The robotic arm working in the hospital. Credit: Queen Mary University London
Two major studies involving researchers at Queen Mary University of London have found that robotic-assisted hip and knee replacement does not reduce the overall early risk of repeat surgery compared with conventional surgery.
Published in The BMJ, the studies analysed more than one million joint replacements recorded in the National Joint Registry between 2018 and 2024. Together, they provide the largest real-world evaluation to date of whether the greater technical precision offered by robotic-assisted surgery translates into better outcomes for patients.
Researchers from Queen Mary, the University of Oxford and the University of Bristol found that, although robotic technology is designed to help surgeons position joint implants more accurately, this did not translate into a lower overall early risk of repeat surgery following either hip or knee replacement.
In robotic-assisted joint replacement, the surgeon remains in control of the operation, using computer and robotic technology to help plan and guide the placement of the implant.
The findings come as the NHS plans a major expansion of robotic surgery, aiming to increase the number of robotic-assisted procedures sevenfold by 2035. Robotic systems require substantial investment, costing around £1 million to introduce and adding approximately £1,000 to £2,500 to the cost of each procedure.
In the hip replacement study, researchers found no overall reduction in repeat surgery or mortality associated with robotic surgery. However, robotic hip replacement was associated with a lower risk of further surgery for problems related to implant positioning. This specific benefit did not translate into an overall reduction in the need for repeat surgery.
For knee replacement, researchers found no difference in the risk of repeat surgery between robotic-assisted and conventional procedures.
The studies examined early outcomes, and the researchers say longer-term follow-up will be needed to establish whether differences in implant survival emerge over time.
The team used a method known as target trial emulation to analyse large-scale real-world registry data. The statistical approach aims to make comparisons between groups more closely resemble those of a clinical trial by balancing patients according to known differences in their characteristics.
Dr Hasan Mohammad, Academic Clinical Lecturer in Trauma and Orthopaedics at Queen Mary University of London and lead author, said:
“This study, which uses novel methodology and represents the largest real-world analysis of its kind worldwide, provides important independent evidence for patients, surgeons and policymakers at a time when robotic hip and knee replacement surgery is being adopted rapidly.
“New technology should deliver meaningful benefit for patients and represent good value for a publicly funded health service.”
A new review published in Sciencebrings together growing evidence that the X and Y chromosomes do much more than determining biological sex. They also shape how cells function, age and respond to disease.
Differences in health between men and women have long been attributed mainly to sex hormones such as estrogen and testosterone. However, genes on the X and Y chromosomes also play a direct role, working both on their own and alongside hormones.
The review was co-led by University of Arizona Cancer Center physician-scientist Dr. Dan Theodorescu and Dr. Dena B. Dubal of the University of California, San Francisco. It describes how sex chromosomes influence immunity, metabolism, brain aging, cancer and heart disease, and what this could mean for diagnosis, treatment and the design of clinical trials.
“X and Y chromosomes are often thought of as simple determinants for biological sex, but their role in human health is much larger,” said Theodorescu, one of the study’s corresponding authors and Nancy C. and Craig M. Berge Chair and Director of the Cancer Center. “Our review shows that these chromosomes carry genetic instructions that shape how our cells age and how our bodies defend against major diseases throughout our lives.”
The study shows that the genes on the X and Y chromosomes, rather than circulating hormone levels alone, determine disease risk, progression and therapeutic responses across key heath areas including aging, cancer, neurological conditions, immune system functions and cardiometabolic disease.
The review, which evaluated and synthesized existing evidence from human studies, mouse models and genomic technologies, describes several processes inside cells that shape health across the lifespan.
In women, one of the two X chromosomes is largely switched off early in development, but some of its genes stay active and others can switch back on with age, giving female cells extra doses of certain genes. Studies in mice suggest it also matters whether a cell’s active X came from the mother or the father. Men inherit their only X chromosome from their mother, while in women each cell uses either the mother’s or the father’s copy. In mice whose cells relied mostly on the mother’s X, faster brain aging and memory decline was observed.
With age, some cells lose a sex chromosome. In women, loss of an X is linked to higher leukemia risk, though its broader effects remain largely unknown. In men, loss of the Y, most often measured in blood, is linked to cancers, heart disease, severe infections and Alzheimer’s disease. The loss of these chromosomes is being explored as both a biomarker of and potential contributor to age-related disease.
