Medical College at Thomas Jefferson University. “This work adds to the growing body of evidence supporting surgical interventions such as hypoglossal nerve stimulation as an effective alternative treatment for select patients with obstructive sleep apnoea.”
Calorie content drives food preference despite similar taste in individuals with and without obesity
Source: Pixabay CC0
Higher calorie foods were preferred among individuals with and without obesity despite similar taste and texture, according to a study published December 17th in the open-access journal PLOS Biologyby Albino Oliveira-Maia from the Champalimaud Foundation, Portugal, and colleagues.
Eating sends signals to the brain with information about a food’s energy content, which can influence food preferences irrespective of flavor. People with obesity often have impairments in areas of the brain where dopamine is released, which may drive reward-related eating and a preference for energy-dense foods rich in fat and sugars. Weight loss due to bariatric surgery has been associated to a normalization of reward-related eating with a shift of preferences toward healthier options, but the underlying mechanisms are not well understood.
In this study, after examining a large group of healthy volunteers, researchers compared food preferences in three groups: 11 individuals with obesity, 23 post-bariatric surgery patients, and 27 non-obese control subjects. They gave participants sweetened low-fat yogurt with and without maltodextrin (a carbohydrate that adds calories to the yogurt with no impact on taste or texture). Participants ate the yogurt at home, alternating between the maltodextrin-containing and -free yogurt. All three groups ate more of the maltodextrin-containing yogurt, despite rating both as equally pleasant. Somewhat unexpectedly, the effects of maltodextrin on yogurt consumption were similar in individuals with obesity relative to their non-obese counterparts.
The study also used radioactive iodine labelling and single photon emission computed tomography to visualise dopamine receptors in the brain. Consistent with previous studies, individuals with obesity had lower dopamine receptor availability than non-obese controls. Dopamine receptor availability was similar in the surgical and non-obese groups and was associated with more restrained eating. These results suggest that obesity-related brain changes can be reversed after bariatric surgery, potentially impacting the amount of food consumed but not necessarily the types of food preferred.
The authors add, “We were very intrigued that, while behaviour was guided towards eating yoghurts with higher energy-content, this did not seem to be a result of explicit choices, since consistent changes in pleasantness of flavours enriched with carbohydrates were not found. Importantly, this behaviour was maintained in patients with obesity and after weight-loss surgery, even though there were important differences in their brain dopaminergic system.”
In a paradigm shift in how we view mutations, researchers uncover forms of DNA damage in healthy cells – most particularly in blood stem cells – that can persist unrepaired for years.
While most known types of DNA damage are fixed by our cells’ in-house repair mechanisms, some forms of DNA damage evade repair and can persist for many years, new research shows. This means that the damage has multiple chances to generate harmful mutations, which can lead to cancer.
Scientists from the Wellcome Sanger Institute and their collaborators analysed family trees of hundreds of single cells from several individuals. The team pieced together these family trees from patterns of shared mutations between the cells, indicating common ancestors.
Researchers uncovered unexpected patterns of mutation inheritance in the trees, revealing that some DNA damage persists unrepaired. In the case of blood stem cells, this can be for two to three years.
The research, published in Nature, changes the way we think about mutations, and has implications for understanding the development of various cancers.
Throughout our life, all of the cells in our body accumulate genetic errors in the genome, known as somatic mutations. These can be caused by damaging environmental exposures, such as smoking, as well as the everyday chemistry occurring in our cells.
DNA damage is distinct from a mutation. While a mutation is one of the standard four DNA bases (A, G, T or C) in the wrong place, similar to a spelling mistake, DNA damage is chemical alteration of the DNA, like a smudged unrecognisable letter. DNA damage can result in the genetic sequence being misread and copied incorrectly during cell division, in a process known as DNA replication. This introduces permanent mutations that can contribute to the development of cancers. However, the DNA damage itself is usually recognised and mended quickly by repair mechanisms in our cells.
If researchers can better understand the causes and mechanisms of mutations, they may be able to intervene and slow or remove them.
In a new study, Sanger Institute scientists and their collaborators analysed data in the form of family trees of hundreds of single cells from individuals. The family trees are constructed from patterns of mutations across the genome that are shared between cells – for example, cells with many shared mutations have a recent common ancestor cell and are closely related.
The researchers collated seven published sets of these family trees, known as somatic phylogenies. The data set included 103 phylogenies from 89 individuals,1 spanning blood stem cells, bronchial epithelial cells and liver cells
The team found unexpected patterns of mutation inheritance in the family trees, revealing that some DNA damage can persist unrepaired through multiple rounds of cell division. This was particularly evident in blood stem cells, where between 15 to 20 per cent of the mutations resulted from a specific type of DNA damage that persists for two to three years on average, and in some cases longer.
This means that during cell division, each time the cell attempts to copy the damaged DNA it can make a different mistake, leading to multiple different mutations from a single source of DNA damage. Importantly, this creates multiple chances of harmful mutations that could contribute to cancer. Researchers suggest that although these types of DNA damage occur rarely, their persistence over years means they can cause as many mutations as more common DNA damage.
