Right side heart failure. Credit: Scientific Animations CC4.0
An early clinical study shows that a new oral drug is safe and well-tolerated in patients with chronic heart failure. The study, led by researchers at Karolinska Institutet, has been published in the scientific journal The Lancet.
Heart failure with reduced pumping capacity means that the heart struggles to pump blood effectively around the body. Despite current treatments, many patients’ condition worsens over time, and existing drugs that strengthen the heart’s contractions can cause serious side effects, such as heart rhythm disturbances and changes in blood pressure.
In the study, researchers investigated a new drug, AC01, which targets the body’s ghrelin receptor. Ghrelin is a hormone that influences metabolism and growth hormone release, and its receptor is also found in heart muscle. AC01 is intended to strengthen the heart’s pumping ability through a different biological mechanism from traditional heart‑stimulating drugs, thereby reducing the risk of side effects.
The study was a randomised, placebo‑controlled phase 1b/2a trial involving 58 patients with stable, chronic heart failure with reduced pumping capacity. Participants received different doses of AC01 or placebo for either seven or 28 days. The main aim was to assess safety and tolerability.
The drug was well tolerated
The results show that the drug was well tolerated. No serious side effects linked to AC01 were reported. The researchers also found no signs of harmful effects on heart rhythm or blood pressure. Exploratory analyses additionally indicated signs of improved heart function, such as increased stroke volume and cardiac output.
“This is an early study with a limited number of patients, but the results suggest that AC01 can be administered safely to people with heart failure. The findings now justify further studies to investigate whether the signals of improved heart function that we have observed can lead to clinical benefit in larger and longer studies,” says Lars Lund, first author and professor at the Department of Medicine, Solna, Karolinska Institutet, and senior consultant cardiologist at Karolinska University Hospital.
Students and dermatologists are determined to find how rosemary and rosemary extract can repair damaged skin without leaving scars
Penn undergraduate student Jiayi Pang (left) and Penn PhD candidate Emmanuel Rapp Reyes (right) found that rosemary can help skin wounds heal without causing scars.
The social media trend touting rosemary and rosemary extract as part of skincare routines is now backed by science. A compound found in rosemary leaves may significantly improve the healing of skin wounds and reduce scarring, according to new research published in JCI Insight from the Perelman School of Medicine at the University of Pennsylvania.
“Many skin injuries end in scars, and in some people, it can lead to long-term cosmetic and even functional issues,” said senior author Thomas Leung, MD, PhD, an associate professor of Dermatology at Penn. “Our findings suggest that rosemary extract, and specifically the antioxidant, carnosic acid, can shift the healing process from scarring to healthy skin regeneration. We don’t have proven ways to consistently do that in humans.”
The hypothesis behind the hype
The inspiration for this study stemmed from an unusual place: TikTok and Instagram. After seeing beauty influencers and other social-media users touting the skin-healing benefits of homemade rosemary extract serums and products with rosemary, Penn undergraduate student Jiayi Pang and Penn PhD candidate Emmanuel Rapp Reyes turned to Leung for expertise. Then, they did what all good scientists do: they went to the lab and ran their own tests.
“We hypothesized there was likely something real behind the hype because rosemary contains many antioxidants,” said Pang, co-lead author of the study. “But we knew in order to really uncover its potential, we needed to prove its healing properties and uncover how exactly it was facilitating healing.”
Conducting the research in mice, the researchers made cream with carnosic acid, a naturally occurring antioxidant mostly existing in rosemary, to accelerate wound closure and restore hair follicles, oil glands, and cartilage. They also found that a particular nerve sensor in the skin previously identified as essential to scarless healing, TRPA1, was critical for stimulating the healing in this instance, too. When tested in mice without the TRPA1 sensor, which previous research from Leung showed is responsible for scarless healing, carnosic cream lost its impact.
“We also identified other herbs, such as thyme and oregano, that may activate TRPA1. But rosemary stood out for its potency and safety,” said Rapp Reyes, co-lead author of the study. “Other natural ingredients, such as mustard oil, or the topical medication imiquimod are known to also stimulate the TRPA1 receptor, but unlike rosemary, those can cause irritation and inflammation,”
The researchers also found a localised effect from rosemary; scarless healing only occurred when carnosic acid cream was applied to the site of the injury but not when it was applied to skin far from the wound.
