People with autism spectrum disorder (ASD) in the United States face a 14-year deficit in life expectancy, finds a study published in JAMA Network Open. The study provides one of the first large-scale estimates of age-specific death rates and life expectancy among people with ASD.
Autism research has historically focused on biology, genetics, environmental risk factors, and diagnosis, with less attention to long-term health outcomes, crucial for understanding the natural history of the disorder and for developing intervention programs. The new findings, from researchers at Columbia University Mailman School of Public Health and the University of Colorado Anschutz, highlight substantial disparities in life expectancy and identify causes of excess mortality that may be preventable.
“Autism is a complex lifelong condition with substantial costs to the US healthcare system,” said Guohua Li, DrPH, MD, professor of Epidemiology at Columbia Mailman School. “Elevated mortality risk in people with ASD has been reported since the late 1980s, but life expectancy for the autistic population remained unknown because of inadequate data on age-specific death rates.”
To examine life expectancy and causes of excess mortality, the researchers analysed data from the Transformed Medicaid Statistical Information System and Children’s Health Insurance Program Statistical Information System. The enhanced Medicaid data include mortality information linked to the National Death Index for beneficiaries in all 50 states and the District of Columbia from 2000 through 2020.
During the 21-year study period, 2 048 046 individuals with ASD were enrolled in Medicaid. Of these, 76 percent were male; 49 percent were non-Hispanic White, 15 percent were non-Hispanic Black, and 17 percent were Hispanic. A total of 18 268 Medicaid beneficiaries with ASD died between 2000 and 2020.
Life expectancy at birth for Medicaid beneficiaries with ASD was 64.9 years –5.6 years shorter than for the overall Medicaid population and 13.8 years shorter than for the U.S. general population. Estimates were broadly similar across sex and racial and ethnic groups, although the gap relative to the general population was greater for women than for men.
Life expectancy among Medicaid beneficiaries with ASD increased by 1.7 years during the study period, from 63.9 years in 2000–2004 to 65.6 years in 2015–2019. However, the gap compared with both the broader Medicaid population and the U.S. general population persisted.
Medicaid beneficiaries with ASD had a 44 percent higher mortality risk than other Medicaid beneficiaries. Excess mortality occurred across most categories of diseases and health conditions, with particularly heightened risk from influenza, malnutrition, pneumonitis, non-transport accidents, drowning, and pneumonia.
The researchers also found that, compared with the general population, autistic women experienced a greater life expectancy deficit than autistic men, largely associated with higher rates of psychiatric comorbidities and related excess mortality.
“Life expectancy for the autistic population enrolled in Medicaid in the United States is about 65 years, which is the same as for the general population in Haiti or Angola,” said Carolyn DiGuiseppi, MD, PhD, professor of epidemiology at Colorado School of Public Health. “This finding is sobering.”
“The good news is that much of the excess mortality among people with ASD is avoidable through improved social support, primary care, and home- and community-based services,” Said Li, who is also professor of anaesthesiology at Vagelos College of Physicians and Surgeons.
For some South Africans, the beginning of the flower season is met not with the joys of spring but rather with a sniffy nose, itchy eyes and a cacophony of sneezing.
In South Africa, allergic rhinitis (hayfever) affects an estimated 20% to 30% of the population – children and adults. Asthma affects around 20% of children and 10% of adults. Air pollution can worsen asthma and eczema symptoms and cause eczema.
Most people recognise that pollen, despite being invisible to the naked eye, is a dominant airborne allergen driving conditions like hayfever. Sufferers are acutely aware that pollen in the air changes seasonally, depending on what is flowering.
But South Africans still know too little about when pollen seasons begin and end, or how they differ across the country. This is because there’s been very little consistent, long-term pollen monitoring. Without local records showing when different plants release pollen, it’s hard for doctors to identify what is causing a patient’s allergy. People with allergies are also left guessing when to start taking medicines that could prevent their symptoms.
Now, a pioneering scientific initiative is changing that. The South African Pollen Monitoring Network, set up seven years ago, sourced equipment and built research teams in different cities. The network has now produced South Africa’s first five-year pollen calendars for several different natural regions. These calendars show which plants release pollen in each region, when they release it and how pollen levels change during the year.
