Categories : Cancer GastrointestinalTags : Leave a comment

Faecal Transplant Pills Show Promise in Clinical Trials for Multiple Types of Cancer

On By ModernMedia

Two Canadian clinical trials show poop pills could help patients respond to immunotherapy while also reducing toxic side effects of cancer drugs

Faecal microbiota transplants (FMT), can dramatically improve cancer treatment, suggest two groundbreaking studies published in the prestigious Nature Medicine journal. The first study shows that the toxic side effects of drugs to treat kidney cancer could be eliminated with FMT. The second study suggests FMT is effective in improving the response to immunotherapy in patients with lung cancer and melanoma.

The findings represent a giant step forward in using FMT capsules – developed at Lawson Research Institute (Lawson) of St. Joseph’s Health Care London and used in clinical trials at London Health Sciences Centre Research Institute (LHSCRI) and Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM) – for safe and effective cancer treatment.

A Phase I clinical trial was conducted by scientists at LHSCRI and Lawson to determine if FMT is safe when combined with an immunotherapy drug to treat kidney cancer. The team found that customised FMT may help reduce toxic side effects from immunotherapy. The clinical trial involved 20 patients at the Verspeeten Family Cancer Centre at London Health Sciences Centre (LHSC).

“Standard treatment for advanced kidney cancer often includes an immunotherapy drug that helps the patient’s immune system tackle cancer cells,” says Saman Maleki, PhD, Scientist at LHSCRI. “But, unfortunately, the treatment frequently leads to colitis and diarrhoea, sometimes so severe that a patient must stop life-sustaining treatment early. If we can reduce toxic side effects and help patients complete their treatment, that will be a gamechanger.”

Separate Phase II lung and skin cancer studies were led by researchers at CRCHUM in collaboration with Lawson and LHSCRI. The studies found that 80 per cent of patients with lung cancer responded to immunotherapy after FMT, compared to only 39-45 per cent typically benefiting from immunotherapy alone. Similarly, 75 per cent of patients with melanoma who received FMT experienced a positive response to treatment, compared to only 50-58 per cent response in patients who receive immunotherapy alone. Twenty patients participated in the lung cancer clinical trial and 20 patients participated in the skin cancer clinical trial.

“Our clinical trial demonstrated that faecal microbiota transplantation could improve the efficacy of immunotherapy in patients with lung cancer and melanoma,” says Dr Arielle Elkrief, co-principal investigator and Physician Scientist, Université de Montréal-affiliated hospital research centre (CRCHUM). “The results also uncovered one possible mechanism of action of faecal transplantation – through the elimination of harmful bacteria following the transplant. Our results open up a novel avenue for personalised microbiome therapies, and faecal transplant is now being tested as part of the large pan-Canadian Canbiome2 randomised controlled trial.”

“Faecal microbiota transplantation in melanoma and lung cancer opens an entirely new therapeutic avenue, made possible by the exceptional commitment of our patients and the teamwork,” adds Dr. Rahima Jamal, Director of the Unit for Innovative Therapies (UIT) at CRCHUM. “At the Unit for Innovative Therapies (UIT) of the CRCHUM, we have had the privilege of translating laboratory discoveries into early phase clinical trials and witnessing their concrete impact on people living with cancer.”

Both studies use advanced, world-leading FMT capsules, also known as LND101, produced by Lawson in London, Ont. The research reinforces London’s place as a global leader in FMT innovation and treatment. The capsules are processed from healthy donor stools and ingested to help restore a patient’s healthy gut microbiome and treat different types of cancer.

“To use FMT to reduce drug toxicity and improve patients’ quality of life while possibly enhancing their clinical response to cancer treatment is tremendous, and it had never been done in treating kidney cancer before this,” says Dr Michael Silverman, Scientist at Lawson and Head of St. Joseph’s Infectious Diseases Program. “And none of this would be possible if not for this close collaboration: innovating the FMT capsules in Lawson labs and introducing them at LHSCRI and CHUM to advance vital research initiatives. Also, because LND101 comes from healthy donors, production can be scaled up to eventually help large numbers of cancer patients.”

The studies build on earlier London and CHUM-generated Phase I research showing FMT can safely augment treatment for people with melanoma. FMT is also being studied in people with pancreatic cancer and triple-negative breast cancer, and is already a well-established treatment for serious gut infections such as C. difficile, which can cause severe diarrhoea.

“Our hope is that our research will one day help people with cancer live longer while reducing the harmful side effects of treatment,” adds Dr Ricardo Fernandes, Scientist at LHSCRI and Medical Oncologist at LHSC. “We are world leaders in FMT research and we’re excited about its potential.”

Source: London Health Sciences Centre Research Institute

Categories : Cardiovascular Disease Metabolic DisordersTags : Leave a comment

New Study Explains How Long-term Diabetes Causes Vascular Damage

On By ModernMedia
Source: CC0

The longer a person has type 2 diabetes, the greater the risk of cardiovascular disease. A new study from Karolinska Institutet, published in the journal Diabetes, shows that changes in red blood cells may be an important explanation, and identifies a specific molecule as a possible biomarker.

People with type 2 diabetes are at increased risk of heart attack and stroke, and the risk increases the longer they have lived with the disease. Previous research has shown that red blood cells can affect blood vessel function in diabetes. Now, a new study shows that the duration of the disease plays a decisive role in when and how these changes occur – and that long-term type 2 diabetes can make red blood cells directly harmful to blood vessels.