The team at Penn, however, notes that individuals should speak with their doctors before incorporating rosemary skincare products in their daily regimens or mixing up their own rosemary-based concoctions. Nevertheless, given rosemary’s accessibility and low cost, the researchers hope their findings will inspire further investigation into its use in human wound care, especially for patients at risk of excessive scarring.
“If rosemary is part of your skincare regimen and you think it’s working, it likely is,” said Leung. “I’m proud that the young scientists that led this research sought answers to questions in their everyday lives.”
By calming inflammation and reducing excess fat, semaglutide may postpone several molecular signs of aging, pointing to the potential of GLP‑1 receptor agonists to help prevent age‑related diseases.
Semaglutide slowed biological aging across multiple epigenetic clocks in a randomised, double-blind, placebo-controlled clinical trial. The strongest signals were seen in epigenetic measures linked to inflammation, brain, heart, blood, kidney, liver and metabolic health, suggesting that the drug may influence aging-related biology across multiple body systems. The findings offer early clinical evidence that GLP-1 receptor agonists may influence aging biology.
Glucagon-like peptide-1 (GLP-1) receptor agonist medications have gained widespread attention for effectively treating obesity, lowering blood sugar and decreasing the risk of cardiovascular disease. Some researchers have proposed that these drugs may also influence the biology of aging, but direct evidence in humans has remained limited. Now, a new study provides the first randomised, placebo-controlled clinical evidence that semaglutide, a widely used GLP-1 drug, slows down the accumulation of biological aging markers in the DNA of adults with HIV. The study is published in Nature Communications.
Researchers at the University of California San Diego and several partner institutions analysed data from a previously published clinical trial of 108 adults with HIV‑associated lipohypertrophy, a condition in which excess fat builds up around the abdomen. About half of the participants received weekly injections of semaglutide, with the rest receiving placebo injections.
The team used a set of biological “epigenetic clocks” to track cellular aging over the 32-week treatment period. These clocks detect DNA methylation, chemical marks on DNA that help regulate how genes are turned on or off without changing the genetic sequence itself. By measuring changes in these marks, the team could assess whether the treatment was associated with a slower or faster biological aging pattern.
People with HIV often experience accelerated aging, even if it is well-controlled with antiretroviral therapy, according to first author Michael Corley, PhD, associate professor at UC San Diego School of Medicine and the Stein Institute for Research on Aging. However, the study found compared to the placebo group:
Participants treated with semaglutide exhibited a broad pattern of slower biological aging across epigenetic clocks linked to inflammation and blood, brain, heart, kidney, liver and metabolic health.
The drug slowed the pace of biological aging by 9 %, as measured by the DunedinPACE epigenetic clock.
The drug significantly slowed biological processes associated with the risk of all‑cause mortality and age-related disease, as measured by the PCGrimAge epigenetic clock.
Research suggests there are several mechanisms by which semaglutide may influence biological aging. By reducing inflammation and metabolic stress, GLP-1 drugs decreased chronic immune activation, a primary driver of accelerated aging in people with HIV. They also reduce visceral and ectopic fat that accumulates around the abdomen and organs, which may help curb the inflammatory and metabolic signals that promote aging.
“Emerging data also suggest that GLP-1 drugs may reprogram certain cells in different organs, which could help explain why we see effects across multiple aging clocks,” said Corley.
While the study focused on people with HIV‑associated lipohypertrophy, Corley says it may also offer lessons for the wider population.
“Many of the biological processes we study in HIV are also central to aging in the general population,” he said. “Because these processes can emerge earlier or be more pronounced in people with HIV, this community can help us identify interventions that may improve healthspan more broadly.”
In a related pilot study published in npj Aging, Corley and another team of researchers found that taking semaglutide for 24 weeks:
Reduced the rate of biological aging for 42% of participants with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD) as measured by the DunedinPACE epigenetic clock. Those participants also had a greater reduction in liver fat compared with participants whose pace of aging sped up.
Slowed aging associated with the risk of all‑cause mortality in 34% of participants as measured by the PCGrimAge epigenetic clock.
Increased the length of telomeres in nearly 49 % of participants as measured by the PCDNAmTL epigenetic clock. Those participants also tended to walk faster after treatment, suggesting better physical function.
Together, these studies add to growing evidence that GLP-1 drugs may influence pathways involved in biological aging.
“We are not saying that semaglutide reverses aging or makes people younger. What we are seeing is a signal that it may slow some of the biological processes associated with aging.”