Previously, pollen was measured in only a few African cities, and researchers used different methods, making it difficult to compare the results. The new network uses the same method to collect pollen from the air at all its sites. However, many pollen grains look so similar that scientists can identify only the plant family, such as grasses, rather than the exact species.
The network covered inland grassland sites in Johannesburg and Bloemfontein, and savanna sites in Pretoria and Kimberley. Its coastal sites represented fynbos in Cape Town, the Indian Ocean coastal belt in Durban and Albany thicket in Gqeberha.
We are medical and environmental researchers who have studied pollen for more than 50 years collectively. Together with MSc candidate Yolanda Makgale, we formed a team that constructed these pollen calendars.
We found that grass was the most common pollen everywhere, Bloemfontein had the highest overall pollen levels, Johannesburg had the most tree pollen, and Kimberley the most grass pollen.
This research is important because these calendars could help doctors diagnose and manage allergies and support warnings about periods of high pollen exposure.
The pollen causing allergies in inland cities
Over five years, South African Pollen Monitoring Network researchers identified 103 types of pollen across seven South African cities. Grass produced the most pollen and was the main cause of pollen allergies. Inland cities had much higher pollen levels than coastal cities, and their grass pollen seasons lasted for more than 200 days a year.
Bloemfontein (grassland biome): highest total amount of pollen recorded over a year, mainly because of its high levels of grass and tree pollen. Grass released pollen for an average of 246 days each year – about eight months.
Kimberley (savanna biome): highest average concentration of grass pollen, with an open, grassy landscape and a grass season lasting, on average, 247 days a year.
Johannesburg (grassland biome): highest average tree pollen, probably due to its large “urban forest” of planted exotic trees.
Pretoria (savanna biome): high tree pollen counts, dominated by the exotic Morus (mulberry) tree, which contributed 25% to the total pollen catch.
Coastal cities
In contrast to the inland cities, coastal cities recorded lower overall pollen loads and shorter grass seasons, often under 100 days a year. This difference is likely due to coastal rainfall washing the pollen out of the atmosphere, combined with strong coastal winds.
Cape Town (fynbos biome): the longest tree pollen season in the country, lasting 297 days a year, starting early in July. The pollen profile is dominated by exotic trees, with Cupressaceae (cypress) accounting for 30% of the five-year average, followed by Myrtaceae (eucalyptus) at 11%, and Pinus (pine) at 9%.
Durban (Indian Ocean coastal belt): low overall pollen catch, with the shortest grass season in the study, lasting just 71 days and starting late in summer.
Gqeberha (Albany thicket biome): lowest overall annual pollen load among all seven cities, alongside the shortest tree (116 days) and grass (92 days) seasons.
Climate change impact on pollen allergies
Between 2019-2021 and 2022-2024, pollen levels fell across most regions. Grass pollen nearly halved, while tree pollen doubled in inland cities. Researchers now need to examine whether rainfall, weather, flowering seasons or changes in land use caused this shift.
Climate change may play a part by changing pollen levels and seasons. It can also increase the risk of “thunderstorm asthma”. During some storms, moisture bursts grass pollen into tiny pieces that winds push towards the ground. When inhaled, they can cause sudden and dangerous asthma attacks.
What this means for allergic patients
For people suffering from hay fever or asthma, calendars tailored to South Africa’s specific regions can act as an early warning system. Knowing exactly when pollen season starts lets patients begin preventive treatments, such as antihistamines or nasal sprays, before their symptoms start.
The new data revealed surprising allergy triggers. For instance, birch tree pollen, a major cause of hay fever in the northern hemisphere, was detected across South Africa where it is an ornamental, non-indigenous tree planted in gardens.
The general public may underestimate the dominant role of exotic trees in driving pollen load in big cities like Cape Town, Johannesburg and Pretoria. This finding should feed into decisions about what to plant.
What needs to happen next
Five years of pollen data show why year-round monitoring matters for public health. Researchers want to extend monitoring into rural areas and include pollen warnings in the national health system. They also hope to use DNA testing to identify allergy-causing plants that look identical under a microscope.
For now, the calendars help South Africans see which pollen is in the air, when levels are highest and when they may need to take precautions.