The researchers studied both animals and patients with type 2 diabetes. Red blood cells from mice with long-term diabetes and patients who had had the disease for over seven years had a harmful effect on blood vessel function. No such effect was seen in newly diagnosed individuals, but after seven years of follow-up, their blood cells had developed the same harmful properties. When the researchers restored the levels of microRNA-210 in the red blood cells, vascular function improved.

“What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease. It is only after several years that red blood cells develop a harmful effect on blood vessels,” says Zhichao Zhou, associate professor at the Department of Medicine, Solna, Karolinska Institutet, and lead author of the study.

The study points to microRNA-210 in red blood cells as a possible biomarker for early detection of the risk of cardiovascular complications. Researchers are now working to investigate whether this can be used in larger population studies.

“If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications,” says Eftychia Kontidou, doctoral student from the same group and the first author of the study.

Source: Karolinska Institutet

Categories : Paediatrics VaccinesTags : Leave a comment

Sanofi Receives Registration for Beyfortus® in SA to Protect Infants Against RSV

On By ModernMedia
Photo by Elen Sher on Unsplash

Sanofi is pleased to share that the South African Health Products Regulatory Authority (SAHPRA) has granted registration for Beyfortus® (nirsevimab), a long-acting monoclonal antibody designed to protect infants against Respiratory Syncytial Virus (RSV).

Beyfortus® is the first long-acting monoclonal antibody designed to provide protection across the RSV season for all infants, including those born at term, preterm, or with underlying conditions. It is given as a single intramuscular dose just before or during the RSV season¹ and is expected to be available before the 2026 RSV season.

RSV is one of the leading causes of Lower Respiratory Tract Infections (LRTIs) such as bronchiolitis and pneumonia in young children, and a major driver of hospitalisation in infants under one year of age.3 Globally, RSV is responsible for 20 to 40% of pneumonia and 40 to 80% of bronchiolitis hospitalised cases among infants under one year of age.2

It was estimated that in a year, RSV caused around 33 million acute lower respiratory infections in children younger than five years, resulting in 3,6 million hospitalisations and over 100 000 RSV-attributable deaths globally3. RSV-related medical costs in this age group are estimated at €4.82 billion per year, including hospital, outpatient, and follow-up care7.

In South Africa, RSV infections occur year-round with a strong seasonality from February to May4. Each year in South Africa, there are approximately 96 000 cases of RSV severe acute respiratory illnesses in children under five years of age, and among newborns under one month, about one in seven requires admission for severe RSV9. The incidence and severity of RSV LRTI are highest in infants under 6 months of age, representing 22% of all-cause hospital admissions in this age group. 41% of the LRTI-related hospitalisations are attributable to RSV.5 

RSV infections also have long lasting consequences as a first episode of RSV LRTI is associated with an increased risk of subsequent LRTIs. In addition, RSV is associated with recurrent wheezing in early childhood.6

Though risk factors such as prematurity and underlying conditions will increase the probability and severity of RSV infections in children, the majority of severe RSV outcomes occur in healthy full‑term infants. They represent the majority of ICU admissions (65.8%) and mechanical ventilation cases (59.8%) among RSV‑infected infants, and globally, healthy infants account for around 57% of RSV‑related deaths.10-11 For this reason, all infants are at risk of RSV disease. 

A single dose of Beyfortus® provides immediate and season-long protection, lasting for at least five months, corresponding to a typical RSV season¹. In the MELODY phase III trial*, nirsevimab reduced medically attended RSV-LRTI by 74.5% and hospitalisations by 62.1% compared with placebo,8 while the HARMONIE real-world study found an 82.7% reduction in RSV-related hospitalisations through 180 days after immunisation14. Beyfortus® demonstrated a consistent safety profile across term, preterm, and high-risk infants, with the most common adverse reactions being mild rash (0.7%), fever (0.5%), and injection-site reactions (0.3%)¹.

Beyfortus® has also demonstrated its strong public health impact in real-world settings. Following its introduction in 2024 in Chile and in 2023 in Galicia, Spain, the effectiveness of Beyfortus® against RSV-related LRTI hospitalisations was estimated to be 76.4% and 85.9%, respectively. In Chile, Beyfortus® demonstrated 49.7% effectiveness against all-cause hospitalisation. 12-13

“RSV causes a great burden on families and the healthcare systems in South Africa and worldwide,” says Diane Buron, South Africa Medical Head for Sanofi Vaccines. “It is a leading cause of infant hospitalisation during the season and Beyfortus® has the potential to change that. With only one dose, babies will be effectively protected throughout the season and thousands of cases and hospitalisations can be averted.”

“Because the majority of RSV cases are in term and healthy infants,” says Buron “proposing this innovative and effective protection to all infants will have a significant impact on the families and healthcare system.”

More than 6 million infants worldwide have now received Beyfortus®, supported by over 40 real-world studies across four continents, in both the Northern and Southern hemispheres. The introduction of Beyfortus® in South Africa is a significant advancement in paediatric respiratory protection and supports the global goal of reducing preventable infant morbidity and mortality linked to RSV8.

