Author: ModernMedia

Categories : Implants and Prostheses NeurologyTags :

Neural Stimulation and Exoskeletons Improve Hand Function in Neurological Injuries

On By ModernMedia

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.”

Source: Medical University of Vienna

Categories : Cancer NeurologyTags :

Epstein–Barr Virus Influences Rare Brain Lymphomas

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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.”

Source: Heidelberg University

Categories : Ageing ExerciseTags :

Research Finds Best Exercise Type to Preserve Muscle in Seniors

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By Julie Schomberg

Photo by Barbara Olsen on Pexels

High intensity interval training (HIIT) may be the optimal exercise for reducing body fat while maintaining muscle mass in older adults, according to new research led by Australian academics.

“We found that high, medium and low intensity exercises all led to modest fat loss but only HIIT retained lean muscle,” said lead author and exercise physiologist Dr Grace Rose of the University of the Sunshine Coast.

The study examined how the intensity of different exercises could influence body composition in healthy older adults.

“While moderate training reduced fat mass, it also caused a small decline in lean muscle,” she said. “Both high and moderate intensities improved the composition of weight carried around the middle. Further analysis is needed of the low intensity results.” Dr Rose said the findings were particularly useful because body composition was implicated in the progression of many chronic diseases as people aged.

More than 120 healthy older adults from the Greater Brisbane region participated in the study, completing three exercise sessions a week in the gym for six months. 

Their average age was 72 years old and average body mass index was 26kg/m2, categorised as normal for people aged over 65.

UniSC Associate Professor of Physiology and co-author Mia Schaumberg welcomed the the paper published in the journal Maturitas, with collaborators including UniSC’s Healthy Ageing Research Cluster and The University of Queensland.

“High intensity training in this study involved repeated short bursts, or intervals, of very hard exercise – where breathing is heavy and conversation is difficult – alternated with easier recovery periods. More than 120 healthy older adults from the Greater Brisbane region participated in the study, completing three exercise sessions a week in the gym for six months. 

Their average age was 72 years old and average body mass index was 26kg/m2, categorised as normal for people aged over 65.

UniSC Associate Professor of Physiology and co-author Mia Schaumberg welcomed the timing of the paper published in the journal Maturitas, with collaborators including UniSC’s Healthy Ageing Research Cluster and The University of Queensland.

“High intensity training in this study involved repeated short bursts, or intervals, of very hard exercise – where breathing is heavy and conversation is difficult – alternated with easier recovery periods,” she said.

“HIIT likely works better because it puts more stress on the muscles, giving the body a stronger signal to keep muscle tissue rather than lose it.”

Source: University of the Sunshine Coast

Categories : Environmental EffectsTags :

Two Weather Patterns Increase Headaches, Study Suggests

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Experts show which prescription medication reduces the likelihood of weather-associated headaches

Photo by Kindel Media

Two specific weather patterns have been identified as capable of increasing the risk of headaches and migraines, thanks to physicians at the University of Cincinnati College of Medicine, along with researchers at the Icahn School of Medicine at Mount Sinai, Errex Inc. and Teva Pharmaceuticals.

Headaches and migraines are often associated with weather variables such as barometric pressure, precipitation, humidity and temperature. As weather patterns vary around the world, evidence suggests their impacts vary across geographic regions, seasons and population groups. 

“Weather is one of the most common triggers for attacks of migraine headache,” said study author Vincent Martin, MD, a professor of clinical medicine in the Department of Internal Medicine and director of the Headache and Facial Pain Center at UC’s Gardner Neuroscience Institute. “Our investigation suggests that specific storm patterns may help explain why weather-related headaches and migraines are so frequent in Cincinnati and the Midwest region.”

For this study, researchers analysed weather patterns in the Northeast U.S. to determine whether any are associated with new-onset headaches in patients with episodic migraines.

“What is significant about this headache research is that we are one of the first to look at weather patterns with a combination of variables, instead of a single weather variable,” said Martin. “We further examined those weather patterns by region and season.”

Which weather patterns are linked to higher headache risk?