Funding came from Wellcome Trust (grant number: 311673), Cipla, Twinsaver, UCT Lung Institute Postdoctoral Research Fellow Award, a CSIR Parliamentary Grant, Novartis, University of Cape Town, Thermo Fisher Scientific, Clicks, Glenmark Pharmaceuticals, Dr Reddy’s, SA Natural Products, and Zeiss Africa.
A recent BBC report described women posing as men to get hold of testosterone gel, hoping to improve their menopause symptoms, because female testosterone products are not easily available to them. But why is the appetite for this predominantly male hormone exploding and are there risks involved?
Testosterone is usually thought of as the defining male hormone. It is linked to puberty, muscle development and reproductive function. But this overlooks an important biological reality. Women also produce testosterone, and it plays important roles throughout the body.
Although blood concentrations are typically about ten to 15 times lower than in men, testosterone remains biologically active in women.
Women make testosterone in their ovaries and adrenal glands, and the body also makes it by changing other hormones in fat, skin and muscle. Some of this testosterone is then used to make oestradiol, the main form of oestrogen in women of reproductive age.
But testosterone is not simply an oestrogen reservoir. It also acts directly on tissues throughout the body, including the bones, muscles, heart and blood vessels, and the brain. This has led researchers to look more closely at how testosterone may affect women’s health.
Similar to men, testosterone declines gradually across the reproductive lifespan, although patterns vary between individuals. This fall begins well before menopause, and unlike oestrogen, it doesn’t fall sharply at menopause as the ovaries decline.
Measuring how far it’s fallen is its own problem. Female levels are so low that routine blood tests have historically struggled to measure them reliably, making it hard to precisely define “normal” concentrations.
So why are increasing numbers of women interested in testosterone therapy after menopause?
What the evidence says
Because testosterone is known to influence sexual desire, one of its most studied uses in women is for hypoactive sexual desire disorder (HSDD) – persistent low sexual desire that causes distress.
A 2019 meta-analysis of 36 randomised trials found that carefully dosed testosterone can improve sexual desire and satisfaction in some postmenopausal women. International clinical guidelines recognise testosterone therapy as an evidence-based treatment for HSDD, the only condition in women for which there is enough clinical evidence to recommend testosterone therapy.
Sexual desire is shaped by relationships, stress, fatigue and mental health as much as by any single hormone. Testosterone is one input among several rather than a master switch.
Beyond sexual desire, high-quality clinical trial evidence in women is largely absent. But this does not necessarily mean testosterone has no broader influence on women’s health.
Randomised trials are the best way to establish whether a treatment causes a particular effect, but they cannot capture everything that happens in everyday medical practice. Patients may have other health problems or take several medicines, making it harder to know whether an improvement is due to testosterone or something else.
Testosterone is not a replacement for standard menopause hormone therapy. When it is prescribed, it is usually alongside oestrogen – and sometimes progesterone. Some women report that even after their conventional HRT (hormone replacement therapy) has been optimised, they still do not feel that their symptoms are fully addressed, and that adding testosterone makes a noticeable difference.
Women and doctors using testosterone in routine menopause care report improvements beyond sexual function. A recent UK study of 510 women at a specialist menopause clinic found that after four months on testosterone gel, women reported improvements in mood, cognitive symptoms and libido. These findings are interesting, but do not prove that the testosterone treatment caused these changes.
Real-world evidence should not replace randomised trials, but neither should the absence of large trials mean that these observations be simply dismissed. Instead, they can help identify effects worth testing in the clinical trials that are still needed.
A market that’s only just catching up
The evidence for using testosterone in women is strongest for sexual desire, but products made specifically for women have been much slower to arrive. In the US, for example, there’s still no approved testosterone product for women.
Of the three major sex hormones produced by the ovaries, oestrogen and progesterone have widely licensed products for women. Testosterone has been much slower to follow, with female-specific products still limited in many countries. This is despite evidence that testosterone can be used safely in women when given at doses designed to keep levels within the physiological female range.
International guidelines have recognised the lack of suitable products for women and called for testosterone treatments designed specifically for them. The issue is now receiving attention from regulators. In September 2026, the US Food and Drug Administration held a public workshop examining evidence gaps and the need for future drug development in this area.
Australia has led the way with Androfeme, a testosterone cream, being formally registered in 2020, specifically for female use. The UK granted it a marketing authorisation in July 2025, but it is not yet routinely available through the NHS.