“When we look inside human cells, we see that X and Y chromosomes are participants in health and disease throughout a person’s life,” said Theodorescu, who is also a professor at the U of A College of Medicine – Tucson. “In cancer, for example, our laboratory has found that tumors that lose the Y chromosome can evade the immune system, yet may respond better to immunotherapy. Understanding this biology could help us tailor treatment.”
The review originated from discussions at the 2025 National institute on Aging Workshop: Sex Differences Impacting Human Health Across the Lifespan, especially with Francesca Duncan of the Northwestern University Feinberg School of Medicine.
“Our hope is that this review will stimulate further investigation and bring greater awareness to the significant potential of studying the X and Y chromosomes in cancer and other diseases, with far-reaching diagnostic and therapeutic implications,” said Theodorescu. “This would help ensure that treatments and diagnostics are tailored to match every patient’s unique profile. When clinical trials are designed to be sex-aware, researchers can turn these cellular differences into personalized medical care.”
Theodorescu’s previous related research focused on how the loss of the Y chromosome in T cells and cancer cells in men gave tumors the ability to evade the immune system, providing an explanation why the loss of the chromosome has been linked to increased mortality from carcinomas. Other recent Theodorescu group research showed how loss of the Y chromosome in normal-appearing tissues acts as an early warning sign and may mark a hidden zone of genetic risk for cancer to develop.
Johannesburg, South Africa – 2 October 2026 – Bonitas Medical Fund unveiled its 2027 product range, signalling a bold step forward in preventive healthcare, improved wellness, personalised support and long-term sustainability within the open scheme market.
Lee Callakoppen, Principal Officer of Bonitas Medical Fund, says: “Healthcare in South Africa is evolving rapidly, and members need more than traditional medical aid cover. They need proactive support, personalised health journeys and meaningful value at every stage of life.”
“Our 2027 product offering and plan enhancements are designed to reflect our commitment to keeping healthcare accessible, affordable and relevant for all our members.”
Earlier detection, better health outcomes
Bonitas has made preventive healthcare a strategic priority for 2027.
“It’s important that members are both enabled and encouraged to identify potential health risks earlier through preventive assessments and screenings,” says Callakoppen.
To support this, Bonitas has expanded access to wellness screenings through a growing provider network that now includes Clicks, Dis-Chem and Medirite pharmacies, bringing basic wellness screening access closer to members across South Africa.
Around 95% of Bonitas members are located within 10km of a health risk assessment provider. With the expanded network, members now have access to more than 1 245 pharmacies nationwide for basic wellness screenings.
The enhancement responds to growing demand. In 2025, health and wellness assessments increased by 138.6% compared to the previous year.
To close the gap between screening and treatment, Bonitas is introducing a GP Confirmation Benefit in 2027. When a potential health risk is identified, eligible members will have access to a risk-funded GP consultation within 14 days of the wellness screening, removing financial barriers to follow-up care and supporting a more connected wellness journey.
Enhancing member experience through more rewards and everyday value
The Benefit Booster, a hallmark of Bonitas innovation, is being expanded by 140% for 2027, offering families up to R12 000 in additional value. For the first time, it will also be available on the BonCap income-based plan.
Complementing this is B-Value, Bonitas’ lifestyle and wellness platform. More than a rewards programme, B-Value supports wellbeing through expert guidance, practical tools and rewards across fitness, nutrition, financial health and stress management. With new partners including Takealot and Checkers Sixty60, members can unlock even more rewards, discounts and lifestyle benefits through healthier behaviours.
Stronger plans, better benefits
Bonitas continues to refine its product range to balance affordability and sustainability for its members. Key enhancements across the product range include improvements to BonPrime, updates to the Standard option and the introduction of a Dental Emergency Benefit on selected plans.
Together, these changes are designed to improve accessibility, affordability and member value while simplifying the healthcare experience.
Expanded support across the care journey
Bonitas continues to invest in proactive healthcare support through initiatives such as Live Lean, the Ocular Health Programme, enhanced rehabilitation support through the new Back, Neck, Shoulder and Knee Rehabilitation programme and expanded mental health services. Together, these programmes are designed to help members manage health risks earlier, access support more easily and achieve better long-term health outcomes.
Smarter digital engagement
Bonitas continues to simplify healthcare through its Member App, Member Zone, WhatsApp support channel and other digital platforms. In 2027, the Fund will also expand digital engagement initiatives, including the Medical Aid Made Easy podcast hosted by Dr B, while enhancing support tools for both employers and brokers.
Balancing affordability with sustainability
“Against a challenging economic backdrop, affordability remains a key priority. Strategic purchasing and provider negotiations continue to help maximise value for members while supporting the long-term sustainability of the Fund,” Callakoppen adds.