— Michael Corley, PhD
“We are not saying that semaglutide reverses aging or makes people younger,” said Corley. “What we are seeing is a signal that it may slow some of the biological processes associated with aging. With newer GLP-1–based therapies now emerging, the field has an opportunity to test whether different drugs in this class have distinct effects on aging biology and to identify which patients may benefit most.”
Larger clinical trials are needed to confirm the findings, determine how long treatment effects last, and establish optimal dosing and treatment duration for both people with HIV and the broader population. Future studies will also be needed to test whether the effects of GLP-1 effects on aging biology are enhanced when combined with lifestyle interventions such as diet, exercise and sleep optimization.
The Stein Institute for Research on Aging plans to translate these results into individualized “aging dashboards” to track biological aging with epigenetic clocks, enabling clinicians to design personalised therapies that target the underlying mechanisms of aging and help prevent age‑related diseases.
Data from more than 91 000 participants in the UK Biobank who wore activity monitors for seven days revealed an association between prolonged sedentary behaviour and the risk of cancer death
Each additional hour of prolonged, uninterrupted sedentary behaviour in a person’s day is associated with a 9% higher risk of cancer death, according to a study published July 2nd in the open access journal PLOS Medicineby Frederick Ho of the University of Glasgow, UK, and colleagues.
Previous studies have shown that spending more total time on sedentary behaviour, such as sitting, reclining or lying down while awake, is linked to poorer health outcomes. However, most sedentary behaviour guidelines focus on total time spent sedentary, rather than whether that time is accumulated in many short intervals or fewer prolonged intervals.
In the new study, researchers analysed data from 91 292 UK Biobank participants who had worn activity monitors for 7 days and were followed for a median of 12.38 years afterward. Activity was categorised as either prolonged sedentary (bouts of at least 30 minutes with at least 90% of time sedentary), interrupted sedentary behaviour (which lasted less than 30 minutes or was broken up with more than 10% non-sedentary time), or varying degrees of physical activity.
Prolonged sedentary behaviour was associated with a higher risk of cancer mortality (HR 1.09; 95% CI 1.06, 1.11), overall cancer incidence, obesity-related cancers (such as oesophageal, liver, kidney, pancreatic, colorectal, breast, ovarian, and thyroid cancers), and type 2 diabetes-related cancers. Interrupted sedentary behaviour showed the opposite pattern, associated with lower risk across all outcomes. Replacing one hour per day of prolonged sedentary behaviour with light physical activity was associated with a 12% lower risk of cancer death (HR 0.88; 95% CI 0.79, 0.99).
As a single-cohort study of UK Biobank volunteers, who have known health volunteer bias and higher physical activity levels than the general UK population, the findings may not be generalisable and do not prove causality. The researchers also had no data on the context of sedentary behaviour, such as whether it was during work or driving.
“Our findings suggest that the health effects of sedentary behaviour may depend not only on total sedentary time, but also on whether that time is accumulated in prolonged bouts or interrupted by activity,” the authors say. “This pattern is biologically plausible: experimental studies have shown that interrupting prolonged sitting with short bouts of activity can improve metabolic responses compared with uninterrupted sitting.”
The authors add, “Current health guidelines focus heavily on moderate or vigorous exercise, but our findings show that light movement shouldn’t be ignored. Moving forward, clinical trials will help us move beyond blanket advice and develop personalised strategies for breaking up sitting time.”
The new implant (to the right) consists of a small ball encased in a larger ball, which gives better stability. Photo: Sandra Gunnarsson. Credit: Queen Mary University of London
A major international clinical trial had found that an emerging type of hip replacement implant dramatically reduces complications in people with pelvic fracture. The study, published in The Lancet, involved 1600 patients across 44 hospitals in the UK and Sweden. The DUALITY trial is the largest clinical trial to compare dual mobility total hip replacements (DM-THR) with standard total hip replacements (THR). The team found that people treated with DM-THR were 70 per cent less likely to experience a dislocation post-surgery – the most common complication after hip replacement for fracture.
A broken hip in older people is one of the most common serious injuries worldwide, affecting more than 14 million individuals each year and accounting for 1.4% of total direct healthcare expenditure in established market economies. The type of hip fracture studied in the DUALITY trial represents approximately half of all hip fractures experienced globally.