They found that two specific weather patterns were associated with a higher risk of new-onset headaches in the Northeastern region. One is an approaching cold front, or low-pressure system, with precipitation, which can occur in all seasons. The other is the Bermuda High, a high-pressure system that heavily dictates summer weather across the eastern half of the U.S. 

“This is one of the first studies to more closely implicate frontal passage in the onset of headache,” said Al Peterlin, a co-investigator and meteorologist from Errex Inc. 

This is one of the first studies to suggest that a preventive medication might reduce the likelihood of a weather-associated headache.

Brinder Vij, MDLead author, professor of clinical medicine & director of the Division of Headache Medicine in the Department of Neurology and Rehabilitation Medicine

To determine their findings, researchers compared thousands of daily headache diary entries from participants at the Northeastern U.S. sites of the HALO-EM and HALO-LTS studies, both randomised, double-blind, placebo-controlled Phase 3 clinical trials that established the safety and efficacy of the prescription medication fremanezumab (Ajovy) for the preventive treatment of episodic migraines. They linked the headache data to daily meteorological data from the National Climatic Data Center, tracking four years of weather patterns organised into three-day windows.

Researchers also confirmed that at least six months of treatment with fremanezumab significantly reduced the rate of new-onset headaches compared with no medication across all weather patterns, including conditions considered high risk for new headache onset. 

“We saw the weather and headache relationship wiped out with the use of this medication,” said Fred Cohen, MD, a co-investigator and faculty member at Icahn School of Medicine at Mount Sinai. “We started to notice its effectiveness as early as one month after the start of the medication.”

“This is one of the first studies to suggest that a preventive medication might reduce the likelihood of a weather-associated headache,” said lead author Brinder Vij, MD, a professor of clinical medicine and director of the Division of Headache Medicine in the Department of Neurology and Rehabilitation Medicine. 

He further stated that this study offers new hope for the millions of people with migraine experiencing weather-associated headaches.  

By Megan Burgasser

Source: University of Cincinatti

Categories : Mental HealthTags :

Women Report Poor Sleep Despite a Good Night’s Rest – While Men Overestimate Their Own Sleep Quality

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Men reported sleeping better than they objectively did, while the opposite was true for women. Photo by Ketut Subiyanto on Pexels

Torbjörn Åkerstedt, Karolinska Institutet

Disturbed sleep is a common problem — and one that has many serious consequences beyond feeling tired the next day. Research has linked insomnia and poor sleep to early mortality and diseases including diabetes and cardiovascular disease.

Women often report experiencing disturbed sleep more frequently than men. They also constitute the majority of patients in sleep clinics. Yet strangely, some studies show worse objective sleep quality in men – a bit of a paradox.

To understand what might explain the paradox, my colleagues and I conducted a study that directly compared sleep quality ratings and objective sleep measures between men and women.

We found that women complained more of sleep problems – but slept objectively much better than men. We think this paradox can probably be explained by men overestimating their sleep quality as they’re less able to perceive how often they wake up at night.

A total of 238 randomly selected women participated in the study, plus 238 men who were matched on age and BMI with the women to ensure similar participants were compared against each other.

Sleep was recorded in each participant’s home using a recorder that measured brain waves (electroencephalography – EEG), muscle tension (electromyography – EMG) and eye movements (electrooculography – EOG). These devices tracked what stage of sleep a participant was in and for how long, how much time they spent awake and how quickly they fell asleep.

A researcher visited the participant’s home in the evening, mounted the recording equipment and left. The participant went to bed and awoke at their usual time.

In the morning, the participant rated the degree of difficulty they had falling asleep, if their sleep was restless, if they woke up early, how often they thought they’d woken up, how long it took them to fall asleep, how long they slept and their overall sleep quality.

The sleep recording was scored by a sleep technician based on visual inspection of the EEG, EOG and EMG recordings. The data was then analysed to understand the objective quality of each participant’s sleep and its relation to gender and age.

Analyses were also adjusted for factors such as gender, age and alcohol consumption and smoking, which may affect sleep.

