A once-nightly oral pill helped control obstructive sleep apnoea in a large, phase 3 clinical trial presented at the 2026 ATS International Conference. The drug, called AD109, is the first therapy to treat OSA by addressing its underlying mechanisms and targeting the neuromuscular causes of airway collapse. The trial results will be published in the American Journal of Respiratory and Critical Care Medicine.
The trial, called SynAIRgy, showed that patients who took AD109 had fewer breathing interruptions during sleep, less oxygen deprivation, and improved blood oxygen levels overall. More than 40 percent of patients saw their OSA disease severity category improve, and 18 percent achieved complete disease control.
“These results provide encouraging evidence that targeting neuromuscular dysfunction can translate into meaningful clinical outcomes, aligning with our evolving understanding of the disease biology,” said first author Patrick John Strollo, MD, a sleep medicine physician at the University of Pittsburgh Medical Center.
Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for OSA, but many patients are unable to tolerate treatment. AD109 could help fill that gap with an easier treatment option, Dr Strollo said.
“In many other chronic diseases, such as cardiovascular disease, asthma, or type 2 diabetes, it would be unthinkable for the majority of diagnosed patients to remain untreated or undertreated. Yet that remains the reality in OSA,” he said. “An oral pill that targets the underlying neuromuscular drivers of airway collapse during sleep could help address this gap and broaden the range of effective options for patients who remain untreated today.”
AD109 combines two medications, aroxybutynin and atomoxetine, which work together to support muscles in the throat and prevent the airway from sagging or collapsing during sleep.
For the trial, which ran for six months at 69 sites across the U.S. and Canada, researchers enrolled 646 adults with mild to severe OSA who couldn’t tolerate or refused CPAP.
Patients taking AD109 saw their apnea-hypoxia index, which measures the number of breathing interruptions per hour, decrease by about 44 percent, compared with 18 percent in the placebo group. Oxygen desaturation index (the number of times during the night that blood oxygen drops) and hypoxic burden (oxygen deficiency) also improved in the AD109 group.
Importantly, improvements were observed consistently across a broad range of patients, including those with varying severity levels and body types.
Along with improved outcomes, the drug showed an acceptable safety profile with mild, expected side effects. The most common side effects were dry mouth, nausea, insomnia, and difficulty urinating. Around 21 percent of patients discontinued therapy due to side effects.
Dr Strollo noted that the results will be published alongside a companion mechanistic review by ATS in the American Journal of Respiratory Cell and Molecular Biology.
“Together, these peer-reviewed articles connect late-stage clinical outcomes with the biological mechanisms that drive the disease, targeted by the mechanism of action of AD109, providing a more complete and integrated view of OSA and strengthening confidence in the approach,” he said.
AD109 has received Fast Track designation from the FDA for the treatment of OSA, recognising the significant unmet need for effective, well-tolerated pharmacologic therapies for OSA. Apnimed has submitted its New Drug Application (NDA) for AD109 to the FDA. Based on FDA feedback, Apnimed expects a potential PDUFA target action date in 1Q 2027, subject to FDA acceptance of the NDA for review.
Icing a sprained ankle or sore muscle, long used to reduce pain and swelling, may in the longer run delay recovery and prolong pain, new research suggests.
In a preclinical study published in Anesthesiology, McGill University researchers found that even though cryotherapy (icing) eased pain in the short term, recovery time was more than doubled in some cases.
“These results highlight a paradox: treatments that reduce inflammation and relieve pain in the short term may, in some cases, interfere with the biological processes required for full recovery,” said lead author Lucas Lima, a research associate at the Alan Edwards Centre for Research on Pain.
The findings add to a growing body of research questioning the long-term benefits of common anti-inflammatory strategies, said Lima. Previous studies have shown that medications such as acetylsalicylic acid (Aspirin) can also extend the duration of pain, and animal research has suggested icing may delay tissue repair.