A total hip replacement where both the ball and socket of the hip are replaced, is recommended for older, active individuals with some types of hip fracture. For most patients, the procedure improves mobility and quality of life, but dislocation post-surgery can be common and can have serious consequences for those affected. When dislocation occurs, patients often require emergency hospital admission, procedures to reset the joint, and sometimes further surgery. This can lead to longer recovery times, added distress, and increased risk of further health problems.
Dual mobility-THR uses a small ball encased in a much larger plastic ball, and was developed specifically to reduce the risk of dislocation. In the DUALITY trial, the team aimed to establish if DM-THR reduced the risk of dislocation compared to THR. The results showed that the DM-THR implant does improve stability in the hip joint, making it less likely to dislocate after surgery. They found that within one year of surgery, just 1.3 per cent of patients receiving DM-THR experienced a dislocation, compared with 4.2 per cent of those given a standard THR. Importantly, the study found no increase in other risks such as infection or death, and overall complication rates were lower in patients receiving DM-THR.
The researchers conclude that dual mobility implants should be considered the preferred option for suitable older patients undergoing total hip replacement after a broken hip. Crucially, DM-THR requires no new technology or training. Surgeons are already familiar with both implant types, meaning the change could be implemented immediately within existing practice.
Professor Xavier Griffin, study author and Chair of the Centre of Bone and Joint Health at Queen Mary University of London and Honorary Consultant Orthopaedic Surgeon at Barts Health NHS Trust, said:
“Dislocation is the most common major complication following hip replacement for a broken hip. People that experience this painful complication often require further surgery and the recovery following this is usually long, slow and painful. So, it has been an area that I, along with our surgeons around the world, have been wondering if there is any benefit to using these type of hip replacements in people with a broken hip. The fantastic news from DUALITY is that we can make a really substantial reduction in the risk. I hope that this research will make a real difference to many future patents who might avoid this catastrophic problem.
I’ve tried to run similar studies before but never been able to deliver one that is big enough to give us a reliable answer to the question. Meeting the team in Uppsala and making this international collaboration a reality has been a game changer for accelerating how quickly we can discover the answers to these sorts of questions.”
Professor Nils Hailer, study author, Chair of Orthopaedics at Uppsala University and Consultant Orthopaedic Surgeon at Uppsala University Hospital, said:
”After many years of analysing registry data and seeing both advantages and limitations of dual mobility hip replacements, I was eager to obtain solid evidence for or against the concept. Together with colleagues at Queen Mary, we succeeded in delivering a large, pragmatic, orthopaedic randomized trial involving both smaller hospitals and major referral centres across two countries.
“The results provide robust support for the use of dual mobility constructs in hip fracture patients in need of a total hip replacement. Beyond the findings themselves, I believe this collaboration sets a new benchmark for future randomized trials in European orthopaedic research, and we will jointly continue working towards that goal.”
Researchers say that beyond improving outcomes for patients, reducing dislocations could have a significant impact on healthcare systems. Complications such as post-surgery dislocations increase hospital stays, require additional operating time, and drive unplanned readmissions. Although dual mobility implants are currently more expensive than standard implants, researchers believe the reduction in complications could offset the higher upfront cost. A full economic analysis is underway.
Over the last three decades, differences in unhealthy cholesterol levels and blood pressure between older adults with obesity and those with a normal Body Mass Index (BMI) have narrowed or disappeared in several high-income countries, suggests a study published in The Lancet. The authors propose that this trend is due to the greater, and possibly more intensive, use of cholesterol-lowering medication (such as statins) and blood pressure medication in people aged over 40 living with obesity in high-income countries.
Obesity is known to increase blood pressure and unhealthy cholesterol levels, which can impact cardiovascular health and increase the risk of heart attack, heart failure, and stroke. However, prior to this study, there was little information on blood pressure and cholesterol levels, and how they have changed, for people with obesity compared with people with normal BMI.
Author Prof Majid Ezzati, from the School of Public Health at Imperial College London (UK), says: “Our study suggests that, in high-income countries, taking medication to lower blood pressure and cholesterol has helped middle-age and older adults lower their cardiovascular risk to levels that are similar to people with normal BMI.”
He continues, “At a time that weight-loss medications are becoming more widely used, our results give a picture of the cardiovascular health of people likely to be prescribed them, which allows the healthcare system to understand how blood pressure and cholesterol treatments benefit the population alongside weight-loss medications.”
