Killer T cells about to destroy a cancer cell. Credit: NIH
Scientists at the University of Southampton have begun work on reprogramming natural killer cells to create pre-armed, long-lasting protection against common respiratory viruses including colds, flu and RSV. The approach differs from traditional vaccination, which uses weakened pathogen to train adaptive responses.
Professor of Hepatology Salim Khakoo from the University of Southampton said the technique could change how people protect themselves from flu, colds and RSV: “We’re working on creating a natural killer cell found in the lungs with a memory about how to fight the viruses immediately someone is infected. The idea is to arm our body naturally by enhancing these cells so that they can prevent infection from ever becoming established.”
Natural killer cells act as early responders that can destroy infected cells before a virus spreads, but they are short-lived. Co-lead Dr Andres Vallejo noted that learning to reprogram them could yield long-lasting versions resident in the airways, ready to respond on first exposure. The team received £2.5 million for the TRIUMPH-NK project under a £57 million Advanced Research + Invention Agency (ARIA) initiative. Success would aim for protection against most common respiratory viruses rather than single strains. Viruses such as flu, RSV and Covid remain major causes of illness and winter hospital admissions in the UK.
University of East Anglia researchers have found that small changes in pupil size and blink patterns can indicate mental workload during virtual reality tasks. Combining AI with eye tracking in VR may eventually support personalised treatment for chronic pain.
Lead researcher Dr Jordan Tsigarides said chronic pain affects an estimated 1.5 billion people worldwide and is a leading cause of disability. The work forms part of his PhD exploring AI and sensor technology to make VR treatments more responsive, aiming to balance challenge and comfort.
“Chronic pain affects an estimated 1.5 billion people worldwide and is one of the leading causes of disability. Virtual reality has enormous therapeutic potential – whether that’s guiding patients through a peaceful woodland, supporting relaxation exercises or engaging them with games and puzzles that help manage pain. It can help reduce chronic pain by immersing users in engaging, interactive environments that capture the brain’s attention and draw it away from pain, reduce pain-related stress and anxiety, and may even help retrain how the brain processes pain over time.
“But most virtual reality programs offer the same experience to everyone, even though people’s pain and mental effort can fluctuate from moment to moment. Our work suggests future systems could read mental effort through the eyes and adapt therapy in real time to each individual. If a headset can detect when someone is becoming mentally overloaded, it could potentially adapt the experience automatically to keep them engaged and maximise therapeutic benefit.”
In a study of 84 volunteers (42 healthy controls and 42 with chronic musculoskeletal pain such as arthritis or fibromyalgia), participants completed escalating memory (N-back) challenges while wearing a VR headset with eye tracking. As cognitive demand rose, pupils widened and blink rates increased.
AI models analysing temporal patterns distinguished low versus high mental workload with up to 88% accuracy in healthy volunteers. Tasks were well tolerated, with very low reported motion sickness or discomfort. The findings support feasibility of VR-embedded eye tracking for cognitive-load estimation; reliable individual-level inference in chronic pain will require participant-calibrated models and further validation. The researchers hope this could enable wearable systems that adapt therapy in real time.
Dr Tsigarides said: “These results suggest a future in which a headset could continuously monitor the brain’s workload through the eyes, automatically fine-tuning treatment to each individual user.
“Our earlier research showed promising pain reductions in people with fibromyalgia using therapeutic VR. Now we’re exploring how to make those experiences smarter, more responsive, and tailored to each person.
“Until now, most VR has been one-size-fits-all. Our findings could help make treatments more personalised and responsive. This could enhance future VR treatments, not just for pain but potentially for conditions like anxiety or depression.”
“In future, the same principles could be explored in education and professional training, where virtual learning experiences might adapt to the learner’s mental workload.”
However, the study also highlighted a challenge. While AI models performed strongly in healthy volunteers, accuracy was significantly lower among people living with chronic pain, suggesting that standardised approaches may not work equally well for all patients.
The researchers believe future systems may need to be individually calibrated, learning how each person’s eyes respond to mental effort before making treatment decisions.
And they say that larger studies are needed to determine whether adaptive VR therapies can improve real-world outcomes for patients.
Children whose mothers received opioid prescriptions during pregnancy have a higher rate of hospital admission in childhood than unexposed children, including unexposed siblings, according to a new study published October 13th in the open access journal PLOS Medicine by Dong Keon Yon of Kyung Hee University College of Medicine, South Korea, and colleagues.
