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Why did Nobody Catch the Flu in a Transmission Experiment?

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Researchers from University of Maryland Schools of Public Health and Engineering in College Park and the School of Medicine in Baltimore wanted to find out how the flu spreads, so they put college students already sick with the flu into a hotel room with healthy middle-aged adult volunteers. The result? No one caught the flu. 

“At this time of year, it seems like everyone is catching the flu virus. And yet our study showed no transmission – what does this say about how flu spreads and how to stop outbreaks?” said Dr Donald Milton, professor at SPH’s Department of Global, Environmental and Occupational Health and a global infectious disease aerobiology expert who was among the first to identify how to stop the spread of COVID-19.

The study, out in PLOS Pathogens, is the first clinical trial in a controlled environment to investigate exactly how the flu spreads through the air between naturally infected people (rather than people deliberately infected in a lab) and uninfected people. Milton and his colleague Dr Jianyu Lai have some ideas about why none of the healthy volunteers contracted the flu. 

“Our data suggests key things that increase the likelihood of flu transmission – coughing is a major one,” said Lai, post-doctoral research scientist, who led data analysis and report writing for the team. 

The students with the flu had a lot of virus in their noses, says Lai, but they did not cough much at all, so only small amounts of virus got expelled into the air. 

“The other important factor is ventilation and air movement. The air in our study room was continually mixed rapidly by a heater and dehumidifier and so the small amounts of virus in the air were diluted,” Lai said. 

Lai adds that middle-aged adults are usually less susceptible to influenza than younger adults, another likely factor in the lack of any flu cases.

Most researchers think airborne transmission is a major factor in the spread of this common disease. But Milton notes that updating international infection-control guidelines requires evidence from randomised clinical trials such as this one. The team’s ongoing research aims to show the extent of flu transmission by airborne inhalation and exactly how that airborne transmission happens. 

The lack of transmission in this study offers important clues to how we can protect ourselves from the flu this year. 

“Being up close, face-to-face with other people indoors where the air isn’t moving much seems to be the most risky thing – and it’s something we all tend to do a lot. Our results suggest that portable air purifiers that stir up the air as well as clean it could be a big help. But if you are really close and someone is coughing, the best way to stay safe is to wear a mask, especially the N95,” said Milton.

The team used a quarantined floor of a Baltimore-area hotel to measure airborne transmission between five people with confirmed influenza virus with symptoms and a group of 11 healthy volunteers across two cohorts in 2023 and 2024. A similar quarantine set-up was used in an earlier study and exhaled breath testing was used in several pioneering studies by Milton and colleagues on influenza transmission. 

During the most recent flu study, participants lived for two weeks on an isolated floor of the hotel, and did daily activities simulating different ways that people gather and interact – including conversational ice-breakers, physical activities like yoga, stretching or dancing. Infected people handled objects such as a pen, tablet computer and a microphone, before passing the objects among the whole group. 

Researchers measured a wide range of parameters throughout the experiment, including participant symptom monitoring, daily nasal swabs and saliva samples and blood collection to test for antibodies. The study measured the viral exposure in volunteers’ breathing area as well as the ambient air of the activity room. Participant exhaled breath was also measured daily in the Gesundheit II machine, invented by Milton and colleagues at Harvard T.H. Chan School of Public Health. 

Finding ways to control flu outbreaks is a public health priority, says Milton. Flu is responsible for a considerable burden of disease in the United States and globally – up to 1 billion people across the planet catch seasonal influenza every year and this season has seen at least 7.5 million flu cases so far in the United States alone, including 81 000 hospitalisations and over 3000 deaths. 

Source: University of Maryland

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Electrotherapy may be a Promising New Glioblastoma Treatment

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Photo by Anna Shvets

Electrotherapy using injectable nanoparticles delivered directly into the tumour could pave the way for new treatment options for glioblastoma, according to a new study from Lund University in Sweden.

Glioblastoma is the most common and most aggressive form of brain tumour among adults. Even with intensive treatment, the average survival period is 15 months. The tumour has a high genetic variation with multiple mutations, which often makes it resistant to radiation therapy, chemotherapy and many targeted drugs. The prognosis for glioblastoma has not improved over the past few decades despite extensive research.

Electrotherapy – a new treatment method

Electrotherapy offers another strategy to combat solid tumours. Using short, strong electric pulses (irreversible electroporation), non-reversible pores are created in the cancer cells leading to their death. The body’s immune system is simultaneously stimulated. The problem is that surgery is required to place the stiff metal electrodes that are necessary for the treatment. In sensitive tissue, in the brain for example, this often entails a very difficult procedure, which has led to strict criteria regarding which patients can be treated. Johan Bengzon is a researcher in glioblastoma and adjunct professor at Lund University, and consultant in neurosurgery at the Skåne University Hospital. He regularly treats patients with glioblastoma and is frustrated by the limited treatment options.