The study analysed data on blood pressure and cholesterol in people with obesity, overweight, and normal BMI from 110 health datasets including almost one million participants from 1990 to 2024 in seven high-income countries: England, the USA, Japan, South Korea, Taiwan, Thailand and Finland.
Converging cardiovascular risk markers
The study finds that in the 1990s adults with obesity generally had higher blood pressure and high-density lipoprotein (non-HDL) cholesterol levels [1] than people with a normal BMI.
Since 1990, in the majority of the seven countries studied including England and the USA, blood pressure and unhealthy cholesterol fell more steeply among middle-aged and older adults (40–79 years old) with obesity and overweight than among those with normal BMI, narrowing the gap over time. The exceptions were Taiwan and Thailand, which did not see this convergence as universally as other countries.
The findings were most striking in older adults (60–79 years old). In England and the USA, older adults with obesity, and especially with severe obesity, had similar or even lower blood pressure and unhealthy cholesterol levels at the end of the study period than older adults with normal BMI.
Heart medication likely driving the convergence
Over the past three decades, people with obesity were more likely to be prescribed cholesterol-lowering medication (such as a statin) and blood pressure medication than those with a normal BMI.
This gap was especially pronounced in older adults. For example, in England and the USA, around 70–72% of older men with severe obesity (BMI ≥35) were taking cholesterol-lowering medication by the early 2020s, compared with 40–48% of older men with a normal BMI.
Author Lakshya Jain, from the School of Public Health at Imperial College London (UK), says “This latest analysis suggests that the observed convergence in cholesterol and blood pressure levels between people aged over 40 with obesity and those with a normal BMI is largely due to statins and other widely accessible medications to reduce cardiovascular risk. That is a significant public health success story, and one we should not lose sight of as new weight-loss medications enter the picture.”
Cardiovascular risks remain for younger adults with obesity
In younger adults (under 40 years old), the study findings suggest little or no narrowing of the gap in blood pressure or cholesterol between those with obesity and those with a normal BMI. The data also suggests that use of cholesterol-lowering and blood pressure medication is low for this age group, adding further evidence that medication is the driver of the gap reduction in older adults.
Author Ysé d’Ailhaud de Brisis, from the School of Public Health at Imperial College London (UK), says “While good news for older adults with obesity, our results suggest that cardiovascular health risks remain higher for adults under 40 than for their counterparts with a normal BMI. Early lifestyle interventions, screening and, when appropriate, medication in this younger group should be considered to prevent long-term cardiovascular complications linked to obesity.”
The researchers note some limitations of the study, including that their analysis was limited to seven countries which were all high-income, therefore the finding may not be applicable elsewhere, especially for low- and middle-income countries where the use of unhealthy cholesterol and blood pressure lowering medicines is likely to be lower. Additionally, it was not possible to look at the impact of different medication doses, which require data on prescriptions.
Writing in a linked Comment, Dr Yuan Lu, Yale School of Medicine (USA), who was not involved in the study, says, “This study reframes obesity-related cardiovascular risk as reflecting not only excess adiposity, but also treatment access, health-system engagement, and timing of intervention. Convergence of risk factors should not be equated with elimination of obesity-related risk. Although treatment of high blood pressure and cholesterol might mitigate part of the cardiovascular harm associated with obesity, the persistent burden among younger adults and the broader multisystem consequences of obesity highlight the need for integrated prevention strategies that move beyond isolated risk factor treatment.”
A team of scientists from the University of Granada (UGR), the Granada Institute for Biomedical Research (ibs.GRANADA), the Public University of Navarra, and the Biomedical Research Networking Center (CIBER) has demonstrated that limiting food intake to an eight-hour window helps maintain weight loss 12 months after the end of the intervention in overweight or obese adults.
The research has revealed that intermittent fasting – specifically the method popularly known as 16:8, in which participants fast for 16 hours and are allowed to eat during the remaining eight hours – is an effective strategy for maintaining weight loss in the medium term. The study shows that these benefits persist one year later, regardless of whether the eight-hour eating window occurs early in the day (between 9 a.m. and 5 p.m., known as early fasting) or later (between 1 p.m. and 9 p.m., known as late fasting), compared to people who maintain their usual eating routine for 12 hours or more.
The results show that both the early-fasting and late-fasting groups managed to maintain significantly greater weight loss after 12 months. Furthermore, the early-fasting group maintained a greater reduction in fat mass. According to the researchers, these findings suggest that this type of nutritional intervention is not only feasible and effective in the short term but now also demonstrates sustainable effects over time.