The new study provides, for the first time, direct evidence that icing can also affect the duration of pain itself, based on experiments with mice mimicking inflammatory and exercise-related injuries.
Icing is commonly used as part of the RICE protocol, a standard approach to managing injuries that includes rest, ice, compression and elevation. It is widely used by athletes, clinicians and in everyday injury care, but there is limited evidence for its long-term benefits, said the researchers.
“Our results suggest we need to better understand when anti-inflammatory strategies are helpful and when they are not,” said senior author Jeffrey Mogil, James McGill Distinguished Professor and E. P. Taylor Chair in Pain Studies.
He emphasized the results are not yet directly applicable to humans. A clinical trial is underway to test whether the same effect appears in patients recovering from procedures such as wisdom tooth removal.
About the study
“Cryotherapy and Duration of Inflammatory Pain in Mice” by Lucas Lima and Jeffrey Mogil et al. was published in Anesthesiology. The study was supported by the Canadian Institutes of Health Research Foundation and the Louise and Alan Edwards Foundation.
A large South Korean study published by The BMJfinds no increased risk of psychiatric or neurodevelopmental disorders, such as ADHD and autism, in children whose mothers used sedative drugs (benzodiazepines or Z-hypnotics) during pregnancy.
Benzodiazepines and Z-hypnotics are used to alleviate anxiety and insomnia, which are among the most common conditions during pregnancy.
Previous studies have examined the short term safety of benzodiazepine and Z-hypnotic use in pregnancy, but evidence on their psychiatric and neurodevelopment effects in children remains scarce.
To fill this evidence gap, researchers used South Korea’s National Health Information Database to track nearly 3.8 million children born between 2010 and 2022.
Pregnancies exposed to benzodiazepines or Z-hypnotics were compared with unexposed pregnancies and with women who had used these drugs before but not during pregnancy (past users).
Twelve specific neurodevelopmental and general psychiatric disorders were assessed, including substance use disorder, schizophrenia, personality disorder, intellectual disability, autism, ADHD, and behavioural disorder.
Factors, such as mother’s age, income, underlying conditions and other medication use were also taken into account.
Among the 3 809 949 children, 94,482 (2.5%) were exposed to benzodiazepines or Z-hypnotics during pregnancy, 3 715 467 were unexposed, and 147 307 were born to past users.
During the tracking period of up to 14 years, a total of 10 060, 311 997, and 15 645 events occurred in the exposed, unexposed, and past user groups, respectively.
Overall, rates of psychiatric disorders were slightly higher (19.2%) in exposed children compared with 13.8% in unexposed children and 16.5% in the past user group.
However, these associations were no longer significant when the researchers used sibling analysis to disentangle drug effects from shared family, genetic, and environmental factors, and no increased risk was found for individual psychiatric disorders.
Further analyses were generally consistent with the main findings, although some estimates, such as exposure in early and late pregnancy, and longer durations of Z-hypnotic use specifically, remained modestly elevated in certain groups.
This is an observational study, so can’t establish cause and effect, and the researchers acknowledge that a prescription may not always reflect actual ingestion and their follow-up period may be insufficient to capture late onset conditions such as schizophrenia or personality disorders. What’s more, this study was not designed to assess the overall safety of these drugs but specific psychiatric outcomes in children.
However, use of a large, nationally representative database and rigorous methods to overcome confounding suggest the results withstand scrutiny.
As such, they say this study suggests “no substantial evidence that prenatal exposure to benzodiazepines or Z-hypnotics increases the risk of psychiatric disorders in children.”
Although these findings provide reassurance about neuropsychiatric safety, further research is needed to clarify the modest elevations seen in some analyses and help inform discussions when considering sedative therapy in pregnancy, they add.
In a linked editorial, researchers agree that this evidence is reassuring, but this does not mean that sedatives should be prescribed without caution.