“The short distance between the hospital and the University in Lund facilitates cooperation and that’s why I contacted research colleagues to find out if injectable electrodes could be an alternative solution in electrotherapy,” says Johan Bengzon.

Said and done. The research team, with Amit Singh Yadav, Martin Hjort, and Roger Olsson at the helm, had previously used nanoparticles to form injectable and electrically conductive hydrogels to control brain signalling and heart contractions. It is aminimally invasive method in which the particles are injected using a thin syringe directly into the body. The particles break down after the treatment and thus do not need to be surgically removed. Perhaps the same technology could be used to destroy tumour cells in glioblastoma. 

“After surgical treatment, unfortunately the glioblastoma tumour often returns on the outer edge of the area operated on. By drop casting the nanoparticles into the tumour cavity after an operation, we could electrify the edges while the immune system is also activated. In animal models the procedure, due to this irreversible electroporation, led to tumours being wiped out within three days,” says Roger Olsson, professor of chemical biology and drug development at Lund University, who led the study. 

Promising results – but a long way to the patient

The prospects are good and the researchers are very hopeful for the future, even though there is a long way to go before it becomes a clinical reality. The challenge is now to test the method on larger tumours. 

“We have seen that the electrode is well received in the brain. We have not noted any problems relating to side effects and after 12 weeks the electrode disappeared by itself as it’s biodegradable. The technology combines direct tumour destruction with activation of the immune system and can be an important step towards more effective treatment of glioblastoma,” concludes Amit Singh Yadav, researcher at Lund University and first author of the study. 

Source: Lund University

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Shingles Vaccine Linked to Slower Biological Aging in Older Adults

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Shingles vaccination not only protects against the disease but may also contribute to slower biological aging in older adults, according to a new USC Leonard Davis School of Gerontology study.

Using data from the nationally representative US Health and Retirement Study, researchers examined how shingles vaccination affected several aspects of biological aging in more than 3800 study participants who were age 70 and older in 2016. Even when controlling for other sociodemographic and health variables, those who received the shingles vaccine showed slower overall biological aging on average in comparison to unvaccinated individuals.

Shingles, also called herpes zoster, is a painful, blistering skin rash caused by the reactivation of the chickenpox virus, or varicella zoster. Anyone who has had chickenpox is at risk for shingles; while shingles can occur at younger ages, risk is higher for those 50 and older and immunocompromised individuals. Vaccination, which has generally only been provided to older people, offers protection from shingles as well as a lower chance of postherpetic neuralgia, or long-term pain after a shingles infection.

While vaccines are designed to protect against acute infection, recent research has  highlighted a possible connection between adult vaccines, including those for shingles and influenza, and lower risks of dementia and other neurodegenerative disorders, said Research Associate Professor of Gerontology Jung Ki Kim, the study’s first author.

“This study adds to emerging evidence that vaccines could play a role in promoting healthy aging by modulating biological systems beyond infection prevention,” she said.

Measuring the body, not the calendar

Unlike chronological aging, biological aging refers to how the body is changing over time, including how well organs and systems are working. Two people who are both 65 years old may look very different inside: one may have the biological profile of someone younger, while another may show signs of aging earlier.

In the new study, Kim and coauthor Eileen Crimmins, USC University Professor and AARP Professor of Gerontology, measured seven aspects of biological aging:

  • inflammation
  • innate immunity
  • adaptive immunity
  • cardiovascular haemodynamics
  • neurodegeneration
  • epigenetic aging (changes in how genes are turned “off” or “on”)
  • transcriptomic aging (changes in how genes are transcribed into RNA used to create proteins)

The team also used the measures collectively to record a composite biological aging score.

Surprising results beyond shingles prevention

On average, vaccinated individuals had significantly lower inflammation measurements, slower epigenetic and transcriptomic aging, and lower composite biological aging scores. The results provide more insight into the possible mechanisms underlying how immune system health interacts with the aging process.

Chronic, low-level inflammation is a well-known contributor to many age-related conditions, including heart disease, frailty, and cognitive decline. This phenomenon is known as “inflammaging,” Kim said.

“By helping to reduce this background inflammation — possibly by preventing reactivation of the virus that causes shingles, the vaccine may play a role in supporting healthier aging,” she said. “While the exact biological mechanisms remain to be understood, the potential for vaccination to reduce inflammation makes it a promising addition to broader strategies aimed at promoting resilience and slowing age-related decline.”