Body Composition Assessment One Year Later
The study, recently published in Clinical Nutrition, involved 99 adults – half of whom were women – who were overweight or obese. During the first 12 weeks, participants were divided into four groups, all of which followed a Mediterranean diet education program: a control group that maintained its usual eating window (12 hours or longer), an early fasting group (an 8-hour window beginning before 10:00 a.m.), a late fasting group (an 8-hour window beginning after 1:00 p.m.), and a self-selected group where participants chose their own 8-hour eating window.
Changes in weight, fat mass, and fat-free mass were measured before and after the 12-week intervention, as well as one year after the study ended. This study is part of a larger project whose main results have been published in the prestigious journal *Nature Medicine*, where it was observed that participants who practiced TRE, regardless of their eating schedule, lost an average of 3–4 kilos more than the group that received only nutritional recommendations.
Dr. Alba Camacho Cardeñosa, a researcher at the University Joint Institute for Sport and Health (iMUDS) at the University of Granada (UGR) and a postdoctoral fellow at ibs.GRANADA in the Endocrinology and Nutrition Department at San Cecilio University Clinical Hospital, is the study’s first author. She explains that “to date, although we knew that intermittent fasting promotes modest weight loss in the short term, it was unclear whether its effects were sustained over time. By evaluating the participants 12 months after the intervention ended, we demonstrated that the changes in body weight persist.” In addition, the researchers highlight that “a very positive finding is that one in three people decided to continue practicing intermittent fasting on their own during that year of follow-up, suggesting that it is a relatively easy habit to integrate into daily life.”
A Flexible Strategy Against Obesity
The researchers emphasise that an intervention involving just 12 weeks of intermittent fasting may represent an effective medium-term strategy for weight control in overweight or obese adults. Since both early- and late-day fasting regimens have been shown to be effective, the findings offer valuable flexibility for patients to choose the schedule that best suits their lifestyle, thereby improving adherence and success in obesity treatment.
You go to hospital for treatment and to get better. But sometimes, you get something much less welcome: an infection.
Pneumonia, an infection of the lungs, is one of the most common and deadly infections people develop in hospital. Around 50000 patients contract pneumonia in Australian hospitals every year. Around 1900 of them die from it.
It’s rarely monitored and rarely reported. And to date, few studies have looked at how it can be prevented.
But our new trial, published today in The Lancet Infectious Diseases, shows a surprisingly simple action can make a major difference: brushing patients’ teeth.
We found this can reduce the chance of getting this type of pneumonia, called non-ventilator hospital-acquired pneumonia, by 60%.
What is this type of pneumonia?
Non-ventilator hospital-acquired pneumonia occurs in patients who aren’t on a ventilator, usually outside of intensive care settings.
Patients are infected when bacteria from the mouth or throat are breathed into the lungs.
We studied 8,870 patients across three Australian hospitals to see whether improving oral care – which included tooth-brushing – could reduce this type of pneumonia.
Usually, when patients go to hospital, they don’t pack a toothbrush – especially in emergencies.
The intervention in our study was deliberately simple. We:
gave patients in hospital a toothbrush and toothpaste in a bag when they were admitted
educated patients and hospital staff about the importance of tooth-brushing. The toothbrush also had a written prompt on it – “Brush away pneumonia”
assisted patients who needed help with tooth-brushing
audited how oral care was being delivered and gave feedback to hospital wards.
We introduced the intervention into one ward at a time over 12 months at each hospital. This gradual roll-out is known as a stepped-wedge cluster randomised trial. It can test new health interventions when it’s too difficult to randomise individuals without revealing who is receiving the intervention and who isn’t.
We found that this relatively simple intervention increased the proportion of people who cleaned their teeth from 16% to 62%.
This increasing oral care led to a 60% reduction in the risk of acquiring pneumonia, from the equivalent of eight infections per month on a typical ward of 30 patients, to less than four infections per month.
This is the largest trial of its kind and the first completed across multiple hospitals.
Why does brushing teeth help?
The mouth is home to billions of bacteria. Oral hygiene often deteriorates when people are unwell, sedated, immobile, or taking certain medications.
When this happens, bacteria build up on the teeth, gums and tongue. If these bacteria are breathed in – even in tiny amounts – they can cause pneumonia.
Yet in busy hospitals, oral care is often overlooked. Patients may not know just how important oral care is. Staff are often busy with competing priorities and oral care can be de-prioritised. There is also a general lack of understanding about the importance of oral care.