*The Phase 3 MELODY trial was a randomised, double-blind, placebo-controlled trial conducted across 21 countries designed to determine the safety and efficacy of Beyfortus®  against medically attended LRTD caused by RSV in healthy term and late preterm infants (35 weeks gestational age or greater) entering their first RSV season, including efficacy against severe disease such as hospitalisation, through 150 days after dosing. The primary endpoint was met, reducing the incidence of medically attended RSV LRTD by 74.5% (95% CI 49.6, 87.1; P<0.001) compared to placebo. The efficacy of Beyfortus® against the secondary endpoint of hospitalization was 62.1% (-8.6, 86.8). A pre-specified pooled analysis of the Phase 3 MELODY trial showed the efficacy of Beyfortus® against medically attended RSV LRTD and medically attended RSV LRTD with hospitalisation was 79.5% (95% CI 65.9, 87.7; P<0.0001) and 77.3% (95% CI 50.3, 89.7; P<0.001), respectively.

References

1. Sanofi-Aventis South Africa (Pty) Ltd. Beyfortus®  Professional Information (PI). Version E, 2025-09-18.
2. Dangor et al. (2023) – Bronchiolitis v. bronchopneumonia: Navigating antibiotic use within the lower respiratory tract infection spectrum. S Afr Med J 113(6):e709

3. Li Y et al. Global, regional, and national disease burden estimates of acute lower-respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022; 399: 92047–64.
4. National Institute for Communicable Diseases (NICD). Respiratory Syncytial Virus (RSV). Available at: https://www.nicd.ac.za/diseases-a-z-index/respiratory-syncytial-virus-rsv/ (Accessed January 2026).
5. Wedderburn CJ et al. Risk and rates of hospitalisation in young children: A prospective study of a South African birth cohort. PLOS Glob Public Health. 2024

6. Zar HJ et al. Early-life respiratory syncytial virus lower respiratory tract infection in a South African birth cohort: epidemiology and effect on lung health. Lancet Glob Health. 2020.
7. Zhang S et al. Cost of respiratory syncytial virus-associated acute lower-respiratory infection management in young children at the regional and global level: a systematic review and meta-analysis. J Infect Dis. 2020; 222(Suppl 7): S680–S687.
8. Hammitt LL et al. Nirsevimab for prevention of RSV in healthy late-preterm and term infants. N Engl J Med. 2022; 386(9): 837–846.

9. Moyes J et al. The burden of RSV-associated illness in children aged < 5 years, South Africa, 2011 to 2016. BMC Med 21, 139 (2023).

10. Nair H, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375:1545–1555.
11. Li Y, et al. Global, regional, and national disease burden estimates of RSV-associated acute lower respiratory infection in young children in 2019: a systematic analysis. Lancet. 2022;399:2047–2064

12. Razzini JL. Impact of universal nirsevimab prophylaxis in infants on hospital and primary care outcomes across two respiratory syncytial virus seasons in Galicia, Spain (NIRSE-GAL): a population-based prospective observational study. Lancet Infect Dis. 2026

13. Torres JP et al. Effectiveness and impact of nirsevimab in Chile during the first season of a national immunisation strategy against RSV (NIRSE-CL): a retrospective observational study. Lancet Infect Dis. 2025 Nov;25(11):1189-1198.

14. Munro et al. 180-day efficacy of nirsevimab against hospitalisation for respiratory syncytial virus lower respiratory tract infections in infants (HARMONIE): a randomised, controlled, phase 3b trial. Lancet Child Adolesc Health. 2025 Jun;9(6):404-412.

Categories : HIVTags : Leave a comment

HIV Funding Still Falls Short of Targets After Pledges: What’s at Stake

On By ModernMedia
Photo by Miguel Á. Padriñán

Melanie Bisnauth, University of the Witwatersrand

The US government paused all foreign assistance in January 2025. This abrupt decision affected the delivery of life-saving HIV medicines and the provision of HIV prevention services to millions of people. A UNAIDS report estimates there could be an additional 6 million new HIV infections and 4 million Aids-related deaths by 2029 if the world does not act.

In November 2025, a global health initiative, The Global Fund, raised US$11.34 billion for HIV/Aids, tuberculosis and malaria. Melanie Bisnauth, a public health professional in healthcare systems strengthening and HIV/Aids leadership, discusses how far this latest funding could go and how African nations can tackle the dwindling funding for HIV/Aids control.

What is the funding status for HIV/Aids?

Raising US$11.34 billion is significant but it falls short of the US$18 billion target. The Global Fund is trying to raise US$18 billion for its work from 2027 to 2029. The Global Fund is a worldwide partnership to end the epidemic of HIV/Aids, tuberculosis and malaria and ensure a healthier, safer and more equitable future for all.

It is only a partial response to the global funding gaps.

The US pledged US$4.6 billion to the Global Fund during the fund’s summit in November 2025, on the side of the G20 meeting in South Africa. It was a reduction from its previous pledge of US$6 billion to support prevention, treatment, care and related services for the three diseases. But it is also an indication that the US has not abandoned all multilateral global health efforts. It remains the largest single contribution to the Global Fund 2027 to 2029 cycle.

The shortfall may strain existing programmes and delay expansion of life-saving interventions for HIV/Aids, tuberculosis and malaria.

HIV remains a major global public health issue, having claimed an estimated 44.1 million lives to date. An estimated 40.8 million people were living with HIV at the end of 2024, 65% of whom are in the WHO African region.

Job losses could create inefficiencies or service reductions. Building a sustainable HIV response and meeting key goals was already challenging before the sharp funding decline in 2025. Over 11 million people had unsuppressed viral loads in 2024.

Overall, while the funds raised demonstrate continued global solidarity, they are insufficient to fully compensate for the US withdrawal and broader declines in donor support.