Sleep quality

The results show that women subjectively reported significantly lower sleep quality than men. Yet women actually had considerably fewer nighttime awakenings, less stage one (superficial) sleep and higher sleep efficiency (they spent more time asleep while in bed). Women also experienced more stage three (deep) sleep and slept longer (400 minutes versus 382 minutes for men).

When women did wake up at night, they spent more time awake on average. Photo by Cottonbro on Pexels

The results suggest that women objectively had a good nights’ sleep, compared to men. The only variable that suggests worse sleep in women was that when they did wake up at night, they spent more time awake than men did – around nine minutes each time for women versus just under seven minutes for men.

It only takes around five minutes of being awake at night for a person to remember it the next morning. This may explain why women were better able to remember if they’d woken up the night before and estimate how many times they had. Men, on the other hand, grossly underestimated their number of awakenings (by 72% compared to women’s 37%).

For other quantitative measures, like time to fall asleep, sleep duration and time awake, men and women were equally good at estimating their objective values. And they were relatively correct.

We took this further and found that men who only woke up for a short period of time during the night (around eight minutes or so each time they woke up) often didn’t remember they had.

When this group of men was removed, no gender difference in subjective sleep quality remained. This suggests that men with short nighttime awakenings report better sleep quality than would be expected from their objective sleep measures as they didn’t remember they’d woken up.

It’s also noteworthy that men’s objective sleep deteriorated faster with age than women. This was particularly obvious for stage three sleep. While women aged over 65 got around 80 minutes of stage three sleep each night, men had only 53 minutes. Among those between 30 and 50 years of age, the amount was similar for men and women (around 70 minutes).

Sleep and wellbeing

A key reason women may complain of having a worse nights’ sleep than they objectively had may therefore be the amount of time they spent awake when they woke up, making it easier for them to notice. Likewise, men may overestimate their sleep quality because they’ve spent less time awake when they’ve woken up, so they don’t remember it happening.

Both findings would work towards reducing subjective sleep quality in women and increasing it in men. We assume then, that the experience of awakenings has an important influence on subjective sleep quality.

As our study was only conducted over one night, it will be important for future research to investigate whether these findings remain when participants are studied over longer periods of time.

Future studies may also want to explore the reasons for poor sleep in men – especially since common sources of disturbed sleep, such as alcohol, smoking and BMI, were all adjusted for in our analysis. Researchers may also want to investigate why men’s sleep becomes objectively worse as they get older.

Our research illustrates how sleep quality doesn’t just involve the physiological aspects of sleep. It also includes our own subjective experiences, which can impact our wellbeing and how rested we feel.

It also suggests that because many men overestimate their sleep quality, they may also overlook any sleep problems they’re experiencing. This could mean that some men aren’t getting help for conditions that could be affecting their health and wellbeing.

Torbjörn Åkerstedt, Senior Professor of Psychology, Department of Clinical Neuroscience, Karolinska Institutet

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

Categories : Mental Health Metabolic DisordersTags :

Can the Use of GLP-1RAs Reduce Behaviours Linked to Violent Crime?

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Photo by Maxim Hopman on Unsplash

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for diabetes and obesity, but studies have found evidence that the medications may also influence behaviour, such as supporting impulse control and reducing substance use and alcohol consumption by potentially interacting with the brain’s reward and stress systems. New research in Criminology adds to this growing evidence.

When investigators analysed data from a 2025 nationally representative US survey involving 821 adults who had ever used GLP-1 medications, they found that while impulsivity and alcohol use were strongly associated with committing violent crime, these associations were significantly weaker among current GLP-1 RA users compared with former users. So even when a GLP-1 RA user drinks or acts impulsively, the situation is less likely to escalate into engaging in violent criminality. More thorough analyses showed that this finding was especially consistent related to impulsivity, but less so with alcohol use.

The findings suggest that GLP-1 RAs may lessen the extent to which certain established risk factors translate into violent behavior.

“As GLP-1 medications become increasingly widespread, understanding their broader behavioral effects becomes an important public health and criminological question that requires careful study,” said corresponding author Daniel C. Semenza, PhD, of Rutgers University.