Patients can help protect themselves
One of the most important messages from our research is patients aren’t powerless. While health-care staff such as nurses play a crucial role, patients who are able to brush their own teeth can meaningfully reduce their own risk.
If you or a loved one is admitted to hospital, you can:
bring your own toothbrush and toothpaste
brush your teeth twice a day if you’re able
ask staff for help if you can’t
remind staff if oral care has been missed.
These small actions can reduce the risk of a serious, life-threatening infection.
What happens next?
Pneumonia is costly – in lives, hospital days and the financial cost of care. But because non-ventilator hospital-acquired pneumonia isn’t routinely reported, it’s often invisible.
Our research challenges the assumption that hospital-acquired pneumonia is an unavoidable complication when you go to hospital.
It also highlights the need for hospitals to monitor non-ventilator hospital-acquired infections, in the same way they monitor falls, pressure injuries and other preventable harms.
Finally, our study strengthens the case for including oral care in national infection-prevention guidelines and nursing practice.
Oral care isn’t glamorous, expensive or technologically advanced – but it works. Sometimes, the simplest interventions are the most powerful.
Study demonstrates the potential of personalised assistive technologies for people with impaired hand function
Researchers at the Medical University of Vienna, in collaboration with ETH Zurich, the Technical University of Munich and Medical Faculty Belgrade, have developed a wearable neurorobotic system that combines electrical neurostimulation with hand exoskeletons. In a clinical trial involving 14 patients with hand impairments caused by neurological injury, the technology supported finger mobility, tactile perception and grip control. The results demonstrate the potential of personalised assistive systems for people living with the consequences of spinal cord or brain injury. The study has recently been published in the journal Science Advances.
Hand movements and the sense of touch are essential for everyday activities such as grasping, eating, dressing or personal hygiene. However, after damage to the central nervous system, motor and sensory impairments of the hand often persist. Conventional rehabilitation can achieve improvements, but does not always lead to sufficient restoration of hand function. There is therefore a great need for assistive technologies suitable for everyday use.
A research team led by study director Stanisa Raspopovic from the Center for Medical Physics and Biomedical Engineering at MedUni Vienna has developed the “SensoExo” system for assisting people with hand sensorimotor impairements. It combines a wearable hand exoskeleton with a custom-fitted neurostimulation sleeve. The sleeve stimulates specific nerves and muscles in the forearm through the skin. Sensors on the fingers detect touch and gripping forces and translate this information into electrical stimulation, providing users with tactile feedback. In addition, functional electrical stimulation can assist users open and close their fingers more easily.
“Our aim was not only to provide mechanical support for movement, but also to restore their sense of touch,” says Stanisa Raspopovic. “The interplay of strength, movement and the sense of touch is crucial, particularly when gripping. Without feedback on how firmly an object is being held, hand function remains significantly limited in everyday life.”
Individualised support depending on the impairment
The system was tested on 14 patients with neurological hand impairments. All study participants exhibited sensory deficits and therefore received tactile feedback via transcutaneous electrical nerve stimulation. In seven individuals with particularly severe motor impairments, functional electrical muscle stimulation was also used to support hand opening and grip strength.
The study compared three conditions: no support, support from an exoskeleton alone, and the combined use of an exoskeleton and neurostimulation. Eight of the 14 participants also completed functional grasping and releasing tasks with bulky and fragile objects. This investigation revealed that the combination of exoskeleton and neurostimulation provided additional benefits compared to an exoskeleton alone. In patients with severe motor impairment, SensoExo improved finger mobility to a greater extent than the exoskeleton alone. The artificially mediated tactile feedback also increased the areas of the hand where touch sensations could be perceived.
“The results show that motor assistance and sensory feedback must be considered together,” explains lead author Andrea Cimolato from the Center for Medical Physics and Biomedical Engineering at MedUni Vienna. “The system can be adapted depending on the individual’s impairment profile. People with more severe motor impairments benefited particularly from additional motor support, while those with pronounced sensory loss used the sensory feedback to grasp fragile objects more precisely.”
Improved grasping of everyday objects
In the functional tests, participants using SensoExo achieved the highest success rates when grasping and carrying objects. With bulky objects, muscle stimulation supported grip strength. With fragile objects, sensory feedback helped to avoid applying too much pressure.