Over recent decades, opioid prescriptions and doses have risen in clinical practice, and a considerable proportion of pregnant women are exposed to these drugs. In the US, for example, data has shown that 14-22% of women filled a prescription for opioids during pregnancy. Prenatal opioid exposure may disrupt infant development and immune system function, but prior studies have had limitations such as confounding factors, limited sample sizes, or restricted follow-up durations.
In the new study, researchers used nationwide health insurance data on mothers and children in South Korea, following a cohort of 2,928,186 children born between 2010 and 2017 for up to 14 years. Children were classified as prenatally exposed to opioids if their mothers received two or more opioid prescriptions during pregnancy, and were compared both with unexposed children and with their own siblings.
Children with prenatal opioid exposure had a 28% higher rate of hospital admission than unexposed children (adjusted incidence rate ratio 1.28, 95% CI 1.28-1.29). The association was smaller but still significant when comparing siblings (aIRR 1.08, 95% CI 1.07-1.10). The effect was also dose-dependent, with higher maternal opioid doses associated with higher admission rates (aIRR 1.19 for low-dose exposure versus 1.40 for high-dose exposure). The elevated admission rates spanned several causes, including infections and respiratory, gastrointestinal and genitourinary conditions, with the association strongest up to five years of age.
“These findings suggest the need for additional postnatal health checks for those born to mothers with opioid prescriptions during pregnancy,” the authors write. “However, these findings should be interpreted with caution, as the study relied on electronic health records, which may not reflect actual use of medication, and unmeasured factors shared within families may still partly explain the observed associations.”
Dong Keon Yon, MD, PhD (co-corresponding author) states, “In a nationwide cohort of nearly three million Korean children, those whose mothers received two or more opioid prescriptions during pregnancy had about a 28% higher rate of hospital admission, most notably for infections and respiratory illness in the first years of life. The risk rose with higher opioid doses and longer prescriptions, which points to a possible biological effect—but when we compared siblings within the same family, the association shrank considerably, so shared family factors clearly explain part of what we see.”
Jiseung Kang, PhD (co-corresponding author), adds, “Because opioids in South Korea are obtained almost entirely by prescription, our data let us examine prescribed opioid exposure in pregnancy unusually cleanly, and following nearly three million children for up to 14 years gave us the statistical power to look at dose, timing, and specific causes of admission separately. The consistency of the pattern across all of these analyses is what makes the finding hard to dismiss.”
Hyeon Jin Kim, MS (joint first author) states, “Our message is not that pregnant women should never receive opioids—for some, pain relief is essential. It is that opioids in pregnancy should be prescribed at the lowest effective dose for the shortest time, and that children born after such exposure may benefit from closer routine health checks, particularly in infancy when the risk was highest.”
Yesol Yim (joint first author) notes, “What surprised us most was how quickly the association faded as children grew older. The excess risk was clearest in the first year of life and had largely disappeared after age five. That pattern suggests a window of vulnerability in early infancy rather than a lifelong effect – and it is a window in which pediatric follow-up can make a real difference.”
Doctors and supporters of unemployed medical professionals protest outside the Natalia Building in Pietermaritzburg, calling for action on doctor unemployment. (Photo: Supplied)
By Sue Segar for Spotlight
They are qualified, ready, and willing to serve their communities. But scores of these doctors in KwaZulu-Natal, are becoming increasingly desperate because of a lack of posts in government hospitals and clinics.
Dr Tholumusa Sibiya remembers, as if it were yesterday, the day, in 2015, when a group of young doctors visited his school in Ingwavuma, KwaZulu-Natal to urge talented pupils to apply to university to study medicine and other health disciplines.
The doctors were from Mosvold Hospital where manager, Dr Andrew Ross, had started a fund to encourage local pupils to train in medicine and return to serve in their communities.
“The message from these young professionals was, ‘yeah, it’s doable. You can also study medicine. And you’re needed.’ That really inspired me,” says Sibiya, who was the top pupil in matric at Nansindlela Combined School.
He knew about Mosvold Hospital because his father worked in the mortuary, and his mother in the laundry services there. But, till then, it hadn’t occurred to him he could be a doctor there some day.
“One of the doctors said something that knocked sense into me. He said as rural kids, we need to work twice as hard to have half of what guys in other schools have,” he recalls.
Sibiya and other pupils from the area then formed a study group, to “share information and support each other”. “It helped a lot working together … especially with mathematics and physics,” he says.