Clinicians should be mindful of signals around prolonged use and late pregnancy exposure, while also balancing the risks of untreated maternal psychiatric illness, they write.
However, they conclude that this study “offers a compelling example of how observational research can generate reliable estimates of prenatal drug safety.
Hantaviruses are not new. They have circulated for decades in rodent populations, particularly in rats and mice. Humans can become infected if they are bitten or scratched by a rodent or by inhaling aerosolised particles. These are tiny bits of rodent urine, faeces or saliva floating through the air that are contaminated by the virus.
Infections between humans can be prevented by closely observing people who were exposed and isolating those who are sick. This limits the risk of further spread, as transmission generally requires close contact.
However, as an interdisciplinary group of scientists working on emerging infectious diseases, we argue that hantaviruses might pose a much bigger threat to African countries than currently known. We are concerned for three reasons.
Firstly, diagnostic testing capacity across much of the African continent remains limited. This is a real issue. In many rural settings, under-resourced diagnostic services may overlook sporadic cases. This may allow hantaviruses to spread without anyone noticing. Our medical expertise tells us that larger outbreaks are likely to be recognised eventually. But these delays in diagnosing the cases will slow down effective control measures.
Secondly, monitoring systems are lacking and likely to miss infections in wildlife and in human beings.
Thirdly, climate change and accelerating changes to the way land is used could increase the risk of spread of hantaviruses from animals to people. This is because global change may increase rodent populations and bring rats and mice into closer contact with humans.
For example, modelling studies in the Americas found broad zones with enzootic circulation (where an animal community always carries a certain disease). This is because many rodent species tend to live across a wide variety of environments where humans are also found. As human and rodent populations increase, the likelihood of encounters also increases. Some rodent species flourish in habitats shaped by humans or even in buildings. This poses a high risk for transmission of pathogens.
As a typical zoonosis (animal disease that spreads to humans), hantaviruses must be seen as a One Health issue. One Health is an approach that understands and takes into account the close connection between human, animal and ecosystem health. Hantaviruses cannot simply be seen as a clinical management or infection control issue.
It is really important that African governments set up better monitoring of wildlife so that they can detect when and where animal viruses like this are likely to spill over into the human population. This will help stop larger outbreaks of hantavirus, which can be deadly.
Weak surveillance may be allowing hantaviruses to spread unnoticed
In Africa, scientists have discovered several hantaviruses, including Sangassou virus in Guinea in small mammal species, such as rodents. More recently, hantaviruses were found in shrews and bats too – not just in rats and mice as previously thought.
The fact that hantaviruses may circulate in a much wider range of animals and environments than scientists originally realised makes their ecology and potential spillover risk into humans more complex.
One of the current problems facing Africa is that there hasn’t been enough research into the ecology of hantaviruses and which animals host them. There are very few genetic sequences available that would allow scientists to analyse interactions between viruses and hosts and the possible risk this poses to humans.
Combined with limited monitoring of the disease, Africa is experiencing a hantavirus surveillance gap. This gap needs to be closed because hantavirus infections and disease may be more widespread than many health systems assume.
Climate change and land use
Climate and land-use change influence rodent populations which host hantaviruses, and increase human-rodent contact. Hantavirus boomed in the US between 1993 and 1995 because El Niño brought very heavy rains and warmer winters, which led to a bumper crop in seeds that rodents eat. This improved nutrition led to a massive increase in rodent numbers. Outbreaks elsewhere have likewise been linked to weather phenomena.
More rodents means more of them seeking food and shelter in the vicinity of humans. More competition for resources leads to more aggressive behaviour between animals and biting transmits the virus. Because El Niño episodes are predicted to become more frequent and intense in future, hantaviruses are likely to affect African countries more and more.
In Africa, land-use change is likely to play an increasingly important role in hantavirus ecology and emergence, as was the case with Lassa fever (another virus spread by rodents) in Nigeria and Guinea. Deforestation, agricultural expansion, mining activities, road construction and urban growth are transforming natural habitats across many regions of the continent. These environmental changes can force populations of rodents, shrews and bats to move into farms, villages, peri-urban settings and water sources used by people.