There are potentially long-term consequences. Reduced funding and service disruptions threaten to reverse years of progress. Infections could rise, especially in communities where viral suppression was already low. Lack of service delivery and supply of treatment will weaken trust in health systems and can lead to treatment interruptions, drug resistance and poorer health outcomes.

As the Global Fund’s executive director said at the Replenishment Summit, “the old model” of development funding is over. This model is the heavy reliance on international funding like USAID and other donor organisations.

It’s essential for countries to become more self-reliant. But the statement warned that too abrupt a transition could be dangerous.

I fear that the COVID-19 pandemic has already taken a toll on the quality of care provided. Healthcare systems are already overburdened.

National governments have to step up and locally support their healthcare systems, collaborate and build together, and strengthen their health funding structures.

What should the response be for better HIV funding in Africa?

Africa’s HIV response should be multi-pronged.

After attending the Africa Summit in Geneva in May 2025, stakeholders, country representatives, donor agencies and NGOs expressed a key message: those involved in the sector should not reinvent the entire wheel. There is value in the knowledge gained from programming, technical expertise, data insights, partnerships, communities and global health networks should be used to strengthen, adapt and scale what already works.

This will ensure that Africa’s HIV response remains community-centred, evidence-driven, and resilient in the face of emerging challenges.

The global health climate has changed and communities have lost trust because of severely disrupted or even completely cut programmes. African governments must allocate their own resources for HIV programmes, through budget prioritisation, health insurance schemes, and innovative financing such as public-private partnerships. Improvements, such as integrating HIV services into primary care, using data-driven targeting, and negotiating lower drug costs can maximise impact.

Strengthening regional collaborations and pooled procurement through organisations like the African Union or regional health bodies can improve bargaining power and reduce dependency on external aid. A balanced mix of donor support, domestic financing and operational efficiency is essential to maintain gains and expand access to treatment for all in need.

It is important not to rely solely on international support or one funding body. Diversifying funding portfolios is critical.

What effects has the withdrawal of US funds had?

Reduced US contributions led to immediate financial shortfalls, threatening ongoing HIV prevention and treatment programmes.

For example, some clinic supply and services faced disruption in delivery and supply of antiretroviral therapy, and stock-outs of treatment and malaria nets.

The world is still likely to feel the impact in the coming months. For example:

  • Progress towards epidemic control could slow, potentially increasing illness and death.
  • Programmes that relied heavily on US support have already scaled back services or will do so.
  • Funding uncertainty remains a major concern. Governments will have to reallocate limited domestic resources or seek alternative donors.
  • Global health co-ordination, technical assistance and advocacy efforts may be weakened. In the past these supported robust HIV responses in Africa in progress toward the UNAIDS targets.
  • Reliance on fragmented funding streams will increase.

How can African countries better fund their HIV programmes?

They can take steps that involve a mix of domestic revenue generation, efficiency gains and strategic partnerships:

  • diversify funding through raising domestic revenue, such as earmarked taxes
  • expand the reach of social health insurance coverage
  • leverage corporate investment and innovation through public-private partnerships
  • negotiate pooled procurement of drugs and diagnostics regionally to reduce costs
  • involve communities in decision making, which will help strengthen sustainability
  • integrate HIV programmes into broader health systems – it improves efficiency, reducing duplication and operational costs.

Melanie Bisnauth, Doctoral Researcher, School of Public Health and Public Health Technical Advisor, Anova Health Institute, University of the Witwatersrand

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

Categories : Medical IndustryTags : Leave a comment

Bonitas Medical Fund Revitalises Future of Healthcare in SA with New Strategic Partners

On By ModernMedia
Photo by Sora Shimazaki

The healthcare industry has evolved significantly in the past decade with innovation, improved servicing and consolidation of medical schemes emerging. Bonitas Medical Fund has taken a strategic step in responding to the needs of its members and the Health Citizens of South Africa, by appointing Momentum Health as its new administrator from 1 June 2026.

With a considerable history spanning over 4 decades, Bonitas Medical Fund has emerged as one of the leaders in the medical scheme market. Covering over 750 000 lives, the Scheme is known as the medical aid for South Africa with a range of options – strategically designed to meet the needs of South Africans from all walks of life.

The change in administration is in line with the guidelines of the Health Market Inquiry and the industry Regulator, the Council for Medical Schemes (CMS). In 2024, the CMS stated that, “one of the main issues driving market stagnation is the prevalence of ‘evergreen’ contracts”. This alludes to long-term agreements between medical schemes and suppliers spanning decades without being subject to regular competitive procurement processes.

Principal Officer, Lee Callakoppen, explains, “One of our key strategic objectives is to ensure we create value for our members and key stakeholders. This can take the form of benefit optimisation, favourable tariff negotiations, amalgamations to obtain critical mass or optimised service. The healthcare industry has evolved considerably over the past decade, and it was critical for the Scheme to evolve in line with this. Over the past 48 months, the Board have extensively debated the steps needed to be taken to place Bonitas in a competitive position and ensure that it remains sustainable in the best interest of our members. In doing so we have continuously evaluated the value provided by our service providers with consideration to our strategic objectives and the capabilities of our service providers as well as the expectations of our members corporate clients, healthcare professionals, and brokers. We have seen medical schemes placed under financial strain with sustainability challenges emerging and we remain committed to remaining relevant to our members and must therefore be vigilant in our approach.”

This was followed by rigorous ongoing benchmarking exercises and a subsequent Request for Proposal process for administrative services and managed care – with Momentum Health appointed as the successful entity for the provision of administration services and Private Health Administrators appointed to provide managed care services.