The workaround has been men’s gel, measuring out a tenth of a sachet by eye. This is a less precise way to deliver a hormone for which the therapeutic dose is so small. If too much is applied, testosterone can rise above the desired range, increasing the likelihood of side-effects, such as acne and increased facial or body hair.
More importantly, evidence on the long-term safety of testosterone in women remains limited, particularly for heart disease, stroke and breast cancer, because trials have generally been short and often excluded women at higher risk of these conditions.
Demand continues to climb despite these uncertainties. NHS prescriptions to women in England rose roughly tenfold between 2015 and 2022, and in the US, testosterone prescribing has almost tripled over the past decade. The need for licensed female-specific testosterone products cannot be ignored, not just to improve access but to allow testosterone in women to be studied with the same scientific rigour it deserves.
Excitement builds ahead of the 2026 Hollard Daredevil Run
The countdown is officially on! There are only a few weeks to go until streets around Mzansi are awash with purple, and the excitement is mounting. Friday 23 October sees the 2026 Hollard Daredevil Run take place at Zoo Lake in Johannesburg and at various locations countrywide.
This annual initiative, which this year carries the bold tagline “Lekker Balls. Lekker Life”, raises much-needed awareness about prostate and testicular cancers and reinforces the potentially life-saving importance of early detection. Over the last seventeen years, the support from Daredevils across South Africa, and beyond, has been nothing short of incredible. It is also the sense of brotherhood and shared purpose that keeps Daredevils coming back.
The Hollard Daredevil Run is highly visible, with participants running 5km in a purple speedo, but its real purpose is getting South African men and their families talking about prostate and testicular cancers, understanding their risks and taking action through early detection.
“We know that thousands of men running in purple speedos gets people’s attention. What matters is what we do with that attention,” says Adél Kriel, Hollard South Africa’s Head of Experiential Marketing. “There is bravery in putting on a purple speedo in public, but behind this bold campaign is a very serious message: Know your risks, know your body and don’t put off getting checked. It could save your life.”
The more men who participate, the greater the funds raised for CANSA and the Prostate Cancer Foundation (PCF) to fund awareness campaigns, Prostate-Specific Antigen (PSA) screening and patient support.
The 2026 Hollard Daredevil Run takes place at Zoo Lake in Johannesburg on Friday, 23 October at 15:00, with runs happening at various locations across the country on the same day. Details of run locations around the country will be shared on the Daredevil Run social media platforms.
Purple speedos are being snapped up fast, but there’s still time to secure your entry. Get your colleagues, friends, fellow students and family members to participate in the run as well as raising funds, and start a conversation about men’s health. After all, the Hollard Daredevil Run has always been about much more than the finish line.
“This October, purple is more than a colour. It’s a conversation starter, but its real impact comes when that conversation extends beyond race day into families, workplaces and communities. The more people who take part, the further that message can reach,” says Kriel. “You don’t have to be a runner. You just have to be willing to show up for this important cause”.
Make a bold decision to make a difference by entering today at https://www.hollard.co.za/daredevilrun. Let’s make this year’s run the most impactful one yet.
About Hollard
The Hollard Insurance Group (“Hollard”) is South Africa’s largest privately owned insurance group. Hollard provides short-term, life insurance and investment products to a diverse customer base. Hollard through Hollard International has access to 10 markets across the continent namely South Africa, Botswana, Ghana, Lesotho, Mozambique, Namibia, Zambia, Kenya, Tanzania and Uganda.
For the first time, Northwestern scientists have identified a set of neurons that play a role in generating anxiety after exposure to cannabinoid drugs, especially under stressful conditions. Cannabinoids are a class of substances that includes THC, the main psychoactive ingredient in cannabis.
In the study, the scientists exposed mice to a threatening odor. Before being exposed to the scent, derived from fox urine, the mice either received a placebo or a synthetic cannabinoid drug.
When they received the drug, the mice froze more often and spent less time investigating the predator door. These anxious behaviours, the scientists found, were linked to the drug’s activation of a small group of cells — known as somatostatin neurons — in the brain’s central amygdala, a region that processes fear and stress.
Importantly, when the scientists genetically silenced these somatostatin neurons, the drugged mice did not avoid the predator scent as much anymore.