When humans expand into previously undisturbed habitats in search of land, food, or economic opportunity, this also creates a new opportunity (known as an ecological interface) where hantaviruses and other zoonotic pathogens may circulate more easily between wildlife reservoirs and humans.
What needs to happen next
When people and wildlife come into close contact, viruses like Andes can jump from animals and begin transmitting between humans. Hantaviruses can cause severe human disease and this is likely far more widespread than currently recognised.
Fortunately, the risk of Andes hantavirus spreading beyond the cruise ship passengers and crew and their close contacts is small. But Sars coronavirus and monkeypox virus are recent examples that some zoonotic viruses have the potential to spread rapidly and widely among humans.
Virological and ecological studies of wildlife reservoirs and surveillance of possible hantavirus infection and disease in humans in endemic regions are needed. This requires specialised diagnostic tools combined with samples from rodents in areas where humans have disturbed their habitat and have since experienced unexplained febrile illness (acute high fevers).
Once there is firm evidence of human disease, scientists and medical professionals will be able to argue for the widespread use of diagnostic tests. The results of these tests will determine how much of a threat the virus poses to human health.
Genetic sequencing and data-sharing partnerships can then help connect animal, environmental and human signals into a clearer picture of risk.
The greatest gap currently may be the failure to identify where, how, and under which environmental conditions spillover events occur before outbreaks emerge.
Strengthening surveillance to identify high-risk interfaces, emerging transmission zones, and drivers of spillover is therefore essential to anticipate potentially pathogenic African hantaviruses before larger outbreaks occur.
Researchers at WashU Medicine and collaborating institutions have developed a novel computational tool that can accurately identify a genetic problem in a gene called RFC1 that is linked to certain forms of peripheral neuropathy. Peripheral neuropathy is one of the most common neurological disorders and can cause pain, sensory loss, imbalance and weakness. It affects 12–20% of all people in the U.S. and can affect up to 30% of adults over age 65. The new research is published in Annals of Neurology.
The disease-causing change, known as an RFC1 repeat expansion, has been associated with neuropathy, but its role across the broader spectrum of patients with unexplained, or “idiopathic,” neuropathy has remained unclear. One reason is that these repeat expansions — in which the set of DNA “letters” AAGGG is repeated many more times than normal — are difficult to detect using standard genetic testing methods.
The research team led by senior author Sheng Chih (Peter) Jin, an assistant professor of genetics and of pediatrics, and first author Zitian Tang, a graduate student in Jin’s lab, set out to bridge this technical gap by developing a new computational pipeline coupled with machine learning that can reliably identify and classify repeat expansions from genome sequencing data. Using this approach, they found that RFC1 repeat expansions may account for more than 2% of cases of idiopathic peripheral neuropathy.
The new tool offers a more affordable and reliable way to look for this extremely complex genetic variation in both clinical and research settings. The finding also supports broader genetic testing for people with unexplained peripheral neuropathy, including those who have muscle weakness as well as sensory symptoms. The team has made the tool public on GitHub, which could help expand testing to help more patients receive an accurate diagnosis and give families clearer information about the genetic causes of their condition.
A higher dietary intake of soy and legumes is linked to a lower risk of high blood pressure, finds a pooled data analysis of the available evidence, published in the open access journalBMJ Nutrition Prevention & Health.
And the optimal daily amount may be around 170g of legumes, which include peas, lentils, chickpeas and beans, and 60 to 80g of soy foods, examples of which include tofu, soy milk, edamame, tempeh, and miso, the findings indicate.
Legumes and soy foods have been associated with an overall lower risk of cardiovascular disease, but the evidence on their potential for lowering high blood pressure is mixed and needs to be systematically quantified, explain the researchers.