These potential benefits could also be persistent. When analysing how the time since vaccination affected results, Kim and Crimmins found that participants who received their vaccine four or more years prior to providing their blood sample still exhibited slower epigenetic, transcriptomic and overall biological aging on average versus unvaccinated participants.

“These findings indicate that shingles vaccination influences key domains linked to the aging process,” Crimmins said. “While further research is needed to replicate and extend these findings, especially using longitudinal and experimental designs, our study adds to a growing body of work suggesting that vaccines may play a role in healthy aging strategies beyond solely preventing acute illness.”

By Beth Newcomb

Source: USC Leonard Davis School of Gerontology

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Sitting for Long Stretches Raises Heart and Diabetes Risks – Even in Active Older Adults

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Photo by JD Mason on Unsplash

Spending too long sitting raises the risk of heart disease and diabetes in people over 60, warns a major global review. Published in the Journal of Physical Activity and Health, the review analysed data from 28 international studies involving 82 000 people aged 60 and older.

It flags strong links between sitting time and worsening markers for chronic disease including high blood sugar, cholesterol, waist size, and blood pressure. And that’s even for people who exercise regularly.

That means — whether watching TV, using a tablet or reading a book — the longer older people sit, the higher their risk of major health problems like heart disease, stroke, and type 2 diabetes.

“This is a link we can’t ignore,” said Dr Daniel Bailey, Reader in Sedentary Behaviour and Health at the Department of Life Sciences, Brunel University of London. “You can meet the weekly exercise target, but if you spend the rest of the day sitting, your health is still at risk.”

In the UK, where more than 12 million people are aged 65 or older, older adults can spend up to 80% of their waking hours sitting down and longer during winter or for people with mobility issues. That means millions may be unknowingly accumulating risks day after day — a concern for families, carers, and health professionals.

One of the most revealing findings was that the harmful effect of sitting for long periods showed up even in otherwise healthy older adults, not just those already diagnosed with illness. Waist measurement, a major predictor of health risk, had the strongest, most consistent link with sitting time.

“We’re seeing these impacts in people who don’t yet feel unwell,” said Dr Bailey. “That means we have a chance to intervene early and protect health before problems start.”

Importantly, the study found limited protective effect from exercise alone. After accounting for how active people were, the damage from long hours of sitting remains.

“The evidence is clear. We urgently need strategies that don’t just encourage exercise, but also help people sit less throughout the day,” said Dr Bailey. “Simple changes make a difference —standing during phone calls, replacing some TV time with gardening or a stroll, or light chores around the house.”

The study by Brunel University of London, the University of Lincoln, Federation University in Australia, and the University of Bedfordshire is the most comprehensive analysis to date linking sedentary behaviour to cardiometabolic risk in later life. As the NHS contends with rising rates of diabetes and heart disease, it spells out to policymakers that keeping moving throughout the day is as vital as structured exercise.

Dr Bailey stressed the shared role of public services, community groups and healthcare professionals to help older people avoid sitting for long stretches: “From GP advice to local councils and charities, there’s a role for everyone in changing the message.”

Source: Brunel University of London

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New Neural Maps Challenge Traditional Descriptions of the Brain

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AI image of neurons created by Gencraft

For more than a century, maps of the brain have been based on how brain tissue looks under the microscope. These anatomical maps divide the brain into regions according to structural variations in the tissue. But do these divisions really reflect how the brain works? A new study on mice from Karolinska Institutet, published in Nature Neuroscience, suggests that this is often not the case.

By describing the brain in terms of electrical activity of its neurons, the researchers have found a new way to understand the functional organisation of the prefrontal cortex, the brain region responsible for planning, decision-making, and other advanced cognitive functions. 

“Considering that deviations in prefrontal cortex function have been linked to virtually all psychiatric disorders, it is surprising how little is known about how this region actually works,” says Marie Carlén, Professor at the Department of Neuroscience at Karolinska Institutet.

Did not align with previous maps

Her research group recorded and analysed the activity of more than 24 000 neurons in awake mice and created the first activity-based maps of the prefrontal cortex. The maps of spontaneous and cognition-related neuron activity did not match the traditional, tissue-based maps.

“Our findings challenge the traditional way of defining brain regions and have major implications for understanding brain organisation overall,” says Marie Carlén.