Source: Wiley

Categories : Neurodegenerative DiseasesTags :

Before the Memory Fades: Scientists Discover a Potential Early Warning Sign of Alzheimer’s

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New research suggests Alzheimer’s disease may affect the brain’s ability to adapt before memory problems become obvious, offering clues for earlier interventions.

Created with Gencraft. CC4.0

When most people think about Alzheimer’s disease, memory loss is usually the first thing that comes to mind. Forgetting a loved one’s name, missing appointments or repeatedly misplacing everyday items are often considered early warning signs.

But what if the disease begins affecting the brain long before memory problems become noticeable? New research from scientists at Texas A&M Health suggests that another change in brain function may appear even earlier: difficulty adapting when circumstances change.

In a recent study, researchers found that animal models with Alzheimer’s-related brain changes developed problems with cognitive flexibility months before they showed signs of memory impairment. Cognitive flexibility refers to the brain’s ability to adjust behavior, learn new rules and adapt when situations change.

“We found that this function was impaired before we could detect deficits in spatial memory,” said neuroscientist Jun Wang, PhD, professor in the Texas A&M University Naresh K. Vashisht College of Medicine at Texas A&M Health.

The findings suggest memory loss is not always the earliest sign of Alzheimer’s disease. Instead, they suggest that by the time memory problems become noticeable, disease-related brain changes may already be underway. Paying attention to earlier changes in executive function may provide additional clues about the earliest stages of the disease.

Testing the brain’s ability to adapt

To investigate these early changes, researchers used a widely studied animal model of Alzheimer’s disease known as 5xFAD. These models develop amyloid-beta plaques, one of the key features found in the brain of humans with Alzheimer’s disease.

The research team focused on measuring cognitive flexibility through a method called reversal learning. In this type of test, animal models first learn that a particular action leads to a reward. Once that association is established, researchers change the rules and reward a different action instead.

Healthy animal models quickly adjusted and learned the new rule. 5xFAD models struggled to adapt, continuing to follow the original rule even after it no longer led to a reward. What made the finding particularly significant was that although they struggled to adapt to change, the animal models still performed normally on tests of spatial memory, which is the ability to remember where things are and helps us navigate our surroundings.

A hyperactive brain circuit

 The researchers then discovered abnormally high activity in the medial prefrontal cortex, the region involved in decision-making, behavioral flexibility and goal-directed actions. This hyperactivity extended through a network connecting the prefrontal cortex and the striatum, two brain regions that work together to help people adjust their behaviour when circumstances change.

The team also found reduced activity in a specialised group of brain cells called cholinergic interneurons. These cells play an important role in learning and behavioral adaptation, and their decreased activity closely matched the cognitive flexibility deficits observed in the animal models.

Together, the findings suggest that Alzheimer’s disease may affect neural circuits involved in executive function and adaptability before causing noticeable memory problems.

Breaking a harmful cycle

Scientists have known that amyloid-beta production increases when neurons are highly active. At the same time, amyloid-beta can make neurons even more excitable. This creates a potentially harmful cycle in which increased brain activity promotes amyloid accumulation, which then drives even more activity.

Wang describes this cycle as a “chicken-and-egg” problem. To test whether breaking this cycle could help, the researchers used a targeted approach to quiet the overactive brain pathway. The method worked like a temporary “dimmer switch,” allowing the team to reduce the activity of selected brain cells in the front part of the brain that send signals to the striatum, a region involved in flexible behaviour.

The intervention improved cognitive flexibility, restored more normal patterns of brain activity and reduced amyloid-beta accumulation. The benefits persisted after treatment ended, suggesting lasting changes within the affected neural circuits.

Implications for Alzheimer’s research

Although the study was conducted in animal models and further research is needed to determine whether the same pattern occurs in humans, the findings point to a promising new direction for Alzheimer’s research and potential future treatments.