To explore this further, the researchers scoured databases for relevant studies published up to June 2025, and found 10 publications that included data from 12 prospective observational studies.
Five studies were from the USA, 5 from Asia (China, Iran, South Korea and Japan), and 2 were from Europe (France and the UK). Nine studies included both men and women, 2 included only women, and 1 included only men.
The number of study participants ranged from 1152 to 88 475 and the number of cases of high blood pressure ranged from 144 to 35 375.
Pooled data analysis of the study findings showed that higher daily intake of legumes and soy foods was associated with a lower risk of developing high blood pressure.
Compared with those with a low intake of legumes, those with a high intake were 16% less likely to develop high blood pressure. Similarly, those with a high intake of soy foods were 19% less likely to develop the condition than those with a low intake.
When assessing the association between quantity and lower risk, a linear reduction (30%) emerged for legumes up to around 170 g/day, while most of the reduction in risk (28-29%) for soy foods was observed at between 60 and 80 g/day, with no further reduction in risk at higher intake.
One hundred grams of legumes/soy is equivalent to a serving size of about one cup or 5–6 tablespoons of cooked beans, peas, chickpeas, lentils, soybeans or a palm-size serving of tofu, explain the researchers.
Using World Cancer Research Fund evidence grading criteria for evaluating the likelihood of causality, the researchers consider the overall evidence to indicate a probable causal relationship between both legume and soy intake and a reduced risk of high blood pressure.
There are plausible explanations for the findings, they say. Legumes and soy are high in potassium, magnesium, and dietary fibre, all of which are known for their blood pressure lowering properties.
And recent research has suggested that the fermentation of soluble fibre from legumes and soy produces short-chain fatty acids that influence blood vessel dilation, while the isoflavone content of soy also seems to help lower blood pressure, they explain.
The researchers acknowledge various limitations to their findings, including the variability of the studies in the pooled data analysis. This included differences in legume types, levels of intake, preparation methods, dietary contexts, and the definition of high blood pressure.
“Despite these limitations, the findings of this meta-analysis have major public health implications, given the alarming global increase in hypertension prevalence,” they point out.
“Current legume consumption across Europe and the UK remains below dietary recommendations, with average intakes of only 8–15g/day, far below the recommendations of 65 to 100g/day recommended for overall cardiovascular health,” they add.
“Although further large-scale cohorts are needed for confirmation, these findings provide further evidence in support of dietary recommendations to the public to prioritise and integrate legumes and soy foods as healthy protein sources in the diet,” they conclude.
“This research strengthens the evidence base for the cardioprotective benefits of plant-based diets. The authors have significantly added to the case for using legumes and soy as primary dietary strategies to mitigate the global burden of hypertension,” comments Professor Sumantra Ray, chief scientist and executive director of NNEdPro Global Institute for Food, Nutrition and Health, which co-owns BMJ Nutrition Prevention & Health.
“The strengths of the study lie in its rigorous dose-response analyses, which offer practical dietary targets for use in public health guidelines and clinical practice. But we can’t entirely rule out the influence of unmeasured influential factors. And the plateauing of benefits for soy at 60–80g/day warrants further investigation, as it remains unclear if this reflects a true biological limit or is a byproduct of the smaller number of studies available for analysis.”
“Hantavirus is a rare zoonotic virus, which means it’s carried by animals – in this case, rodents,” she explains. “Humans typically become infected when they breathe in particles from the urine, faeces or saliva of infected rodents.” Rare cases of human-to-human spread have been reported.
The virus isn’t new and does not spread in the same way as more familiar respiratory infections such as influenza or COVID-19. Most hantavirus infections occur after environmental exposure (in endemic regions), particularly in enclosed spaces where rodent droppings, urine or saliva have contaminated dust. Activities such as sweeping dry droppings in garages, sheds, storage rooms or other poorly ventilated areas may increase the risk of inhaling contaminated particles.