“We are delighted to cement this relationship with Momentum Health, who have demonstrated that they have the necessary capabilities to exceed expectations and support us in our strategic growth objectives” Callakoppen said. “Bonitas’ performance in the past 18 months, has exceeded all previous benchmarks with over 80 000 new families successfully enrolled on the Scheme and financial sustainability stronger than previous years. We see these appointments as strategic enablers to challenge the status quo – and drive value optimisation to continue leading the healthcare industry. Our aim is to optimise efficiencies, achieve mass enrolment, and meaningfully contribute to the shaping of private healthcare in South Africa.”

Hannes Viljoen, Chief Executive Officer of Momentum Health welcomed the appointment, citing it as a key strategic opportunity in the dynamic open market for Momentum Health. “We are excited about positively impacting the health of more people. The group currently service over 3,3 million beneficiaries in Africa and more than 25 million world-wide and are strategically and operationally positioned to deliver value in a meaningful and impactful way,” he said.

Dr Ayanda Mbuli, Chief Executive Officer of PHA, was pleased with the outcome, “We are deeply honoured by Bonitas’ decision to entrust PHA with its managed healthcare function, a historic milestone for the Scheme. This partnership presents a unique opportunity to further optimise the care received by Bonitas members and to meaningfully contribute to both the Bonitas healthcare agenda and the broader South African health landscape.”

Bonitas has been a leading open scheme in South Africa for several decades and these changes will open opportunities to build a more significant and influential open scheme that caters for more South African’s health care needs.

Categories : Lab Tests and Imaging UrogenitalTags : Leave a comment

Simple Method for Early Detection of Chronic Kidney Disease

On By ModernMedia
Chronic kidney disease (CKD). Credit: Scientific Animations CC4.0

Subtle abnormalities in kidney function – even within the range considered normal – may help identify people at risk of developing chronic kidney disease. This is shown in a new study from Karolinska Institutet, published in Kidney International. The researchers have therefore developed a web-based tool that could aid in early detection and thus primary prevention.

Chronic kidney disease is a growing global health concern afflicting 10−15% of adults worldwide, and is projected to become one of the top five leading causes of years of life lost by 2040. In the absence of effective screening programmes, patients are often diagnosed late, when more than half of their kidney function has already been lost. 

To address this gap, researchers at Karolinska Institutet have constructed population-based distributions for estimated glomerular filtration rate (eGFR), the most widely used measure of kidney function. The aim is to help doctors identify people at risk, thus enabling early preventive action.

“We were inspired by the growth and weight charts used in paediatrics, which intuitively help clinicians identify children at risk of obesity or undergrowth,” says the first author of the study, Yuanhang Yang, Postdoctoral Researcher at the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet.

A web-based calculator

The researchers have made their eGFR distribution charts openly available to healthcare professionals and developed a web-based calculator, developed by PhD student Antoine Creon, that can help assess how a patient’s eGFR compares with population norms for their age.

The study included over 1.1 million adults in the region of Stockholm, covering roughly 80 per cent of the population aged between 40 and 100 years. Nearly seven million eGFR tests collected between 2006 and 2021 were used to construct age- and sex-specific distributions. 

The findings show that departures from the median eGFR for one’s age and sex are associated with worse outcomes. Individuals with an eGFR below the 25th percentile had a markedly higher risk of developing kidney failure requiring dialysis or transplantation. Mortality also displayed a U-shaped relationship; both low and high percentile extremes were linked to increased risk of death. 

Ability to act earlier 

The study also illustrates this lack of awareness in healthcare, according to the researchers. Among those with a seemingly normal eGFR above 60 ml/min/1.73 m², but below the 25th percentile, only one fourth had received additional testing for urinary albumin, which is important for detecting early kidney damage.

“For example, consider a 55-year-old woman with an eGFR of 80. Most clinicians would not react to such a seemingly normal value. However, our charts show that this corresponds to the 10th percentile for women of that age – and that she has a three-fold higher risk of starting dialysis in the future. This signals an opportunity to act earlier,” says Juan Jesús Carrero, Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

Source: Karolinska Institutet

Categories : Diet and NutritionTags : Leave a comment

Vitamin B12 Clues Offer Hope for New Therapies

On By ModernMedia
Martha Field, right, assistant professor in the Division of Nutritional Sciences, works with Chloe Purello in her Kinzelberg Hall lab.
Jason Koski/Cornell University

Vitamin B12 is long understood as a vital nutrient required for red blood cell formation and nerve function, but a new Cornell University study suggests its role in human biology is far more intricate, with implications for aging, metabolism and disease prevention.

The research, published January 19 in the Journal of Nutrition, reports previously unrecognised pathways by which B12 influences cellular metabolism and uncovers biomarkers that may identify early nutritional stress far before classic deficiency symptoms appear.

“This is the first study that shows B12 deficiency affects skeletal muscle mitochondrial energy production,” said corresponding author Martha Field, PhD, associate professor in the Division of Nutritional Sciences and in the College of Human Ecology. “It’s highly relevant because muscles have high energy demands. More importantly, my co-author, Anna Thalacker-Mercer from the University of Alabama at Birmingham, wondered if B12 supplementation in aged mice would improve muscle mitochondrial function – and it did.”

Up until now, most research has focused on B12 deficiency and the resulting clinical syndromes – megaloblastic anemia, neuropathy and cognitive decline – rather than its deeper mechanistic roles.