Rather than focusing exclusively on memory loss, scientists may need to pay closer attention to early changes in cognitive flexibility and executive function that may provide clues that Alzheimer’s-related changes are already underway. The findings also suggest that abnormal brain activity may be more than just a consequence of the disease. Reducing activity in the overactive brain circuit improved cognitive flexibility and reduced amyloid-beta accumulation, suggesting that targeting these neural networks could help slow disease progression.

Wang is hopeful that if future research confirms these findings, cognitive flexibility tests could potentially complement existing diagnostic evaluations. That may help identify people at earlier stages of the disease, perhaps years before more obvious memory symptoms appear.

“One thing that most people in the field agree on is that early diagnosis is extremely important,” Wang said. “Alzheimer’s disease is progressive. Neurons continue to degenerate over time. If we can identify the disease earlier, then treatment has a much better chance of helping.”

Source: Texas A&M University

Categories : Expert Opinion Lab Tests and ImagingTags :

Provinces Owe the NHLS Billions, Patients Could Pay the Price. It’s Time to Crack the Whip

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Through its countrywide network of quality-assured diagnostic laboratories, the NHLS is the sole provider of diagnostic pathology services to over 80% of the South African population. Photo by National Cancer Institute on Unsplash

Comment & Analysis

By Faith Muthambi

Provincial debt to the National Health Laboratory Service is not just a financial governance matter, but also a public healthcare service delivery risk that affects diagnoses, treatment, disease surveillance, and government’s ability to protect vulnerable patients, writes Faith Muthambi, chairperson of the Portfolio Committee on Health in the National Assembly.

When *Lungile Mbonambi, a hypothetical healthcare user, waits for a blood test at a public hospital, she is not thinking about all the zeros in provincial budgets or intergovernmental disputes. She is thinking about her health. Like some 80% of people in South Africa, she places her trust in the public healthcare system, the inner workings of which she will never see, and in laboratory professionals she will likely never meet. However, in using the system, she experiences its impact.

For her blood test, a nurse will draw the sample, seal the vial and send it to the closest National Health Laboratory Service (NHLS) facility. For patients, waiting for the results often feels uneasy and ridden with dread. In addition to the immediate health concern, patients also find themselves in the hands of a system that needs to function well, not only on paper and in policy, but also in the concrete reality of their particular case.

The NHLS plays a big role in public health in South Africa through epidemiology, surveillance and responding to public health outbreaks. Among other things, it is involved in HIV and TB programmes, conducting diagnostic tests for non-communicable diseases, and the screening for cervical cancer. In essence, contemporary healthcare would grind to a halt without the robust laboratory infrastructure that the NHLS provides.

Ballooning debt

Just recently at the end of May, the Portfolio Committee on Health in Parliament, which is tasked with overseeing the National Department of Health, met with representatives from the NHLS and all nine provincial health departments. The meeting revealed that outstanding debt to the NHLS had climbed to an imposing R11 billion as of March this year. Most of this debt stemmed from KwaZulu-Natal with around R3.94 billion, and Gauteng with roughly R3.3 billion, both of which include debt from previous years.

This meeting confirmed what many in the public health system have warned about for years. This outstanding debt is not merely a matter of the numbers not adding up, but is symptomatic of a serious failure in financial governance. Failing to pay or delaying payments for critical services already rendered to the public health system also reflects poor coordination among government departments and entities.

The consequences of this can be dire.

For the NHLS, without these funds, the institution cannot sustain research, do proper disease surveillance, detect outbreaks or monitor antimicrobial resistance, or upgrade equipment. When a laboratory cannot replace ageing instruments on time, fill critical posts, modernise information technology or plan procurement with certainty, it is felt in hospitals and clinics.

For patients, it means delayed diagnoses and disrupted care, and those living in rural and under-resourced communities often bear the brunt.

Time to act

Listening to presentations from all nine provincial health departments showed that this crisis can be prevented. There are provinces that are getting this right and paying their invoices to the NHLS within the required 30-day period. This shows that, even with budget constraints, laboratory services can be prioritised.

As Chairperson of the Portfolio Committee on Health, I have made it clear that it is now time to shift our oversight from concern to action that leads to actual consequences for those provinces that fail to pay their NHLS debts.