The current outbreak has drawn attention because it’s been confirmed as the Andes variant of hantavirus. The Andes virus is unusual because it is the only hantavirus variant documented to spread between people. However, Prof Ueckermann emphasises that this form of transmission remains rare and appears to require prolonged, close contact.
“To date, human-to-human spread of hantavirus is extremely rare, and has been described only with the Andes variant and with prolonged close contact, such as people sharing a household,” she says. “There is no evidence of community-wide spread of hantavirus of the kind seen with COVID-19.”
Previous cases of the Andes virus suggest that transmission is associated with close, sustained exposure rather than brief or casual contact. Reported situations include household exposure, being in contact with an intimate partner, caregiving activities or spending extended periods in enclosed spaces in close proximity to an infected person. This distinction is important in interpreting public concern about travel and shared public spaces.
“Based on what we currently know about the Andes virus, the risk to fellow passengers on a flight appears to be low,” Prof Ueckermann says. “Simply being on the same aircraft, walking past an infected person or sitting at a distance would be considered very low risk. Sitting next to a sick person on a long-haul flight may plausibly carry a low risk, while the highest risk would be repeated close contact, such as caring for someone, touching or sharing cups.”
Prof Ueckermann adds that the public health response to the recent outbreak has been appropriate and reassuring. This has included early sequencing of the virus to confirm that it is the Andes variant, monitoring of close contacts and a coordinated approach to managing those affected.
In South Africa, hantavirus is not considered a major public health concern. Confirmed human cases are extremely rare, and the current cases being managed in the country are linked to exposure outside South Africa, not local transmission. Prof Ueckermann stresses that South Africa is not experiencing a hantavirus outbreak.
Symptoms may initially resemble influenza and can include fever, body aches, headache and abdominal pain. In most cases, especially during winter in South Africa, such symptoms are far more likely to be caused by common seasonal infections. However, anyone with a known exposure to rodent-contaminated environments or having had close contact with a confirmed case should seek medical advice if symptoms develop. Urgent care is needed if symptoms progress to shortness of breath, tightness in the chest, rapid breathing, dizziness, confusion, bluish lips or sudden worsening after a flu-like illness.
Practical prevention remains important. People should avoid sweeping rodent droppings, and instead spray the droppings with disinfectant or diluted bleach, allow the area to soak, wipe it up with paper towels and wash their hands thoroughly afterwards. They should also ventilate enclosed spaces before cleaning, wear gloves and a mask. Food and waste should be stored securely, and rodent entry points should be sealed.
“Hantavirus is a rare but potentially serious rodent-borne infection, with very rare person-to-person spread,” Prof Ueckermann says. “The appropriate response is evidence-based awareness, sensible hygiene and rodent control – not panic.”
Netcare Blaauwberg Hospital leads the way in reducing landfill waste
Friday, 15 May 2026: The Green Building Council South Africa (GBCSA) has recognised Netcare Blaauwberg Hospital as the first hospital in the country to achieve Net Zero Waste certification with general waste to landfill reduced by more than 90%.
Valid until 2029, this latest certification marks a new departure for healthcare in the country and a notable step in the Netcare Group’s environmental sustainability strategy, first implemented in 2013.
Chief executive officer of GBCSA, Lisa Reynolds, commended the Netcare Group’s initiative in achieving this significant milestone of Net Zero Waste certification.
“As the first hospital in South Africa to achieve the rating, it will serve as the template for other Netcare Group facility certifications, and provides a case study for all medical facilities looking to execute their sustainability goals,” she says.
“The certification process was characterised by solid teamwork, across the Netcare Group teams, the Zero Waste sustainability consultants, and the technical team at GBCSA, and it is this teamwork that is taking projects beyond the boardroom and into action.”
Alan Abrahams, Netcare’s Cape regional manager and general manager of Netcare Blaauwberg Hospital, congratulated staff and doctors on their enthusiasm for pioneering the Net Zero Waste initiative in the hospital setting.