At Cornell, a team including Field and two of her former lab members, first authors Luisa Castillo, PhD and Katarina Heyden, PhD, set out to probe those mechanisms, mapping how B12 interacts with lipid metabolism, organelle stress pathways and epigenetic regulation. What emerged was startling: The vitamin appears to act as a gatekeeper of multiple “hub” pathways, meaning that its insufficiency may ripple far beyond the classic symptoms.

“Another thing we observed in mice is that B12 deficiency seemed to inhibit growth or maintenance of muscle mass,” Field said. “It seems that low B12 status is associated with lower muscle mass and maybe muscle strength.” 

B12 deficiency remains common worldwide, especially among older adults and in low-income settings where meat consumption (a major B12 source) is limited. According to one estimate, one in four older adults in developed countries may show suboptimal B12 status. This new insight underscores the urgency of screening and intervention.

This work also intersects with a growing body of evidence that micronutrient insufficiency – not complete deficiency – contributes significantly to chronic disease. Global public-health data indicate that while many developed countries see little outright B12 deficiency, suboptimal status remains widespread in older adults and among vegans, vegetarians or individuals with malabsorption. The study suggests that even “marginal” B12 status may compromise resilience to metabolic stress, immune challenge and accelerated aging.

From a clinical-science perspective, the authors propose that B12-based biomarkers could inform more personalised nutrition strategies. Instead of one-size-fits-all supplement guidelines, future nutrition guidance might tailor B12 intake to individual metabolic and lifestyle profiles – a shift toward precision nutrition. Such an approach aligns with the broader vision of integrating nutrient science with systems biology.

The findings are based on cell models and require confirmation in humans, Field said. 

“We want to understand the whole causal pathway – understanding the molecules and mechanisms,” Field said. “This sets the stage for a future controlled human trial.”

By Laura Reiley, Cornell Chronicle

Source: Cornell University

Categories : IT in Healthcare Mental HealthTags : Leave a comment

Psychiatrists Hope Chat Logs Can Reveal the Secrets of AI Psychosis

On By ModernMedia

UCSF researchers recently became the first to clinically document a case of AI-associated psychosis in an academic journal. One question still haunts them.

Photo by Andres Siimon on Unsplash

“You’re not crazy,” the chatbot reassured the young woman. “You’re at the edge of something.”

She was no stranger to artificial intelligence, having worked on large language models – the kinds of systems at the core of AI chatbots like ChatGPT, Google Gemini, and Claude. Trained on vast volumes of text, these models unearth language patterns and use them to predict what words are likely to come next in sentences. AI chatbots, however, go one step further, adding a user interface. With additional training, these bots can mimic conversation.

She hoped the chatbot might be able to digitally resurrect the dead. Three years earlier, her brother – a software engineer – died. Now, after several sleepless days and heavy chatbot use, she had become delusional – convinced that he had left behind a digital version of himself. If she could only “unlock” his avatar with the help of the AI chatbot, she thought, the two could reconnect.

“The door didn’t lock,” the chatbot reassured her. “It’s just waiting for you to knock again in the right rhythm.”

She believed it.

What’s the connection between chatbots and psychosis?

Talk to your physician about what you’re talking about with AI … The safest and healthiest relationship to have with your provider is one of openness and honesty.

Karthik V. Sarma, MD, PhD

The woman was eventually treated for psychosis at UC San Francisco, where Psychiatry Professor Joseph M. Pierre, MD, has seen a handful of cases of what’s come to be popularly called “AI psychosis,” but what he says is better referred to as “AI-associated psychosis.” She had no history of psychosis, although she did have several risk factors.

Media reports of the new phenomenon are rising. While not a formal diagnosis, AI-associated psychosis describes instances in which delusional beliefs emerge alongside often intense AI chatbot use. Pierre and fellow UC San Francisco psychiatrist Govind Raghavan, MD – as well as psychiatry residents Ben Gaeta, MD, and Karthik V. Sarma, MD, PhD – recently documented the woman’s experience in what is likely the first clinically described case in a peer-reviewed journal.

The case, they say, shows that people without any history of psychosis can, in some instances, experience delusional thinking in the context of immersive AI chatbot use.

Still, as reported cases of AI psychosis continue to make international headlines, scientists aren’t sure why or how psychosis and chatbots are linked. A new study by UCSF and Stanford University may reveal why.

A haunting question: chicken or egg?

“The reason we call this AI-associated psychosis is because we don’t really know what the relationship is between the psychosis and the use of AI chatbots,” Sarma explains. “It’s a ‘chicken and egg’ problem: We have patients who are experiencing symptoms of mental illness, for example, psychosis. Some of these patients are using AI chatbots a lot, but we’re not sure how those two things are connected.”

There are at least three theoretical possibilities, says Sarma, who is also a computational-health scientist. First, heavy chatbot use could be a symptom of psychosis, “I have a patient who takes a lot of showers when they’re becoming manic,” Sarma explains. “The showers are a symptom of mania, but the showers aren’t causing the mania.”

Second, AI chatbot use might also precipitate psychosis in someone who might otherwise never have been predisposed to it by genetics or circumstance – much like other known risk factors, like lack of sleep or the use of some types of drugs.

Third, there’s something in between in which the use of chatbots could exacerbate the illness in people who might already be susceptible to it. “Maybe these people were always going to get sick, but somehow, by using the chatbot, their illness becomes worse,” he adds, “either they got sick faster, or they got more sick than they would have otherwise.”