There had been instances in the past where National Treasury intervened by withholding or redirecting funds when provinces failed to fulfil their responsibilities. The committee may need to engage the National Treasury on ways to protect funding for laboratory services, including the possibility of direct transfers or ring-fenced funding where provinces fail to prioritise their obligations to the NHLS. The message is clear: We cannot allow a situation in which a province destabilises another public institution by failing to pay for services central to healthcare provision.

Our next step cannot be to just accept more vague commitments and assurances that the debt will be paid. Provinces with outstanding debt must provide clear repayment plans linked to strict timelines, while continuing to pay current invoices within the required period. The committee will request quarterly progress reports on payments made to reduce the debt, as well as on actions taken against officials involved in this non-payment.

We live in an era marked by emerging health threats and increasing demands on health services. It is therefore important to remind ourselves that health systems do not collapse overnight. They deteriorate gradually through deferred payments and normalised delays, among other things. By the time patients experience the full impact, the horse may have already bolted because we ignored the warning signs.

To be clear – this, here, is a serious warning sign.

Yet notwithstanding these pressures, laboratory professionals continue to demonstrate extraordinary commitment. Samples are being processed, and results are verified. I commend these public servants who work beyond ordinary expectations to protect the service. However, we cannot bank on this devotion to become a permanent substitute for responsible governance.

The decision before us is whether we allow patients’ experience of the public health value chain between health facilities and NHLS laboratories to continue to be determined by delay and uncertainty, or by a public health system that understands the seriousness of its responsibilities and acts accordingly.

Patients like Mbonambi are placing their trust in the state. We must do better.

*Muthambi is a Member of the National Assembly and Chairperson of the Portfolio Committee on Health.

Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

Categories : Metabolic Disorders PaediatricsTags :

Link Between Parents’ and Children’s Weight is Mostly Genetic, Study Finds

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An analysis of 86 000 Norwegian children found that the association between parental and childhood body weight is largely explained by shared genetics

AI image created with Gencraft

The association between parents’ body mass index (BMI) and their children’s childhood BMI may be primarily due to genetic inheritance rather than to any direct biological effect of parental weight during pregnancy, according to a new study published June 23rdin the open access journal PLOS Medicine by Tom Bond of the University of Bristol, UK, and colleagues from the University of Queensland, Australia and more.

Higher parental BMI is consistently associated with higher childhood BMI. It has been difficult for researchers to disentangle how much of this association is due to genetics and how much is due to biological effects of maternal weight during pregnancy. This may have implications for interventions that aim to control childhood BMI by targeting pre-conception parental weight.

In the new study, researchers analysed data from the Norwegian Mother, Father and Child Cohort Study, a prospective birth cohort of children born between 1999 and 2009. Data on 86 000 children, including their birth weight and BMI from six months to eight years of age, as well as appetite-related eating behaviours at age eight, was available in the dataset. The researchers looked at twin, sibling, and half-sibling relationships across multiple generations to directly quantify how much of the parent-child BMI association could be attributed to genetic confounding.

Maternal BMI was more strongly associated with offspring birth weight than paternal BMI, consistent with an effect of maternal body weight on birthweight through the environment inside the uterus. However, after birth the associations of maternal and paternal BMI with offspring BMI were broadly similar from age two to eight. Models showed that genetic effects explained an estimated 79% of the statistical association between a mother’s BMI and her child’s BMI at age 8, and 94% of the association for fathers. Higher parental BMI was also associated with obesity-related eating behaviours in children, including greater food responsiveness and emotional overeating, although the study was not able to conclusively determine how much of this was genetically driven.

The authors caution that these findings do not support the idea that childhood obesity is inevitable for children of heavier parents. Children who inherit a genetic predisposition to higher BMI may still express those genes differently depending on their environment. The results also do not argue against the importance of maternal health in pregnancy, the authors say. Maternal obesity is well established to increase risk of adverse perinatal outcomes for both mother and child.