“Caring for people and caring for the environment should be indivisible, yet progress towards sustainability requires commitment to measurable steps towards the goal of Net Zero Waste within the broader aims of the global Race to Zero,” Abrahams says.
“We appreciate Netcare leadership’s commitment and the support from the Group’s environmental sustainability team who have guided our Net Zero Waste certification journey. This would not be possible without each person in the hospital doing their part to reduce the amount of landfill waste by incorporating small changes into daily practices.”
The GBCSA’s Net Zero Waste Level 2 certification process analyses an existing building’s operational waste generated during day-to-day use and assesses how much of this waste is diverted from landfill, whereas Level 1 is a separate category measuring construction waste reduction in new buildings.
Netcare Blaauwberg Hospital successfully achieved the required diversion rate in line with global best practices through its own waste management processes, without any purchased offsets.
Dimakatso Nhlapo, Netcare’s national lead on integrated waste management, explains that a multidimensional approach is required to achieve Net Zero Waste Level 2 requirements in the healthcare setting.
“Healthcare risk waste, such as blood-contaminated items and pharmaceutical products, is managed in line with regulatory requirements and is not part of this process. Our efforts focused on the hospital’s general waste, which would otherwise be disposed of in landfill,” she explains.
“We looked at where we could minimise waste from every angle and improved the separation of general waste at source through practical measures, such as providing different bins for different types of materials.”
“The shift towards reducing the hospital’s landfill waste to less than a tenth required continuous staff training and education on waste diversion. Onsite general waste sorting systems and improved processes for the recycling of paper, cardboard boxes, plastics, textile waste, and e-waste were established to further reduce the need for landfill,” Nhlapo says.
“We identified items commonly used in the hospital that can be safely reused and set up the necessary systems to ensure they are properly cleaned and disinfected. For organic waste, such as food scraps, we also established a composting system at Netcare Blaauwberg Hospital.”
André Nortje, Netcare’s environmental sustainability manager, adds that when Netcare joined the United Nations Race to Zero 2050 global campaign in 2021, it became the first healthcare institution in Africa to do so.
“Only by setting ambitious environmental objectives can these goals be achieved. Alongside Netcare’s strategic efforts to improve energy and water efficiency and reduce reliance on non-renewable resources across our operations, minimising waste to landfill is a fundamental component of minimising our operations’ footprint on the planet,” he says.
“We anticipate that many of the learnings from this first hospital’s Net Zero Waste certification will be replicable across other Netcare hospitals and will inspire other healthcare providers and corporates to seek ways to reduce landfill waste through similar initiatives,” Nortje concludes.
Researchers have identified the best dosage for each ADHD medication using data from thousands of people with the condition.
A new study published 14 May in the Lancet Psychiatry provides the most comprehensive view of dosage effects for five commonly used medications for ADHD.
To help patients and clinicians choose the right dosage, the international research team led by Professor Samuele Cortese from the University of Southampton has also developed a free online tool based on the findings.
The research was funded by the National Institute for Health and Care Research (NIHR).
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions, affecting about five per cent of school-age children and two to three per cent of adults.
Medication is a key part of treatment, and prescriptions have increased substantially in recent years. However, most clinical guidelines provide limited guidance on the most effective dosages.
Finding the right dose is important to avoid dosages that are too low to be effective or too high, causing unwanted side effects. To identify this dosage ‘sweet spot’, the research team analysed data from 113 clinical trials, including more than 25 000 participants.
They used an advanced method called dose–effects network meta-analysis, which allowed them to estimate how different doses of each medication affect both effectiveness and side effects.
The results show that patterns differ between medications and age groups.
Dr Mikail Nourredine from the University of Lyon, first author of the study, said: “Overall, our findings suggest that clinicians should avoid using doses that are too low to be effective. If symptoms are not well controlled, the dosage may need to be increased.