“The results of this study could explain why a good trip can turn bad pretty quickly if people consume too much cannabis or the situation they are in turns stressful or scary,” said study senior author Dr Sachin Patel, chair of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine.
The study appears in Nature Communications.
How the study was conducted
Patel and colleagues tested several doses of the synthetic cannabinoid on mice and tracked how much time they spent near the predator odor, and whether they froze or fled from the scent. To simultaneously record brain activity, the team implanted a small microscope into the mice’s brain.
The scientists also conducted brain tissue experiments to analyse how the cannabinoids affected interactions between neurons. They found that the drug weakened the brain’s natural “brake” on the somatostatin neurons, allowing them to become more active.
“Higher doses of cannabinoids and environmental stress worked together to synergistically release the ‘brake’ on the central amygdala, which in turn drove excessive anxiety,” Patel explained.
Why the findings matter
Cannabis use in the US has steadily increased in recent years and so have emergency department visits related to adverse effects from the drug. Previous studies have also found an association between cannabis use and increased risk of anxiety in the long term. What’s more, anxiety and mood disorders are also on the rise globally.
“Understanding how cannabis affects brain function to generate its psychoactive effects could ultimately reveal new ways to counteract negative consequences should they arise in some people,” Patel said.
Patel also noted that the findings could have implications beyond cannabis. “Suppressing the activity of somatostatin neurons in the central amygdala could represent a final pathway for reducing anxiety symptoms, not just in the context of cannabis side effects,” he explained.
For millions of people at risk of glaucoma, healthy eye pressure can mean the difference between preserving vision and losing it. Yet despite decades of research, scientists still do not fully understand what regulates daily changes in eye pressure or how those fluctuations may contribute to glaucoma. A series of three studies led by Christopher Passaglia, USF Health professor and associate chair in the Department of Medical Engineering, is helping fill in those gaps.
Recently published in Investigative Ophthalmology & Visual Science, Passaglia’s latest research, with USF alumna Alexandra Zamitalo serving as lead author, centres on a first-of-its-kind wireless eye-pressure monitoring system developed in his lab. The technology collects continuous measurements in rats, which share daily eye-pressure rhythms similar to those observed in humans.
Using the technology, researchers investigated how the body’s circadian rhythm may help regulate pressure inside the eye. This internal clock helps manage sleep, hormone production and other daily functions, with light serving as an important signal that keeps it synchronized.
No one was continuously measuring eye pressure until we figured out a way. It was then that we started seeing patterns that had largely been invisible before, providing one of the most detailed looks yet at the biological mechanisms that control eye pressure. This could eventually help researchers develop new approaches for understanding and treating glaucoma.
Christopher Passaglia USF Professor
Eye Pressure and the Body’s Circadian Rhythm
Most people think of eye pressure as a single number measured during an annual eye exam. But Passaglia notes that eye pressure constantly changes and follows a daily pattern linked to the body’s circadian rhythm.
“Researchers have known for years that eye pressure rises and falls over 24 hours,” Passaglia said. “The problem is that most measurements are taken when patients are awake and sitting in a doctor’s office. What happens while a person is sleeping is rarely captured.”
Passaglia’s monitoring device uses a miniature pressure sensor connected to the rat’s eye through a tiny tube, collecting data while the animals go about their normal activities. Unlike a traditional eye exam, which provides only a snapshot in time, the technology captures pressure changes throughout the day and night.
The measurements showed that eye pressure follows a daily rhythm, rising at night to levels that, if sustained continuously, are associated with glaucoma. Yet the animals do not develop the disease for reasons researchers do not yet fully understand. Researchers also found that the nighttime increase is driven by neural signals traveling from the brain to the eye. That suggests pressure is connected to the biological timing system that coordinates functions throughout the body, rather than being regulated solely within the eye.
“If you think about what the brain does, it’s constantly coordinating activities throughout the body,” Passaglia said. “What we’re showing is that eye pressure appears to be another one of those processes under that kind of control.”
Because elevated eye pressure is a major risk factor for glaucoma, understanding what drives those fluctuations could help researchers determine why some people develop the disease and how it progresses over time.
The Surprising Influence of Light
To test whether circadian rhythms influence eye pressure, researchers disrupted the animals’ normal light-dark cycle by exposing them to constant light.