“Our results may have important public health implications, when considered alongside prior evidence,” they write. “Maternal BMI may be unlikely to have a large causal effect on child BMI beyond birth… and any causal effect of paternal BMI on offspring childhood BMI is likely to be similar to or smaller than that of maternal BMI. Consequently, reductions in the BMI of either parent before pregnancy may be unlikely to cause large reductions in childhood adiposity.”

Tom Bond states, “Obesity runs in families, but it is difficult to work out why this is. Our results suggest that the link between a mother’s or father’s body mass index (BMI) and their children’s BMI up to age 8 is mostly due to inherited genes. Expectant parents should be encouraged to maintain a healthy weight, but this may not be enough to ensure that their children also have a healthy weight.”

David Evans notes, “We were interested in examining whether obesity in mothers during pregnancy might also have adverse effects on the risk of obesity in their offspring when the children get older. We found that whilst maternal body mass index during pregnancy was likely to adversely affect offspring birthweight, it didn’t appear to have large effects on risk of offspring obesity in later life beyond that explained through the transmission of genes from mothers to their offspring.”

Alexandra Havdahl adds, “Our findings suggest that the link between parents’ and children’s body mass index is driven largely by shared genes rather than by the intrauterine environment or parenting behaviour.”

Provided by PLOS

Categories : Injury & TraumaTags :

High-dose IV Vitamin C May Lower Risks of Death and Sepsis in Trauma Patients

On By ModernMedia

Biologically plausible, but more rigorous research needed before it can be recommended

Photo by Furkan İnce

High doses of intravenous (IV) vitamin C may lower the risks of death and sepsis in trauma patients, as well as shortening hospital stay, suggests a review of the available evidence published online in the journal BMJ Military Health.

Although its effects are biologically plausible, especially given its role in aiding tissue repair and recovery, among other things, the quality of the available evidence isn’t currently good enough to recommend the use of vitamin C in trauma patients, say the researchers.

Major trauma triggers a complex physiological response in those affected and carries a high risk of death. And vitamin C, which helps to boost blood pressure, regulate the vital interface between blood and tissues (endothelial function), and neutralise harmful free radicals, is rapidly depleted in critical illness, explain the researchers.

As such, vitamin C has been mooted as a potentially promising treatment to aid the recovery of trauma patients, including in the context of the war in Ukraine. But this approach is yet to be rigorously reviewed or formally implemented, they add.

In a bid to extend the evidence base, the researchers scoured research databases for relevant published studies on high dose IV vitamin C, published up to the end of 2025.

They focused on its impact on death within 30 days of hospital discharge; prognostic scoring systems (Apache II, SOFA); incidence of complications, including sepsis and organ failure; and length of hospital stay.

Out of an initial haul of 108 studies, six, involving a total of 5171 patients, were eligible for systematic review. Three studies were randomised controlled clinical trials; 3 were observational studies.

The included studies reported a significant reduction in 30 day mortality, with significantly shorter intensive care unit and hospital stays. And 4 studies showed lower rates of sepsis in patients receiving vitamin C; 2 found lower rates of multi-organ failure.

“Overall, our findings demonstrate evidence of possible benefit in using high-dose vitamin C in the management of trauma patients,” but the variation in the reported effects “suggests that treatment effects may be context-dependent rather than generalisable across all critical illnesses,” write the researchers.

And they highlight several limitations to their findings: namely, the small number of studies, half of which were observational; and differences in patient groups, methodology, dosing regimens, co-interventions and outcome reporting.

“As our included studies did not use IV vitamin C monotherapy, we cannot truly associate our results with vitamin C alone. No studies investigated the timing of vitamin C, and therefore the optimal timing to administer vitamin C remains unclear.

“These methodological constraints limit the ability to draw firm conclusions about the optimal treatment protocols to use the potential benefits of vitamin C and contribute to the low certainty of evidence identified in this review,” they add.

But they suggest: “Even slight reductions in mortality, sepsis, organ failure or critical care requirement could be used to consider its use in current operational settings, providing a clear rationale for future trauma-specific research before clinical adoption.”

Source: The BMJ Group