“We also found no evidence that going beyond the licensed maximum doses improves average effectiveness, and higher doses are usually linked to more side effects. However, our results derive from group averages. Specific individuals with ADHD may benefit from and tolerate well unlicensed doses.”
Evidence from other studies shows that a substantial proportion of children and adolescents are prescribed low dosages without appropriate increases. That’s despite timely and adequate dose adjustments being associated with better adherence to treatment.
Professor Cortese, an NIHR Research Professor at the University of Southampton, commented: “Our study and the tool have the potential to support shared decision-making between clinicians, patients, and families when choosing the best dose. It is not only a clinician’s decision – patients and caregivers should be involved.
“The tool helps show what can be expected from each dose so that the patient knows why that particular dose has been chosen. We are continuing research to further personalise these recommendations based on individual patient characteristics.”
By Maria Fernanda Ziegler | Agência FAPESP – A study conducted on an animal model by researchers at the Federal University of São Paulo (UNIFESP) in Brazil demonstrated that swimming is more effective than running in promoting healthy heart growth and improving the strength with which the heart muscle (myocardium) contracts.
“Swimming and running are two excellent ways to improve cardiorespiratory health and protect the heart muscle, but we wanted to know if one could be even more beneficial than the other. We found that, although both increase respiratory capacity, swimming goes a step further by combining functional and molecular adaptations that make the heart stronger and more efficient,” says Andrey Jorge Serra, a professor at UNIFESP and coordinator of the study supported by FAPESP.
The study, published in the journal Scientific Reports, demonstrates that swimming promotes greater modulation of microRNAs that control various heart adaptations, such as cardiac cell growth, the formation of new blood vessels (angiogenesis), protection against cell death, and the regulation of contractility and responses to oxidative stress, compared to running training.
MicroRNAs are molecules that regulate the expression of messenger RNAs, which are responsible for protein synthesis.
“Although several studies had already examined the expression of microRNAs regulated by aerobic training in general, little was known about expression patterns when swimming and running were compared in the same experimental setting. Therefore, this study reveals that there’s a distinction in cardiovascular effects between these two modalities,” says Serra.
In the study, the mice underwent an eight-week training protocol consisting of daily 60-minute sessions five days a week. The rats were divided into three groups: one that did not train, one that only ran, and one that only swam. Since running and swimming are very different forms of exercise, the comparison between the training regimens was not based on the speed the animals reached but rather on the relative intensity of the effort, as measured by maximum oxygen consumption (VO₂ max) – an indicator that assesses the body’s ability to capture, transport, and utilize oxygen during physical activity.
According to the results, running and swimming improved physical fitness similarly: between the first and last training sessions, VO₂ max increased by more than 5%. However, only swimming promoted significant structural changes in the heart, such as increases in cardiac and left ventricular mass. Running did not show relevant differences compared to the sedentary animals.
“People’s choice of sport depends largely on personal preference, aptitude, and enjoyment. But our results show that swimming may have a special impact in situations involving myocardial recovery, cardiac rehabilitation, and above all, scientific research. This is also relevant because studies on aerobic exercise often use running and swimming interchangeably, and we now know that the effects aren’t the same,” Serra explains.
Before and after the training period, the researchers administered a series of tests to evaluate various aspects of cardiac health, including cardiorespiratory capacity, fitness, and the structure and function of the heart and myocardium.
The study also analyzed the gene expression and protein pathways involved in physiological cardiac hypertrophy and the mechanisms involved in identifying regulatory microRNAs.
“Although we don’t yet know why this change occurs at the molecular level, of the microRNA, we were able to delve deeply into and investigate the molecular pathways that control physiological hypertrophy,” the researcher adds.
The article “Swimming is superior to running in inducing physiological cardiac hypertrophy and enhancing myocardial performance” can be read at nature.com/articles/s41598-026-36818-2.