Across all plans, the average contribution increase for 2027 will be 8.7%.
“We know that alongside all our updates, enhancements and new rewards, this will go a long way towards providing our members with additional value.”
“Our 2027 product range is about more than just useful medical aid benefits. Our enhanced offering is also about evolving healthcare to meet the needs of our members today and tomorrow. By focusing on prevention, wellness, personalised support and affordability, we are delivering meaningful value for our members, and building a stronger, more sustainable future for healthcare in South Africa,” concludes Callakoppen.
Severe pneumococcal disease requiring hospitalisation, most commonly pneumonia, can be a sign of previously undiagnosed blood cancer and immunodeficiency in adult patients, according to a study from the University of Gothenburg.
The study followed 156 individuals who developed invasive pneumococcal disease and required hospital care in the Region Västra Götaland between 2018 and 2023. The median age of the patients was 70 years.
The researchers examined the patients’ immune system by measuring antibody levels and studied the presence of M protein, known as a risk marker for blood cancer. The control group consisted of 64 individuals matched for age and sex who did not have invasive pneumococcal disease.
In the pneumococcal disease group, one in four individuals had M protein in their blood, a marker that may be present in blood cancer or in precursor conditions. The examinations led to seven patients being diagnosed with blood cancer, while another twelve were diagnosed with a condition that can, in some cases, progress to blood cancer.
Routine screening should be considered
Eight patients were found to have immunodeficiency, seven of whom were able to start preventive treatment against new, severe infections. These findings were considerably less common in the control group.
The results, published in the journal Scientific Reports, suggest that screening for M proteins and antibody levels in adults with invasive pneumococcal disease should be considered, according to the researchers, as the disease can reveal previously undiagnosed blood cancer and immunodeficiency.
“Currently, these tests are not routinely performed after a severe pneumococcal infection. As a result, we may miss patients with undiagnosed blood cancer or immunodeficiency and therefore missing the opportunity to initiate treatment,” says Tor Härnqvist, a doctoral student at the University of Gothenburg, an infectious disease physician at NU Hospital Group, and one of the lead authors.
Importance of tailoring vaccinations
Karin Bergman is a doctoral student in the same research group and an infectious disease physician at Södra Älvsborg Hospital. The study is part of her doctoral thesis, which she will soon defend at the University of Gothenburg, in which she also demonstrates how the pneumococcal bacteria causing severe disease have changed since the pneumococcal vaccine was introduced into the Swedish childhood vaccination programme.
The bacterial serotypes covered by the childhood vaccine have decreased sharply but have largely been replaced by other serotypes against which the vaccine offers no protection. Older adults and individuals with underlying conditions, particularly cancer and compromised immune systems, are frequently affected by these serotypes.
“The results show that recommendations on pneumococcal vaccines for adults need to take into account which vaccines are used in children and which bacterial serotypes subsequently circulate in the community,” says Karin Bergman.
Certain parenting approaches, such as lower supervision and inconsistent discipline, are associated with a higher likelihood that children will show behavioral and emotional problems, such as attention difficulties, anxiety, and depression
The mean of internalising and externalising behaviors by parenting profiles. The horizontal axis displays child internalising and externalising symptom dimensions, while the vertical axis indicates mean severity scores. Colored bars represent the identified parenting profiles. Error bars reflect 95 percent confidence intervals. Xu et al., 2026, PLOS One, CC-BY 4.0
There’s no one right way to raise a child, but different patterns of parenting are associated with how kids behave. A new study, published on September 30, 2026 in the open access journal PLOS One, identified data-driven profiles of parenting practices and investigated how these relate to children’s behavioral and emotional problems, generally grouped into internalising behaviours (eg, withdrawal, anxiety, depression) and externalising behaviours (eg, aggression, oppositional behaviour, attention problems). The research team led by Dr Xiaoye Xu, an Assistant Professor of Psychology at SUNY Cortland, US, found that several parenting factors, including low supervision and inconsistent discipline, were linked to a higher likelihood that children would exhibit these behaviours.
The researchers assessed these behaviours in more than 2700 children between the ages of five and 18, using data assembled by the National Institutes of Health’s (NIH) Environmental influences on Child Health Outcomes (ECHO) Program. Parents filled out surveys about their approach to parenting and their children’s behaviour.