Overall, these findings change the way researchers think about mutations, and have implications for understanding the development of cancer.
When children with obesity undergo weight-loss treatment, the effects have repercussions later in life and the risk of serious health problems and premature death is lower as they reach young adulthood. However, this is not the case for depression and anxiety, a study from Karolinska Institutet published in JAMA Pediatrics reports.
The study shows that children and adolescents who respond well to obesity treatment are less likely to develop obesity-related diseases, such as type 2 diabetes, hypertension and dyslipidaemia as young adults.
The treatment studied involved support for children with obesity and their families designed to motivate healthy diets, exercise and sleep habits – what is known as “behavioural lifestyle therapy”.
“The results are very good news,” says the study’s last author Emilia Hagman, principal researcher at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet. “Whether or not the treatment of obesity in childhood has long-term health benefits have been debated, since weight-loss is hard to maintain.”
Higher risk of dying as young adults
The study shows that children with obesity who respond to treatment also run a lower risk of premature death. A previous study, published in PLOS Medicine by the same research group, has shown that children with obesity have a much higher mortality risk in early adulthood, and were much more likely to die from suicide and somatic conditions. Just over a quarter of deaths were obesity-related.
“This emphasises the importance of providing early treatment, as we know that timely intervention increases the likelihood of success and helps mitigate the long-term health risks associated with obesity,” says Dr Hagman.
Depression and anxiety are not affected
However, the risk of depression and anxiety was not affected by the treatment outcomes in childhood, the JAMA Pediatrics paper shows. No matter the outcome of obesity treatment in childhood, the risk of anxiety and depression was unchanged in young adulthood.
“It has been believed that weight loss could decrease symptoms of depression and anxiety, but we can now show that it’s not the case,” says Dr Hagman. “Even though there’s a link between the two comorbidities, they must be treated in parallel.”
The study included over 6700 individuals who had received treatment for obesity during childhood identified via the BORIS register (the Swedish Childhood Obesity Treatment Register) and who were then followed up as young adults in the Swedish Patient Register, the Prescribed Drugs Register and the Cause of Death Register. A control group from the general population was also used, matched by age, sex and place of residence.
GLP1 analogues, which have become popular obesity drugs in recent years, were not part of the study as they were yet approved when the study participants were being treated for obesity. As Dr Hagman points out, it is still uncommon for this type of drug to be administered to children.
“I’m in favour of their use as these drugs eases feelings of hunger, which is something that some children struggle with” she says. “That said, lifestyle therapy is still the foundation of all treatments for childhood obesity.”
The research group will now be trying to identify therapy options that are most effective for different individuals and the health/risk markers that are significant for future health.
One of the first acts President Trump took on assuming office again on January 20, 2025, was to unilaterally withdraw the United States from the World Health Organization (WHO). Trump complained of the WHO’s “mishandling” of the COVID pandemic, influence by other countries, and the US financial support was excessive compared to China, which “has 300 percent of the population of the United States, yet contributes nearly 90 percent less to the WHO.”
The WHO released a statement, expressing its regret at the decision and pointing out its importance: “WHO plays a crucial role in protecting the health and security of the world’s people, including Americans, by addressing the root causes of disease, building stronger health systems, and detecting, preventing and responding to health emergencies, including disease outbreaks, often in dangerous places where others cannot go.”
The organisation also took aim at Trump’s criticism of its lack of reforms: “With the participation of the United States and other Member States, WHO has over the past 7 years implemented the largest set of reforms in its history, to transform our accountability, cost-effectiveness, and impact in countries. This work continues.”
Critics say that the move would only hand China the opportunity to effectively take control of global health if it chooses to becomes the WHO’s main contributor: though the US is the single largest contributor, it contributed only $1.3 billion in the 2022-23 biennium. An affordable amount compared to the vast sums both countries spend on their militaries. While the WHO did lavish praise on China, many experts saw it as undue and perhaps concerning – but China’s contribution, while currently small, is rising: $86 million in the 2018-19 biennium. After the US, the next largest contributors are Germany ($856 million) and the Bill and Melinda Gates Foundation ($830 million).
The Society for Healthcare Epidemiology of America (SHEA) stressed the importance of global health cooperation. In a statement, the organisation wrote: “It is essential that the United States continues our connection with the WHO to coordinate surveillance, monitoring, detection, prevention, research, and response to public health threats including outbreaks, antimicrobial resistance and high consequence pathogens such as viral haemorrhagic fevers (Ebola, Marburg), Mpox, and highly pathogenic avian influenza (eg, H5N1).”
Indeed, Trump may not simply be able to withdraw by presidential decree; since the US joined the WHO by an act of Congress, it would likely take congressional approval to leave it and Trump may face a lawsuit over this.
Trump previously announced his intention to withdraw the US from the WHO in 2020, something which Gostin et al. warned in The Lancet would not work out well for the US and the world. “Withdrawal from WHO would have dire consequences for US security, diplomacy, and influence. WHO has unmatched global reach and legitimacy.” Additionally, they warned of the sheer difficulty of such a messy divorce: “The US administration would be hard pressed to disentangle the country from WHO governance and programmes.”