We were actually surprised by how strong the effect was,” Passaglia said. “When we exposed them to constant light, the rhythm disappeared and mean pressure started climbing. That was a much stronger effect than we expected.”
The results suggest light may play a larger role in regulating eye pressure than researchers previously understood. While the studies were conducted in rats and do not suggest that everyday exposure to artificial light causes glaucoma, they provide further evidence that the eye is closely connected to the body’s internal clock and raises new questions about how disrupted light cycles may affect long-term eye health.
Pathway for Future Glaucoma Research
While the findings are not expected to immediately change how glaucoma is treated, identifying the neural pathways, chemical messengers and eye tissues involved in regulating eye pressure gives researchers a clearer picture of how the system works from the brain to the eye.
By revealing when and how circadian signals influence eye pressure, the research may help explain why some therapies work differently at different times of day and whether treatment timing could influence effectiveness.
“What we’re really trying to understand is the fundamental biology,” Passaglia said. “Once you understand the mechanism, then you can start thinking about better ways to intervene.”
Original written by Joey Garcia, University Communications and Marketing
Photo by Towfiqu barbhuiya: https://www.pexels.com/photo/bottle-with-pills-11361813/
Researchers and clinicians from Monash University and Bayside Health’s Melbourne Sexual Health Centre are trialling new combinations of antibiotics to treat persistent bacterial vaginosis (BV), following their landmark discovery that the condition is sexually transmissible.
Bacterial vaginosis is the most common vaginal condition among women of reproductive age and is caused by a loss of healthy vaginal bacteria and an overgrowth of other bacteria which upsets the natural balance of the vaginal microbiome.
The discovery reshaped international thinking on the condition and won this year’s Australian Infectious Diseases Research Centre Eureka Prize for Infectious Diseases Research.
Their latest study, published in The Lancet Obstetrics, Gynaecology & Women’s Health, builds on the original finding to reveal why some women continue to experience a repeat diagnosis of BV even when their male partners are treated concurrently, identifying two distinct pathways to repeat infection: re-infection and persistence of BV-bacteria.
Lead author Dr Lenka Vodstrcil, a Senior Research Fellow at Monash University and Bayside Health’s Melbourne Sexual Health Centre, said this has enabled them to work on tailoring treatments that will improve cure rates for millions of women worldwide.
“While partner treatment improves cure for most women in a monogamous relationship, there are some women who have persistent BV-bacteria that survive initial therapy before couples resume sex after treatment,” Dr Vodstrcil said.
“By identifying this early, we can intervene with more intensive female-focused treatments before the infection takes hold again.”
Senior author Vice-Chancellor’s Distinguished Professor Catriona Bradshaw, clinician scientist and Head of Research Translation and Mentorship at Monash University and Bayside Health’s Melbourne Sexual Health Centre, said the new approaches to treatment that are being trialed by her team include longer duration and new combinations of antibiotics designed to eradicate persistent BV-causing bacteria.
“Using partner-treatment to mitigate re-infection and more intensive strategies that target persistence of BV-bacteria, we hope to create more effective treatment approaches that can be tailored to an individual and achieve higher levels of cure for all women,” Professor Bradshaw said.
The robotic arm working in the hospital. Credit: Queen Mary University London
Two major studies involving researchers at Queen Mary University of London have found that robotic-assisted hip and knee replacement does not reduce the overall early risk of repeat surgery compared with conventional surgery.
Published in The BMJ, the studies analysed more than one million joint replacements recorded in the National Joint Registry between 2018 and 2024. Together, they provide the largest real-world evaluation to date of whether the greater technical precision offered by robotic-assisted surgery translates into better outcomes for patients.
Researchers from Queen Mary, the University of Oxford and the University of Bristol found that, although robotic technology is designed to help surgeons position joint implants more accurately, this did not translate into a lower overall early risk of repeat surgery following either hip or knee replacement.
In robotic-assisted joint replacement, the surgeon remains in control of the operation, using computer and robotic technology to help plan and guide the placement of the implant.
The findings come as the NHS plans a major expansion of robotic surgery, aiming to increase the number of robotic-assisted procedures sevenfold by 2035. Robotic systems require substantial investment, costing around £1 million to introduce and adding approximately £1,000 to £2,500 to the cost of each procedure.