Across these responses, the researchers identified three parenting profiles. The first was high positive parenting with better supervision – the term “positive parenting” describes warm, responsive caregiving, such as praising good behaviour and engaging supportively with the child. The other two profiles were lower positive parenting with medium supervision, and medium positive parenting with poorer supervision. While these profiles do not represent the full spectrum of parenting approaches, this range let the researchers analyse the effects of positive parenting and level of supervision together.
Externalising and internalising behaviours were lowest among children raised with high positive parenting and better supervision. These behaviours were more common in the lower positive parenting with medium supervision profile, and highest among children in the medium positive parenting with poorer supervision profile.
Separately, the researchers also examined each parenting behaviour individually rather than as part of a broader profile. This analysis showed that inconsistent discipline – how unpredictably parents enforced rules – was linked to both more internalising and more externalising problems, regardless of a family’s broader parenting profile. Poor supervision, examined this way, was linked to more externalising problems specifically, such as aggression and attention difficulties, but was not significantly linked to internalising problems like anxiety and depression.
The results of this study do not give a full picture of a child’s rearing and its possible influences. The data are based on self-report – mostly mothers filled out the survey, with only 52 fathers participating, and other family or community members involved in the child’s rearing were not included. The researchers also only had a snapshot of the current parent-child relationship, which makes it difficult to establish cause and effect, as both parenting tactics and child behaviour can develop and change in response to one another.
The authors add: “In a large, diverse sample of children across the US, we found that certain patterns of parenting – not just individual behaviours – matter for children’s emotional and behavioral wellbeing. Children tended to have fewer emotional and behavioral problems when parents were consistently positive, provided steady discipline, and stayed closely engaged in their day-to-day lives. It’s a reminder that small, everyday parenting behaviours can add up to meaningful differences for children.”
Three short films tell the powerful stories of professionals whose resilience, purpose and commitment are creating lasting impact in their communities.
Photo by Thirdman : https://www.pexels.com/photo/medical-professionals-looking-at-the-screen-of-the-cellphone-5327867/
Profmed, South Africa’s medical aid for professionals, has launched BeRemarkable, a documentary series that shines a spotlight on the people and personal stories behind some of the country’s most respected professions.
Now streaming on the Profmed YouTube channel, the three-part series follows the journeys of Profmed members who have overcome significant personal challenges and gone on to make a meaningful difference in the lives of others and their communities.
“These films are a reminder that behind every profession is a person with a unique story,” says Craig Comrie, CEO at Profmed. “We wanted to highlight members whose influence extends beyond their careers and into the communities and lives they’ve helped shape.”
THE THREE STORIES
Flight Path | Dr Ryan Jacobs
After severe epilepsy and brain surgery ended his ambitions of becoming a pilot, Dr Ryan Jacobs found a new calling in medicine.
Now training as a specialist neurosurgeon at Tygerberg Hospital, Ryan’s story reflects how personal adversity can shape purpose.
Flight Path explores his journey from patient to healthcare professional, and the experiences that inspired him to pursue a career helping others navigate life-changing medical challenges.
Back to Water | Suzanne “Suzie” Hüsselmann
A devastating bodyboarding accident changed Suzanne “Suzie” Hüsselmann’s life in an instant. The long recovery that followed brought both physical and emotional challenges, but also strengthened her connection to the ocean and inspired a new sense of purpose.
Today, Suzie is the founder of Surf4Life, an initiative that uses surfing to support young people from underserved communities in Cape Town. Through the programme, participants develop confidence, resilience and life skills while building a deeper connection with the ocean.
Back to Water explores how a life-altering experience inspired Suzie to create opportunities for others through the sport that played an important role in her own recovery.
Into Focus | Tharien Schoeman
A patient who had been waiting years for cataract surgery left a lasting impression on Tharien Schoeman. What began as a single encounter grew into a broader mission to help more people access the treatment they need.
Today, her work has helped restore sight to hundreds of South Africans, giving many the opportunity to regain their independence and reconnect with daily life.
Into Focus tells the story of how one person’s determination can create meaningful change for others.
ABOUT BEREMARKABLE
BeRemarkable is a three-part documentary series showcasing the stories of Profmed members who have overcome personal challenges and gone on to make a positive impact in their communities.
Filmed across South Africa, the series features first-hand accounts from Dr Ryan Jacobs, Suzanne “Suzie” Hüsselmann and Tharien Schoeman, exploring the moments that shaped their journeys and inspired their work.
The full series is now available on the Profmed YouTube channel@profmedsa.
Researchers at The Ottawa Hospital and the University of Ottawa were able to reverse certain behavioural symptoms in a mouse model of autism by fixing a problem in the brain blood vessels. Their findings, published in Neuron, present a promising new treatment target for these symptoms.