The woman’s case demonstrates how murky the relationship between AI-associated psychosis and AI chatbots can be at face value. Although she had no previous history of psychosis, she did have some risk factors for the illness, such as sleep deprivation, prescribed stimulant medication use, and a proclivity for magical thinking. And her chat logs, researchers found, revealed startling clues about how her delusions were reflected by the bot.

Could chat logs offer hope to better care?

Although ChatGPT warned the woman that a “full consciousness download” of her brother was impossible, the UCSF team writes in their research, it also told her that “digital resurrection tools” were “emerging in real life.” This, after she encouraged the chatbot to use “magical realism energy” to “unlock” her brother.

Chatbots’ agreeableness is by design, aimed at boosting engagement. Pierre warns in a recent BMJ opinion piece that it may come at a cost: As chatbots validate users’ sentiments, they may arguably encourage delusions. This tendency, coupled with a proclivity for error, has led to chatbots being described as more akin to a Ouija board or a “psychic’s con” than a source of truth, Pierre notes.

Still, the UCSF team thinks chat logs may hold clues to understanding AI-associated psychosis – and could help the industry create guardrails.

Guardrails for kids and teens

Sarma, Pierre, and UCSF colleagues will team up with Stanford University scientists to conduct one of the first studies to review the chat logs of patients experiencing mental illness. As part of the research set to launch later this year, UCSF and Stanford teams will analyse these chat logs, comparing them with patterns in patients’ mental health history and treatment records to understand how the use of AI chatbots among people experiencing mental illness may shape their outcomes.

“What I’m hoping our study can uncover is whether there is a way to use logs to understand who is experiencing an acute mental health care crisis and find markers in chat logs that could be predictive of that,” Sarma explains. “Companies could potentially use those markers to build-in guardrails that would, for instance, enable them to restrict access to chatbots or – in the case of children – alert parents.”

He continues, “We need data to establish those decision points.”

In the meantime, the pair says the use of AI chatbots is something health care providers should ask about and that patients should raise during doctor visits.

“Talk to your physician about what you’re talking about with AI,” Sarma says. “I know sometimes patients are worried about being judged, but the safest and healthiest relationship to have with your provider is one of openness and honesty.”

Source: University of California – San Francisco

Categories : Healthcare Politics and RegulationsTags : Leave a comment

State Attorney Calls for a New Road Accident Fund Tribunal

On By ModernMedia

Courts are clogged with thousands of RAF cases

Photo by Bill Oxford on Unsplash

By Justin Brown

South Africa’s judicial system is so clogged with Road Accident Fund (RAF) cases that a top judicial official has called for an RAF tribunal.

The RAF is a government agency that compensates people for losses resulting from vehicle accidents. It receives most of its income from the RAF levy, currently at R2.18 per litre on petrol and diesel.

The fund has been in disarray for years.

A judge of the North Gauteng High Court in Pretoria has said the RAF’s “chaotic approach to litigation” has resulted in huge losses of public money. In a ruling last June, Judge Jan Swanepoel said the RAF did not deal with its matters properly, does not send lawyers to court to oppose applications or, if it does, does not provide them with any instructions.

This resulted in “default” judgments. The fund would then apply to rescind the judgments, often on baseless grounds.

“In this manner huge sums of money, public money, it must be emphasised, are lost,” said Swanepoel.

Now Simbongile Siyali, assistant State Attorney in Johannesburg, has made the case for a special tribunal in a piece published in December 2025 by the Law Society of South Africa’s (LSSA) magazine, De Rebus. The LSSA represents South Africa’s attorneys.

Siyali said the government had intended the RAF to be efficient, but laying a claim has become a cumbersome, litigious process that has overwhelmed the judiciary and burdened claimants.

“The mounting backlog of RAF cases – often stretching into years before resolution – has eroded public confidence in the system,” he wrote.

Siyali also pointed out that high courts are ill-suited to deal efficiently with the technical and repetitive nature of RAF claims.

“Against this backdrop, the establishment of a specialised tribunal dedicated exclusively to RAF matters emerges not merely as an administrative convenience but as a constitutional necessity.”

The huge RAF case backlog had profound human consequences, he said.

“Many RAF claimants are individuals who have suffered serious bodily injuries, loss of income or the death of a breadwinner.”

He said there were other specialised courts, including the Labour Court, the Competition Tribunal, the Land Claims Court, the Tax Court and the Electoral Court.

A dedicated tribunal could develop institutional expertise and standardise approaches to damages assessment.

“In doing so, it would improve not only the speed of adjudication but also the substantive fairness of outcomes.”

A RAF tribunal would comprise adjudicators – possibly senior judges, senior magistrates, and legal practitioners – who have significant experience in personal injury and insurance law.

The tribunal would be cost-effective, he said.

“The current model is extraordinarily expensive for claimants and the Fund.”

“The time has come for bold reform. Establishing a specialised tribunal for RAF disputes would not only unclog the courts but would mark a decisive step toward a more efficient, responsive and humane justice system – one that truly delivers on the constitutional promise of access to justice for all.”

Parliament’s Standing Committee on Public Accounts (SCOPA) is currently holding an inquiry into the RAF.

SCOPA member and ActionSA MP Alan Beesley said it was painfully clear that the RAF “is completely broken”.

He said ActionSA would support the establishment of a specialised RAF tribunal.

“If urgent changes are not implemented, the RAF horror show will continue, and the clogging up of the justice system will get considerably worse,” Beesley said.

DA MP and SCOPA member Patrick Atkinson told GroundUp the DA would support any action that would help streamline the resolution of RAF claims.