Against the odds
Sibiya’s hard work paid off, and armed with an Umthombo bursary, he was accepted at the University of KwaZulu-Natal to study dental therapy. A year later, he transferred to the university’s medical school, and qualified as a doctor in 2022.
“My parents were ecstatic,” he says.
Straight after qualifying, he did two years of internship at Empangeni’s Ngwelezana Hospital, followed by community service at Manguzi Hospital in northern KwaZulu-Natal. “I rotated from one department to the next – paediatrics, maternity, the emergency unit – and learnt so much. It was the best,” he says.
He was geared up and ready to return home to serve his rural community as a doctor. His long-term dream was to work as an emergency physician in a hospital in rural KZN; maybe to specialise as an anaesthesiologist. But to specialise, you need to work in a public facility.
That was 2025. Since then, Sibiya has not been able to find a job as a doctor in the public healthcare sector. “I started applying in October last year,” he says. “But, so far, nothing.”
Many unemployed doctors
Sibiya is not alone. Spotlight has spoken to several other young doctors who are in the same boat. He reckons there are well over a hundred recently qualified doctors looking for work just in KwaZulu-Natal, others put the number at closer to 200. Even this may be an undercount since it doesn’t fully account for doctors who are still unemployed from previous years, or who have stopped looking for work. Some recent reporting suggests that the National Department of Health does not have a reliable count of how many unemployed doctors there are who are looking for work in the country.
Those who have received government bursaries, cannot fathom “why the government invests in us, then dumps us”. “Even now, they’re sending a new batch to study overseas, but where will they work?” says one doctor, who suggests that Cuban-trained doctors are prioritised for jobs because the government allegedly has a contractual obligation to give them jobs.
Currently, Sibiya and others have few alternatives but to try and do locums in private practises or in private hospitals.
“We’ve worked hard, done all that’s necessary to qualify and completed our internships and community service in preparation for careers in service to others, but we cannot find jobs,” says Sibiya.
Scrambling to make ends meet
We are meeting Sibiya on a Sunday at a coffee shop in Pietermaritzburg. He is currently living in Margate on the KwaZulu-Natal south coast and has come to Pietermaritzburg to do a locum shift for a private GP.
“I do shifts wherever I can find them. Primarily, I’m working in the emergency unit at the Shelly Beach (private) Hospital on the south coast. They call me whenever they need me, but I have no contract. That’s how I’ve been paying bills,” he says.
He keeps up with scores of other unemployed doctors on three different WhatsApp groups where, among others, they share job and locum opportunities, advise and support each other, and coordinate some of their interactions with the provincial health department.
“There are many people on the group(s) who aren’t able to get locum posts,” he says, “and they are really struggling. Some have depression. Sometimes it boils down to cars being repossessed, people going back home. Some people say, ‘I can’t put bread on the table, I’m selling my stuff because I can’t make ends meet’.”
“The mother of a friend of mine, also an unemployed doctor, called me recently and told me he’s drinking every day because the stress has been too much,” says Sibiya. “Some of the stories will make you cry.”
The situation is particularly tough on young doctors from poor backgrounds who do not have the funds to sustain themselves without work for extended periods.
‘I can feel I’m going into a depression’
Dr Raeesa Kathrada says she has sent her CV “to every doctor I know and to every private hospital and applied for every locum position.
“I can feel I’m going into a depression … as are my colleagues. Many people reach out to me, saying they don’t know how to survive,” she says.
Kathrada says some doctors have been waiting up to three years to find jobs.
Dr Lawrence Khoza from Osizweni, near Newcastle, is also struggling to find a position in the public sector. He started a private general practice, but he says he wants to work for the government and to see patients for free. “My passion is to help poor patients … but now I can only help those in the middle class who can afford medical aid,” he says.
Dr Nazo Nxumalo, originally from Mtubatuba, qualified in medicine at UKZN in 2022, did a two-year internship at Empangeni’s Ngwelezane Hospital and her community service at the Nseleni Community Health Centre in 2025. “After that, it was unemployment,” says Nxumalo. “It was like being dropped in the middle of the ocean.”
“I really thought that, after my community service, employment in the public health system would follow,” she says. “Basically, the department has left us stranded. We went into medicine, a very important job in society, believing we were entering a profession where our skills would always be needed.”
Understaffing in public health facilities
The unemployed doctors say that, while they are struggling to find work, the province at the same time desperately needs more doctors if it is to improve the quality and availability of healthcare services. “There is a big shortage; doctors are suffering in silence. The demand is there but the government is turning a blind eye,” says Khoza.