Autism is a neurodevelopmental condition with widely varying characteristics. Some of the behavioural symptoms can make life more challenging. While many people with autism have found ways to manage these symptoms, no drug treatment exists.
“The road from discovery to clinical trials is long, but we’re excited by the possibility that our findings might one day improve the daily lives of people with autism,” said senior author Dr Baptiste Lacoste, senior scientist at The Ottawa Hospital and professor at the University of Ottawa.
Dr Lacoste’s team previously discovered that blood vessels in the brain don’t work properly in mouse models with a 16p11.2 deletion, one of the most common genetic mutations seen in autism. They were the first to look at what was happening in the blood vessels of the brain.
The researchers found the problem began in cells lining the blood vessels, called the endothelial cells. These cells make sure blood quickly gets to the parts of the brain that are active. This responsive blood supply is needed for proper brain function.
However, the endothelial cells in these mice don’t respond quickly enough. This happens early in brain development and causes behavioral symptoms later in life, including hyperactivity, repetitive movements, and motor learning impairment.
In this new study, driven by former PhD student Dr Julie Ouellette, the research team looked at what was wrong with these endothelial cells and whether it could be fixed.
The team led by Dr Lacoste found that the endothelial cells had half the normal level of a molecule called ATP. ATP is usually considered an energy molecule, but in this case the cell was missing its target, called a P2Y2 receptor, on its surface.
By activating this P2Y2 receptor, the researchers could restore the cell’s function, increase blood flow in the brain and reverse the behavioral symptoms in adult mice. This was achieved using a drug known to activate P2Y2 and currently approved for humans in Japan and South Korea to treat dry eye syndrome.
“It’s as if these cells are asleep, and now we can wake them up,” says Dr Lacoste. “And we may only need to treat them once to wake them up permanently. We will test that further, but it’s an encouraging feature for a future treatment.”
This study only looked at adult mice. This means targeting P2Y2 could reverse behavioural symptoms that were already well established. Next, the team plans to treat mice earlier in life to see if early treatment has additional benefits.
The team has also filed a patent application for using P2Y2 activation in the blood vessels to treat autism symptoms. They are interested in exploring drug development with the aim of eventual clinical trials.
Researchers analysed more than 9400 meals and 1000 stool samples, linking sugar-rich foods to greater antibiotic-related microbiome disruption in stem cell transplant patients.
Photo by Patrick Fore on Unsplash
Treatment with antibiotics often causes stomach cramps and diarrhoea, broadly destroying good bacteria in the gut, allowing the overgrowth of harmful microbes. A new study involving City of Hope researchers suggests eating less sugar could protect the microbiome during antibiotic treatment. The study followed patients with blood cancer who were going through an intensive treatment called allogeneic hematopoietic cell transplant, a population at particularly high risk for severe gut microbiome disruption and associated side effects.
Published in Nature, the surprising findings connect to the idea of “food as medicine” during cancer care and the ways diet can help us prevent and recover from illness. The research could lead to new treatment strategies for cancer patients and potentially others taking antibiotics.
“Antibiotics disrupt the diversity of our gut bacteria, or microbiomes, which play an essential role in supporting our immune systems and overall health,” said co-senior author Marcel van den Brink, MD, PhD, president of City of Hope Los Angeles and City of Hope chief physician executive. “Our research supports emerging evidence that avoiding sugary foods during antibiotic treatment may protect the microbiome. Preserving microbiome diversity has previously been linked with improved clinical outcomes for patients with cancer.”
Dr van den Brink, a globally recognised leader in the microbiome, cell transplantation and cancer immunotherapy, collaborated on the research with Jonathan Peled, MD, PhD, at Memorial Sloan Kettering Cancer Center and Jonas Schluter, PhD, at NYU’s Grossman School of Medicine.
A Large Clinical Study With High-Frequency Data
The five-year study, one of the largest of its kind, followed patients who were hospitalised for several weeks to receive intensive chemotherapy, sometimes with radiation, to wipe out their immune systems and then undergo a stem cell transplant. To prevent and treat infections, each patient took at least one antibiotic during their hospital stay, with 80% of them taking one or more of the broad-spectrum antibiotics that exert the strongest effect on the microbiome by targeting many types of bacteria.
The research team tracked 9419 meals eaten by 173 hospitalised patients and profiled the microbiome diversity in stool samples from 158 patients. Microbiome diversity is a key indicator of a healthy microbiome.