“The technology is currently a prototype and not a fully developed medical device for everyday use,” emphasises Raspopovic. “However, the study provides early clinical evidence that non-invasive neurostimulation combined with wearable robotics can form a realistic basis for future personalised assistance systems.”
Primary CNS lymphomas in immunocompromised patients are among the rarest and at the same time most aggressive cancers – yet evidence-based recommendations for diagnosis and treatment have been lacking. An international research team led by Heidelberg Faculty of Medicine at Heidelberg University and the German Cancer Research Center has now identified characteristic imaging features of these tumours and developed a prognostic model to better assess disease outcomes. The researchers found that tumours positive for Epstein-Barr virus were associated with particularly poor prognosis. The findings, published in the journal Blood, may help guide future diagnostic and treatment strategies.
Primary CNS lymphoma is a rare cancer that arises from malignant white blood cells. Affected individuals develop tumours in the brain and, more rarely in the spinal cord, the eyes, or within the cerebrospinal fluid. These lymphomas can occur in people with weakened immune systems, for example after organ transplantation, in autoimmune diseases, or in association with HIV infection. This subtype, known as immunodeficiency-associated primary CNS lymphoma (ID-PCNSL) affects approximately 50 people per year in Germany. Researchers at the Heidelberg Faculty of Medicine at Heidelberg University had already shown in earlier work that ID-PCNSL is not simply a variant of classical CNS lymphoma, but a distinct disease entity characterised by specific genetic alterations.
A recent study by the International Primary CNS Lymphoma Collaborative Group – an international network dedicated to the study of CNS lymphomas – has now provided further insights into the diagnosis and treatment of ID-PCNSL. Including data from 308 patients treated at 23 hospitals across seven countries, the study is the largest conducted to date on this rare cancer. The researchers analysed clinical findings, magnetic resonance imaging scans, and tumour tissue samples. Scientists from the Heidelberg Faculty of Medicine at Heidelberg University and the German Cancer Research Center (DKFZ) played a leading role in the study.
Epstein-Barr Virus influences imaging and prognosis
Epstein-Barr virus (EBV) is known to play a central role in this cancer and was detected in 79.2 percent of the tumours examined. “Our analyses show that EBV-positive tumours often follow a more aggressive course and are associated with an unfavourable prognosis,” says first author Dr Leon Kaulen. He conducts research at the Heidelberg Faculty of Medicine at Heidelberg University and at the DKFZ and is a physician at the Department of Neurology at Heidelberg University Hospital (UKHD). EBV-positive tumours also showed characteristic imaging features including different patterns of contrast enhancement compared with EBV-negative tumours.
The researchers developed a prognostic model based on three factors that can help to better predict the course of ID-PCNSL and patient survival more accurately. The three identified factors are the detection of EBV in tumour tissue, age, and the patient’s performance status. Depending on the combination of these three factors, disease courses differed markedly among the patients studied. If only one of the three risk factors was present, the median survival was 135 months. With two risk factors, it decreased to 29 months. If all three factors were present, median survival was reduced to three months. “The prognostic model, with its clear stratification, represents a major advance. It will enable us to assess patients much more precisely in the future and to tailor therapies more effectively to the individual clinical situation,” says senior author Professor Wolfgang Wick, Heidelberg Faculty of Medicine at Heidelberg University, Chair of the Department of Neurology at UKHD, and Head of the Clinical Cooperation Unit Neurooncology at DKFZ and UKHD.
Considering immunodeficiency and cancer together
So far, no standardised therapy has been established for patients with immunodeficiency-associated primary CNS lymphoma. “Our research provides important insights into which approaches may be associated with more favourable outcomes,” says Dr Leon Kaulen. Patients whose immune system could at least partially be reconstituted – for example through adjustment of immunosuppressive medication or effective treatment of HIV infection – and who additionally received combination chemotherapy with rituximab and methotrexate typically (85 percent) responded well to treatment. In a substantial proportion of patients, the disease also remained stable in the long term and became undetectable.“ Our data suggest that the interplay between the tumour and the weakened immune system plays a central role,” says Dr Kaulen. “Both aspects should therefore be addressed together in treatment.”
“With the current study, a robust evidence base for this rare disease is now available for the first time,” summarises Professor Wick. “This represents an important step toward precision medicine even in rare diseases. Relevant research in rare tumour entities can often only be carried out in large international consortia. International scientific collaboration therefore deserves particular attention.”