Several doctors who are currently employed at public sector hospitals in the province agree that they need help. One doctor, from a rural hospital speaks about “long lines of patients, late into the day” and doctors often working overtime and never taking a lunch break because “we can’t afford the 15 or 30 minutes of having no doctor on duty”. We are not naming the employed doctors quoted in this story since they could potentially suffer repercussions for speaking out.
“Whenever people leave our hospital, the posts are not filled because of budget cuts,” says another employed doctor. “Several departments here are severely short staffed.”
A recent report from South Africa’s Health Ombud paints a similarly grim picture. Following an investigation into the deaths of six healthcare workers at six public health establishments in KwaZulu-Natal, the Ombud found that while their deaths were not a result of workplace bullying, victimisation, or adverse working conditions in the hospitals under investigation, there were “significant” systemic challenges affecting healthcare professionals in the health establishments. These included “persistent staffing shortages, frozen vacant posts, rising workloads, shortages of medical equipment and supplies, inadequate employee wellness support services, infrastructure challenges, and security concerns affecting healthcare workers”.
A rough benchmark is that 1 doctor is needed for every 1 000 people, although experts stress that target ratios may differ based on factors like disease profile and population density. According to a 2025 parliamentary answer, the ratio in KwaZulu-Natal stood at around 0.38 doctors per 1 000 people – according to the District Health Barometer it was at just under 0.4 in 2024.
Though the KwaZulu-Natal Department of Health does not describe the situation as a crisis anywhere we could find, they do acknowledge shortages. Their 2025-2026 annual report largely blames a budget crunch. “The ongoing budget cuts due to implementation of austerity measures have had a significant impact on the ability of the department to fill vacant critical posts especially among clinical specialists (nurses and doctors), allied health professionals including in finance and human resource administrative posts,” the report reads.
Protests in Pietermaritzburg
On 17 June this year, a large group of unemployed doctors protested outside Natalia, which houses the KZN Department of Health and the Office of the Premier, to call on the provincial government to act urgently to create jobs for the numerous unemployed medical professionals.
With many wearing scrubs and holding placards, the doctors voiced their willingness to serve their communities. They highlighted the shortage of qualified doctors, the systemic strain in provincial hospitals and clinics, and a poor doctor-to-patient ratio in the province.
The protesters also pointed out that some doctors have been waiting for years for jobs; and that their ambitions to specialise in various medical areas were being severely hindered because of the lack of government posts.
They submitted a memorandum addressed to KZN Premier, Thami Ntuli, Health MEC Nomagugu Simelane, and head of the health department, Penny Msimango. Among others, the protestors demanded that the provincial health department advertise all the vacant medical officer positions at various public healthcare institutions within 14 days and that it develops a sustainable long-term plan to provide posts annually and address doctor unemployment beyond 2026.
Not enough money
In a written response to the protestors, the department said: “A filling of vacant posts is dependent on the availability of funds to compensate employees. The department is underfunded for 2026/7 financial year, therefore not all vacant posts can be filled.” They said that, due to the budgetary constraints, they could not commit to timelines for filling posts.
Spotlight sent the KwaZulu-Natal Department of Health a detailed set of questions (which you can read here) on the afternoon of Thursday15 October. We gave them a deadline of end of business on Tuesday 20 October. While the department acknowledged that they received our questions, they did not provide responses by the deadline.
On July 6, Simelane met with representatives of the unemployed doctors and representatives from the South African Medical Association Trade Union (SAMATU) (the unemployed doctors say that SAMATU had to be present since the department does not recognise the group of unemployed doctors).
According to Sibiya, the meeting did not go well. “Their clear message was that the department has enforced austerity measures and they do not have money to fund posts. They committed to try and look for 20 posts but that was all they could promise,” he says. In his view, 20 is not nearly enough. The department later upped the number of newly released posts to 50. The unemployed doctors say that while these jobs have been advertised, there have been no further movement.
But what stung Sibiya more was the sense he got that the department had accepted the situation and given up. “What was really astonishing was that they said they are comfortable with the numbers of doctors in the province on paper,” he says. Spotlight asked the department whether this characterisation is accurate, but did not receive an answer.
“Our response is that …. if something’s declared a crisis, finances are moved to meet that crisis, be it at provincial or national level,” Sibiya says. “I’m sure the public feels the same way: the doctors on the ground by no means meet the demand. They could hire all the unemployed doctors in the province, and still the demand wouldn’t be met.”