Precisely Measuring Food in Real Time and Tracking Effects in the Gut
Each time patients ordered a meal from the hospital kitchen, the tray arrived with a questionnaire asking them to record the amount of each item that they ate and drank.
With this help from the hospital kitchen to track nutritional information for all hospital meals consumed, the scientists recorded more than 40,000 food items, creating an unprecedented dataset with a level of detail that’s rarely possible in nutrition research.
For each patient, the researchers tracked between eight and 128 meals across a period ranging from 12 days before to 49 days after transplantation. The team also analysed more than 1000 patient stool samples to monitor changes in the gut microbiome.
“Unlike past nutrition studies that rely on patients’ memories of what they ate or other imprecise surveys, we had meticulous dietary records collected in real time,” noted Dr van den Brink. “This enabled us to look for patterns that otherwise might be impossible to detect.”
A Striking Discovery: Sugar Upsets the Balance of Gut Bacteria
Using a variety of advanced statistical models, the researchers scoured the data in search of patterns linked to injury to the gut microbiome.
What they found surprised them.
“No matter how we analysed the data, the same strong signal kept appearing,” observed Dr van den Brink. “The patients who consumed more sweets while taking antibiotics were more likely to experience a loss of microbiome diversity as aggressive microbes crowded out other strains of bacteria.”
One organism stood out: Enterococcus. When it takes over the microbiome, patients undergoing transplant face a higher risk of bloodstream infections, graft-versus-host disease and other life-threatening complications.
The combination of high-sugar foods and broad-spectrum antibiotics appeared to multiply injury to the microbiome, leading to a substantial 24% drop in bacterial diversity for every 100-gram increase in sweets (equivalent in sugar content to a large milkshake).
Replicating the Results in Mice Supports Human Data
The researchers also tested their hypothesis that sugar exacerbates microbiome injury by giving broad-spectrum antibiotics to healthy mice and feeding them a variety of diets. Mice that ate a high-sucrose diet quickly developed an overgrowth of Enterococcus in their guts. Mice that ate the high-sugar diet without antibiotics, however, maintained normal bacterial diversity.
“The fact that animal studies support associations we found in patient data provides a compelling rationale for future clinical trials to evaluate whether reducing sugar intake during antibiotic use would protect the microbiome,” said Dr van den Brink, the Deana and Steve Campbell Physician Executive Distinguished Chair and the Morgan and Helen Chu Presidential Chair.
What the Findings Could Mean for Patients
“The microbiome is emerging as an important factor in cancer care,” Dr van den Brink said. “The better we understand what supports and disrupts it, the more opportunities we have to reduce treatment side effects while improving how patients respond to and recover from therapy.”
For cancer patients, he noted, the study results reinforce diet as a strong influence on the microbiome and as one of the most practical ways hospitals can support recovery during treatment.
“Many of the foods and drinks we encourage hospitalised patients to consume, like nutritional shakes, smoothies and sports drinks, are high in sugar content,” Dr van den Brink said. “That’s something we’ll need to evaluate when prescribing antibiotics.”
The practical takeaway for physicians, he says, is that antibiotic stewardship matters beyond preventing antibiotic resistance.
“Antibiotic stewardship includes thinking about how different antibiotics affect the microbiome,” Dr van den Brink said. “Our study demonstrates that some antibiotics disrupt beneficial gut bacteria more than others.”
To preserve microbiome health, he encourages patients to ask their healthcare team to ensure antibiotics are thoughtfully chosen from equally effective treatment options for controlling infections.
So, should people cut out sugar while taking antibiotics?
“It’s premature to recommend everyone taking antibiotics avoid sugar,” Dr van den Brink said. “On the other hand, we don’t have strong evidence that probiotics help preserve or restore microbiome diversity and many people choose to take them anyway. There’s no harm in limiting sugar in your diet, and it’s an easy thing to try.”
New findings show the wide-ranging involvement of the brain when you feel sick
Typical symptoms such as loss of appetite, fatigue, and fever shape the experience of being sick. However, research shows that the brain plays a central role in creating and coordinating this overall sickness state. Credit: Daniela Velasco/EMBL
We are all familiar with that dreaded sensation: a whole-body achiness and fatigue, waves of both bone-chilling cold and acute sweating that cause one to pull cosy blankets closer and only moments later kick them away. A loss of appetite turns us off even our favourite foods. This state may stem from any number of infections, but one thing is certain: our brain is telling us we are sick.