In the hip replacement study, researchers found no overall reduction in repeat surgery or mortality associated with robotic surgery. However, robotic hip replacement was associated with a lower risk of further surgery for problems related to implant positioning. This specific benefit did not translate into an overall reduction in the need for repeat surgery.
For knee replacement, researchers found no difference in the risk of repeat surgery between robotic-assisted and conventional procedures.
The studies examined early outcomes, and the researchers say longer-term follow-up will be needed to establish whether differences in implant survival emerge over time.
The team used a method known as target trial emulation to analyse large-scale real-world registry data. The statistical approach aims to make comparisons between groups more closely resemble those of a clinical trial by balancing patients according to known differences in their characteristics.
Dr Hasan Mohammad, Academic Clinical Lecturer in Trauma and Orthopaedics at Queen Mary University of London and lead author, said:
“This study, which uses novel methodology and represents the largest real-world analysis of its kind worldwide, provides important independent evidence for patients, surgeons and policymakers at a time when robotic hip and knee replacement surgery is being adopted rapidly.
“New technology should deliver meaningful benefit for patients and represent good value for a publicly funded health service.”
A new review published in Sciencebrings together growing evidence that the X and Y chromosomes do much more than determining biological sex. They also shape how cells function, age and respond to disease.
Differences in health between men and women have long been attributed mainly to sex hormones such as estrogen and testosterone. However, genes on the X and Y chromosomes also play a direct role, working both on their own and alongside hormones.
The review was co-led by University of Arizona Cancer Center physician-scientist Dr. Dan Theodorescu and Dr. Dena B. Dubal of the University of California, San Francisco. It describes how sex chromosomes influence immunity, metabolism, brain aging, cancer and heart disease, and what this could mean for diagnosis, treatment and the design of clinical trials.
“X and Y chromosomes are often thought of as simple determinants for biological sex, but their role in human health is much larger,” said Theodorescu, one of the study’s corresponding authors and Nancy C. and Craig M. Berge Chair and Director of the Cancer Center. “Our review shows that these chromosomes carry genetic instructions that shape how our cells age and how our bodies defend against major diseases throughout our lives.”
The study shows that the genes on the X and Y chromosomes, rather than circulating hormone levels alone, determine disease risk, progression and therapeutic responses across key heath areas including aging, cancer, neurological conditions, immune system functions and cardiometabolic disease.
The review, which evaluated and synthesized existing evidence from human studies, mouse models and genomic technologies, describes several processes inside cells that shape health across the lifespan.
In women, one of the two X chromosomes is largely switched off early in development, but some of its genes stay active and others can switch back on with age, giving female cells extra doses of certain genes. Studies in mice suggest it also matters whether a cell’s active X came from the mother or the father. Men inherit their only X chromosome from their mother, while in women each cell uses either the mother’s or the father’s copy. In mice whose cells relied mostly on the mother’s X, faster brain aging and memory decline was observed.
With age, some cells lose a sex chromosome. In women, loss of an X is linked to higher leukemia risk, though its broader effects remain largely unknown. In men, loss of the Y, most often measured in blood, is linked to cancers, heart disease, severe infections and Alzheimer’s disease. The loss of these chromosomes is being explored as both a biomarker of and potential contributor to age-related disease.
“When we look inside human cells, we see that X and Y chromosomes are participants in health and disease throughout a person’s life,” said Theodorescu, who is also a professor at the U of A College of Medicine – Tucson. “In cancer, for example, our laboratory has found that tumors that lose the Y chromosome can evade the immune system, yet may respond better to immunotherapy. Understanding this biology could help us tailor treatment.”
The review originated from discussions at the 2025 National institute on Aging Workshop: Sex Differences Impacting Human Health Across the Lifespan, especially with Francesca Duncan of the Northwestern University Feinberg School of Medicine.
“Our hope is that this review will stimulate further investigation and bring greater awareness to the significant potential of studying the X and Y chromosomes in cancer and other diseases, with far-reaching diagnostic and therapeutic implications,” said Theodorescu. “This would help ensure that treatments and diagnostics are tailored to match every patient’s unique profile. When clinical trials are designed to be sex-aware, researchers can turn these cellular differences into personalized medical care.”