“We are not trying to fight”
As the 2026 convenor of the KZN Unemployed Doctors group, Sibiya has been in the middle of much of these developments. The group was formed a few years back with the goal of communicating with the provincial health department to raise doctors’ concerns about unemployment. It was only after several other efforts at engaging the department had not gone anywhere that they decided to protest.
In the meeting, he says they stressed “that we’re not here to fight”. “We understand the department has financial constraints. But we’re talking about the health of the entire province resting on a few shoulders who are really tired; and people ready to work cannot be integrated into the system because of austerity measures”, he says.
“I think we must all agree it’s a crisis. Once we do this, I’m certain funds can be mobilised from somewhere,” he says. “Alternatively, we could expand the system of employing sessional medical officers, where doctors work for a certain number of hours in clinics and hospitals, and earn less.”
But, says Sibiya, “it’s almost as though they’ve given up”.
That sense that those in power are not hearing them was recently reinforced when premier Ntuli reportedly called on doctors who have left the province to return home and help strengthen the health system. More than one unemployed doctor told Spotlight that they were enraged by the comments in the context of their struggle to get jobs. “It’s ridiculous,” says Sibiya. “After all our efforts to speak to the government, and being ignored, now this.”
“Just go private!”
Meanwhile, Sibiya and scores of other young, unemployed doctors are still having to scramble to make ends meet.
Sibiya says people often say to unemployed doctors that they should go private. “Yes, that’s an option, but from the point of view of specialising, it destroys the pipeline. And if all of us go private, then in upcoming years, we will be talking about a shortage. And, in a time of NHI, why are doctors having to work in private”, he asks.
“It’s worse for us coming from Ingwavuma, funded by Umthombo, where when we signed the contract, we were told, ‘You’re going to come back and serve your community’. I was happy to do that,” he says. Umthombo is a scheme that supports young people from rural KwaZulu-Natal to study medicine and then to return to serve their communities once qualified.
Despite all the setbacks, the dream of serving his community remains alive for Sibiya. His eyes light up when he talks of his dream to work rurally, preferably at the hospital he loves, Manguzi.
But, right now, that dream seems far away. He says his main focus at the moment is just to survive.
Cold-water immersion is a popular post-workout recovery strategy, but new research suggests it may offer no greater benefit to muscle strength recovery than heat-based methods. The study, published in the Journal of Thermal Biology, investigated how different thermal recovery strategies affect muscle recovery following exercise-induced muscle damage.
Researchers led by the University of East London found that while heat-based interventions altered several physiological markers associated with cellular stress and muscle repair, neither heat nor cold resulted in superior recovery of muscle strength over a 72-hour period.
The research involved 40 healthy, physically active adults who completed an intensive exercise protocol designed to induce temporary muscle damage and delayed onset muscle soreness.
Participants were randomly assigned to one of four recovery strategies:
30 minutes of hot-water immersion at 42°C
15 minutes of cold-water immersion at 9°C
30 minutes of hot-air exposure at 30°C
Passive recovery at room temperature
Researchers then monitored changes in muscle strength, muscle soreness and a range of molecular markers associated with muscle damage and inflammation over the following 72 hours.
Immediately following exercise, muscle strength decreased by approximately 36% across all groups. Although strength gradually recovered over the monitoring period, no statistically significant differences were observed between the four recovery strategies.
However, the different recovery approaches produced distinct physiological responses. Participants receiving heat-based treatments showed increased expression of heat shock protein 72 (HSP72), a cellular stress protein associated with protective and repair-related processes within muscle. In addition, concentrations of creatine kinase-MM (CK-MM), a marker commonly associated with muscle damage, returned towards baseline more rapidly in the heat-based recovery groups than in the cold-water immersion group.
These findings suggest that heat-based recovery strategies may influence some of the biological processes involved in recovery following muscle-damaging exercise. However, these physiological changes did not translate into significantly greater improvements in muscle strength or reductions in soreness during the 72-hour recovery period.
Dr Freya Bayne, Lecturer in Sport and Exercise Science at University of East London and lead author of the study, said:
Cold-water immersion remains one of the most popular recovery strategies used by athletes and recreational exercisers alike. Our findings suggest that heat-based recovery methods produce different physiological responses following strenuous exercise, particularly in relation to markers associated with cellular protection and muscle repair.
We observed increases in heat shock protein expression and a faster return towards baseline for some markers associated with muscle damage.”