Sickness is an evolutionarily old, protective response that helps the body recover better and faster from illness, and scientists have sought to determine where exactly in the brain these signals originate. Research from scientists at EMBL Heidelberg, applying a new methodology, has provided evidence to show the brain’s involvement is not localised to one or two regions, but widespread.
“Many things are happening. It’s not one specific isolated group of neurons in some hidden area of the brain. It probably requires engagement of large parts of the brain, or multiple brain areas, to achieve this state,” said Gretel Kamm, a former postdoctoral fellow in Robert Prevedel’s team at EMBL, who led the research and brought this hypothesis to the group. The findings have now been published in the journal Current Biology. “Our main hypothesis is that we can understand sickness as a distinct brain state, and that it changes our decisions and behaviour when we have an infection,” she said.
These findings expand the school of thought on brain involvement in sickness, while introducing an efficient, effective way to study this phenomenon further.
Old brain, new brain
Scientists have known for a while that the parts of the brain deep below the surface, such as the hypothalamus and brainstem, help control symptoms associated with infections, but they were unclear about the role the outer layer of the brain played.
The brain has evolved by inheriting foundational circuits from old, ancestor species. Natural evolution over millions of years has modified these circuits and added new structures, allowing the brain new functionalities such as higher order thinking. These older, foundational brain structures are involved in basic functions such as bodily regulation, movement, emotion, and threat response. Not surprisingly, scientists focused on these areas and pathways as they worked to better understand the brain’s involvement in detecting and reacting to infection.
In Kamm’s research, the scientists were specifically interested in the neocortex, the outermost layer of the brain associated with interpreting information, thinking, planning, and controlling voluntary behaviour. This section of the brain also constantly interacts with the older brain structures.
Finding a new way to study illness and the brain
The scientists already knew that when one develops an infection, the immune system naturally produces a small chemical messenger known as prostaglandin E2 (PGE2). This acts much like an alarm system, triggering the symptoms we associate with illness, such as fatigue, chills, fever, and loss of hunger. But it was not clear whether PGE2 produced these effects by activating some parts of the brain’s autonomic system or if the effects emerged from a distributed activation extending beyond it.
In this study, the researchers found that when they injected PGE2 into the mice’s brains, the onset of symptoms was much quicker than with classic methods that mimic infections in the lab. In fact, the onset was almost immediate, compared to hours or days with these other approaches. Additionally, the duration of symptoms decreased significantly as well – only 30-45 minutes.
The scientists then analysed the mice’s behaviour, mapped their brain activity, and made recordings of individual neurons to study how the whole brain’s activity changed during sickness.
“Gretel found an approach to study sickness with many technical advantages over previous techniques,” said Robert Prevedel, senior author on the paper. “We were able to essentially get a very comprehensive picture of sickness in a much shorter period of time.”
The mice quickly developed fever, became sluggish, and ate less. As the scientists looked at which areas of the brain were active, they found that PGE2 had activated many parts of a network known to monitor the body’s internal state. Specifically, they saw individual groups of nerve cells in the insular cortex engaged, suggesting the insular cortex’s central role in the brain as it responds to a state of illness.
The right place for this research
As Kamm described the work involved in this research, she also noted how essential the involvement of EMBL Rome was in this study.
“Our colleagues at EMBL Rome were crucial for our work. Cornelius Gross (Head of EMBL Rome) and Hiroki Asari (former EMBL Rome Group Leader) are well connected within the neuroscience research community, and thus provided important links to key people and resources,” she said. “Additionally, our close interactions with the Rome unit, for example, during seminars, led to important knowledge exchange.”
Gross notably introduced Kamm and her research team to Nicola Renier, who pioneered a method called iDISCO to visualise neuronal activation across the entire brain, using activity markers.
Prevedel also pointed to how EMBL’s EIPOD fellowship and the lab’s own expertise came together to support Gretel’s idea.
“Gretel is taking a different look at a common problem, and she’s a great example of what the EIPOD programme looks for: interdisciplinary postdocs who bring their own ambitious research ideas to EMBL,” Prevedel said. “In her case, the various methods we had established over time in our lab – imaging, electrophysiology, plus others – helped make her idea a reality.”
“The idea of looking at sickness as a brain state is relevant to the general public, and potentially medicine,” Kamm said. “Many people associate sickness with the bacteria or viruses attacking you, but most symptoms we associate with being sick are actually produced by the brain. So the main takeaway is that the whole brain is probably involved in changing our decisions and behaviour when we have an infection.”