Theodorescu’s previous related research focused on how the loss of the Y chromosome in T cells and cancer cells in men gave tumors the ability to evade the immune system, providing an explanation why the loss of the chromosome has been linked to increased mortality from carcinomas. Other recent Theodorescu group research showed how loss of the Y chromosome in normal-appearing tissues acts as an early warning sign and may mark a hidden zone of genetic risk for cancer to develop.
Johannesburg, South Africa – 2 October 2026 – Bonitas Medical Fund unveiled its 2027 product range, signalling a bold step forward in preventive healthcare, improved wellness, personalised support and long-term sustainability within the open scheme market.
Lee Callakoppen, Principal Officer of Bonitas Medical Fund, says: “Healthcare in South Africa is evolving rapidly, and members need more than traditional medical aid cover. They need proactive support, personalised health journeys and meaningful value at every stage of life.”
“Our 2027 product offering and plan enhancements are designed to reflect our commitment to keeping healthcare accessible, affordable and relevant for all our members.”
Earlier detection, better health outcomes
Bonitas has made preventive healthcare a strategic priority for 2027.
“It’s important that members are both enabled and encouraged to identify potential health risks earlier through preventive assessments and screenings,” says Callakoppen.
To support this, Bonitas has expanded access to wellness screenings through a growing provider network that now includes Clicks, Dis-Chem and Medirite pharmacies, bringing basic wellness screening access closer to members across South Africa.
Around 95% of Bonitas members are located within 10km of a health risk assessment provider. With the expanded network, members now have access to more than 1 245 pharmacies nationwide for basic wellness screenings.
The enhancement responds to growing demand. In 2025, health and wellness assessments increased by 138.6% compared to the previous year.
To close the gap between screening and treatment, Bonitas is introducing a GP Confirmation Benefit in 2027. When a potential health risk is identified, eligible members will have access to a risk-funded GP consultation within 14 days of the wellness screening, removing financial barriers to follow-up care and supporting a more connected wellness journey.
Enhancing member experience through more rewards and everyday value
The Benefit Booster, a hallmark of Bonitas innovation, is being expanded by 140% for 2027, offering families up to R12 000 in additional value. For the first time, it will also be available on the BonCap income-based plan.
Complementing this is B-Value, Bonitas’ lifestyle and wellness platform. More than a rewards programme, B-Value supports wellbeing through expert guidance, practical tools and rewards across fitness, nutrition, financial health and stress management. With new partners including Takealot and Checkers Sixty60, members can unlock even more rewards, discounts and lifestyle benefits through healthier behaviours.
Stronger plans, better benefits
Bonitas continues to refine its product range to balance affordability and sustainability for its members. Key enhancements across the product range include improvements to BonPrime, updates to the Standard option and the introduction of a Dental Emergency Benefit on selected plans.
Together, these changes are designed to improve accessibility, affordability and member value while simplifying the healthcare experience.
Expanded support across the care journey
Bonitas continues to invest in proactive healthcare support through initiatives such as Live Lean, the Ocular Health Programme, enhanced rehabilitation support through the new Back, Neck, Shoulder and Knee Rehabilitation programme and expanded mental health services. Together, these programmes are designed to help members manage health risks earlier, access support more easily and achieve better long-term health outcomes.
Smarter digital engagement
Bonitas continues to simplify healthcare through its Member App, Member Zone, WhatsApp support channel and other digital platforms. In 2027, the Fund will also expand digital engagement initiatives, including the Medical Aid Made Easy podcast hosted by Dr B, while enhancing support tools for both employers and brokers.
Balancing affordability with sustainability
“Against a challenging economic backdrop, affordability remains a key priority. Strategic purchasing and provider negotiations continue to help maximise value for members while supporting the long-term sustainability of the Fund,” Callakoppen adds.
Across all plans, the average contribution increase for 2027 will be 8.7%.
“We know that alongside all our updates, enhancements and new rewards, this will go a long way towards providing our members with additional value.”
“Our 2027 product range is about more than just useful medical aid benefits. Our enhanced offering is also about evolving healthcare to meet the needs of our members today and tomorrow. By focusing on prevention, wellness, personalised support and affordability, we are delivering meaningful value for our members, and building a stronger, more sustainable future for healthcare in South Africa,” concludes Callakoppen.