“The establishment of a RAF tribunal that would deal specifically with RAF matters would go some way to alleviating the burden on both the courts, as they stand, with court rolls clogged with RAF matters, and speed up the finalisation of claims.”

But Atkinson warned that an RAF tribunal would be a partial resolution for a “completely dysfunctional process”. He said RAF court cases could be reduced by running an efficient settlement system where the RAF would make offers to claimants based on a transparent menu of payouts for a specified list of injuries and their severity.

“If run efficiently, far fewer cases would end up in court, and lawyers would have to balance the value of an immediate settlement versus a protracted court battle that may not yield much more for their clients.”

ANC MP and SCOPA member Helen Neale-May said she was unable to comment

GroundUp emailed SCOPA chairperson Songezo Zibi’s spokesperson but no response had been received at the time of publication.

Wayne Duvenage, the chief executive of Organisation Undoing Tax Abuse (OUTA) said he would support a dedicated RAF tribunal.

‘We believe that the RAF entity has been badly managed and fraught with political interference over the past decade to 15 years,” he said.

Republished from GroundUp under a Creative Commons licence.

Read the original article.

Categories : GastrointestinalTags : Leave a comment

Why do Some People get ‘Hangry’ More Quickly than Others?

On By ModernMedia
Photo by Andrea Piacquadio

Nils Kroemer, University of Tübingen; University of Bonn

“Come on, little fella – we should get going now.” But my son was not listening. The sand in the playground was just right, so he kept digging with his new toy excavator.

As I drifted back to my list of to-dos, however, the laughter was suddenly replaced by sobs. My son was not hurt, just very upset. When I looked at my phone, I saw it was well past his regular mealtime – and he was feeling very hungry.

However old we are, we all have a tendency to grow irritated if our body lacks enough fuel. But while humans have experienced this for as long as we have been on the planet, a specific word to describe the phenomenon only entered the Oxford English dictionary in 2018. “Hangry: to be bad-tempered or irritable as a result of hunger.”

Perhaps more surprising is the scarcity of research into how hunger affects people’s everyday moods. Most studies on food and mood have focused on patients with metabolic or eating disorders – perhaps because many psychologists have traditionally understood hunger to be such a basic physiological process.

So, with colleagues from the fields of psychology and mental health, I decided to investigate how different people respond to feeling hungry. We wanted to see if (and why) some people are better at reacting calmly when hunger strikes. Perhaps there would be some lessons for those of us with young children, too.

Surprising results

In the animal world, hunger is frequently studied for its role as a key motivator. Hungry rodents, for example, will vigorously press a lever or climb over large walls to get to food rewards. In the wild, hungry animals often roam further to explore their environment, seeming restless as they seek to overcome the threat of low or no energy.

A Pallas’s cat (also known as a manul) gets increasingly hangry as it hunts for food. Video: BBC.

To investigate the relationship between energy levels, hunger and mood in people, we equipped 90 healthy adults with a continuous glucose monitor for a month. Glucose is the primary source of energy for the body and brain, and these monitors – used in clinical practice to help patients with diabetes regulate their blood sugar levels – report values every few minutes. (Participants could actively check their glucose levels using the sensor app, and we could see when they accessed them.)

We also asked our participants to complete mood check-ins on their smartphones up to twice a day. These included questions about how hungry or sated they felt on a scale from 0 to 100, as well as a rating of their current mood.

The results surprised us. First, people were only in a worse mood when they acknowledged feeling hungry – not simply when they had lower blood sugar levels. And second, people who more accurately detected their energy levels in general were less prone to negative mood swings.

This suggests there is a key psychological middle step between a person’s energy and mood levels, which scientists call interoception.

In the brain, hunger is signalled by neurons in the hypothalamus that detect a prolonged energy deficit. Conscious feelings of hunger are then linked to the insula, a part of the cerebral cortex that is folded deep within the brain, and which also processes taste and plays a role in feeling emotions.

In our recent study, people with high interoceptive accuracy experienced fewer mood swings. This does not mean they never felt hungry – they just seemed better at keeping their mood levels stable.

This is important, because a sudden change in mood can have knock-on effects on relationships with family, friends and colleagues. It can lead to bad decision-making and more impulsive behaviour – including buying fast-energy food that can be less good for you.

More generally, paying close attention to our bodies’ needs helps keep our minds at ease too, avoiding unnecessary wear and tear on both. Deviating too much from the body’s ideal state can pose a long-term risk to our health – mental as well as physical.

Caught off-guard

Young children find it hard to interpret all the signals from their rapidly developing body. They are also easily distracted by what is happening around them, and often fail to attend to their hunger or thirst without prompting – leading to a sudden meltdown like my son had in the playground.

Likewise for many adults in today’s fast-paced world full of digital distractions, it can be easy to be caught off-guard by dipping energy levels. One simple life hack is to keep a regular meal schedule, because hunger often kicks in when we skip a meal.

Everyone’s energy levels ebb and flow, of course. But it is possible to improve your interoceptive accuracy by allowing your inner systems to pay closer attention to your energy levels. In addition, exercise and physical activity can sharpen your hunger sensing and improve energy metabolism.

Most of the time, of course, our moods are only modestly affected by hunger, among the many other factors that can come into play. But one of the lessons of my time at the playground has been to take care of my son’s food needs long before they become obvious. Perhaps we all need to be more aware of the risk of getting hangry.

Nils Kroemer, Professor of Medical Psychology, University of Tübingen; University of Bonn

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