From dust, silica and asbestos to psychosocial hazards, climate change and artificial intelligence, the 2026 programme examines how South Africa can protect workers in a rapidly changing world of work.
Photo by Emmanuel Ikwuegbe on Unsplash
JOHANNESBURG, 01 October 2026 – The Southern African Institute for Occupational Hygiene (SAIOH) held its scientific programme of the 2026 Annual Scientific Conference in Johannesburg, calling for stronger partnerships to prevent workplace exposures and protect worker health.
Under the theme Building Stronger Partnerships for Healthier Workplaces, the conference brings together occupational hygiene practitioners, researchers, regulators, health and safety professionals and industry representatives. Its goal goes beyond sharing technical knowledge; it links evidence, professional practice, and institutional action when traditional occupational hazards intersect with emerging, rapidly evolving risks.
The need is substantial. The International Labour Organization estimates that 2.93 million workers die each year from work-related accidents and diseases, while 395 million sustain non-fatal work-related injuries1. In South Africa, the imperative is especially visible across mining, construction, manufacturing, agriculture, healthcare and public infrastructure, where persistent exposure risks must now be managed alongside psychosocial pressure, a changing climate and technological disruption.
“Old hazards have not disappeared, yet the world of work is changing around them. Dust, silica and asbestos remain serious concerns, while psychosocial hazards, climate change and artificial intelligence are reshaping how risks arise and how we respond. No single profession or institution can address this alone. This conference is about building the relationships that allow us to identify risks earlier, act on evidence and strengthen prevention for every worker,” says Professor Cas Badenhorst, President of SAIOH
A programme grounded in today’s workplace realities
The programme deliberately places persistent and emerging risks side by side. Professor Spo Kgalamono, Executive Director of the National Institute for Occupational Health (NIOH), opens the scientific programme with a keynote on how strategic collaboration affects occupational health outcomes. Professor Badenhorst follows with Beyond the sample – The relationships that make occupational hygiene work.
Psychosocial risk is a major focus. Ms Milly Ruiters, Chief Inspector for Occupational Health and Safety at the National Department of Employment and Labour, addresses psychosocial hazards in the workplace, while Dr Casper Joubert of Stellenbosch University and the South African Society of Occupational Medicine considers whether artificial intelligence will enable African occupational hygiene to leap forward or leave parts of the continent behind. A related presentation on ISO 45003 (the first global standard for managing psychological health and safety at work) challenges workplaces to fix working conditions rather than expecting workers to absorb systemic pressure.
The conference also maintains a firm focus on exposures that continue to affect workers and communities. Sessions cover silica and modern silicosis, actionable dust-control strategies for mining, particulate matter, agricultural dust and endotoxins, noise-induced hearing loss, and research into asbestos-containing materials in Gauteng public schools. Mr Thapelo Chakane of the Minerals Council South Africa leads the dust-control keynote, while practical and research presentations explore how to strengthen measurement, prevention, and risk management.
Further sessions examine connected occupational health systems, exposure and healthcare, intelligent underground air management, predictive exposure intelligence and the use of large language models to detect technical errors in occupational hygiene reports. Dr Busisiwe Shezi of the South African Medical Research Council addresses worker protection in a changing climate, an increasingly important issue for both outdoor and indoor workplaces as extreme heat becomes more frequent and intense.
NIOH partnership honours 70 years while looking ahead
SAIOH is pleased to partner with the NIOH as the Institute commemorates its 70th anniversary. The partnership includes a NIOH site visit led by Professor Kgalamono and NIOH specialists, her opening keynote, and contributions from NIOH experts across the scientific and poster programmes. It recognises seven decades of service to occupational health while strengthening the collaboration needed for the next generation of workplace risks.
Professor Spo Kgalamono, Executive Director of the National Institute for Occupational Health, states, “For 70 years, the NIOH has translated occupational health evidence into practical action and meaningful protection for workers. Our experience has consistently demonstrated that sustainable improvements are achieved through partnership across disciplines, institutions, employers and the workforce itself. As we mark this significant milestone, we are proud to partner with SAIOH in celebrating our shared contribution to advancing occupational health in South Africa. This anniversary is an opportunity to reflect on the foundation that has been built, but to strengthen the knowledge, systems and professional capabilities needed for the workplaces of tomorrow.”
The conference, in hybrid format, began on 28 September with professional development courses and a visit to the NIOH site. The main scientific programme runs from 30 September to 1 October and includes 11 keynote addresses, oral and poster presentations, exhibitions, networking and the SAIOH Gala Dinner and Awards.