The researchers found that the activity patterns of neurons reflected the hierarchy of information flow in the brain rather than the structure of the tissue. Neurons with slow, regular activity turned out to be characteristic of the prefrontal cortex, which sits at the top of this hierarchy. The same activity pattern also marked regions at the top of the prefrontal cortex’s own internal hierarchy. Slow, regular activity is thought to characterise the integration of information flows, a process that is central to cognitive functions such as planning and reasoning. 

Different neuronal activity patterns work together

Carlén and her colleagues discovered that neurons involved in decision-making were concentrated in regions high up in the prefrontal hierarchy. Surprisingly, these neurons were characterised by very fast activity patterns. 

“This suggests that cognitive processes rely on local collaboration between neurons whose activity patterns complement one another. Some neurons appear to specialise in integrating information streams, while others have high spontaneous activity that supports quick and flexible encoding of information, for instance, information needed to make a specific decision,” says Marie Carlén.”

Source: Karolinska Institutet

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Heavy Menstruation and Iron Deficiency Common Among Teen Girls

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Photo by Marta Branco

More than half of teenage girls experienced heavy bleeding and 40% had an iron deficiency, in a study carried out among girls in upper-secondary schools. The research, led from Lund University in Sweden, also shows that young teenage girls who experience heavy menstrual bleeding – and are therefore at greater risk of iron deficiency – can be identified using a simple questionnaire.

The 2023 study, published in PLOS One, was carried out in two Swedish upper-secondary schools; a total of 394 girls aged 15 and over took part. They responded to questions about menstruation and eating habits and provided blood samples for analysis of blood count (Hb) and iron stores (ferritin). 
Lund University has previously reported how the research team saw a particularly high risk of iron deficiency and anaemia among those eating a vegetarian or pescetarian diet. Now, researchers have gone further and investigated how the extent of menstruation affects iron deficiency and anaemia.

“We see a lot of young girls who are tired and distracted. Linking that to menstruation or diet is not obvious,” says Moa Wolff, researcher and associate professor at Lund University, specialist physician in general medicine at Region Skåne and the researcher in charge.

Girls with heavy menstruation were three times more likely to have an iron deficiency, with an even higher risk for those who restricted the quantity of meat in their diet.  

“Many of them only compare with their own previous experiences without knowing what counts as heavy menstrual bleeding. We also note that many are not aware of the over-the-counter medicines available that reduce the volume of blood,” says Lisa Söderman, gynaecologist and postdoc researcher at Karolinska Institutet who collated the results for the article in question. 

SAMANTA questionnaire could be a new tool for school health services

Part of the study evaluated a Spanish questionnaire which asks six questions. This is the first time it has been used in Sweden and the first time it has been tested on teenage girls anywhere, even though it is a validated screening instrument for adult women.
 
“Based on the answers to the questionnaire, it was possible to clearly identify which secondary school students were at risk of having low iron levels. It is easy to use and could be a valuable tool for school health services and youth clinics or other care healthcare settings where we meet these girls,” says Moa Wolff.
 
Previous research shows that iron deficiency in young people may affect their energy levels, schoolwork and general wellbeing. Iron stores – Ferritin – form an important component in the formation of red blood cells and is needed for oxygen transport. Therefore, iron deficiency with low ferritin levels can eventually lead to a drop in haemoglobin, which can result in anaemia.
 
“In the next few years, some of these girls will get pregnant. When that happens, we would like them to have good stores of iron to enable as complication-free a pregnancy as possible, with a successful labour,” says Lisa Söderman.

Source: Lund University

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Full-fat Cheese Linked to a Reduced Dementia Risk

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Eating cheese and cream with a high fat content may be linked to a lower risk of developing dementia. This is shown by a new large-scale study from Lund University. The researchers analysed the dietary habits of more than 27 000 people and linked these to the occurrence of dementia over a follow-up period of up to 25 years.

The debate about low-fat diets has long shaped our health advice and influenced how we view food and health. For several decades, fear of saturated fat and its link to cardiovascular disease has dominated. The MIND diet1 is a diet developed with the aim of reducing the risk of dementia. The diet includes protective foods such as vegetables, nuts, fruits, berries, whole grains, and fish, while cheese is one of the foods that should be limited.

Emily Sonestedt, researcher in nutritional epidemiology at Lund University in Sweden, and her colleagues, therefore wanted to investigate whether there was any link between dairy products and dementia. They collected dietary data from 27,670 people using the Malmö Diet Cancer population study, in which the participants respond about their dietary and cooking habits. The average age at the start of the study was 58, and the participants were followed for an average of 25 years, during which time 3,208 people developed dementia. The dementia diagnoses were obtained from the Swedish patient registry. For cases diagnosed up to 2014, additional validation studies were conducted in which dementia specialists reviewed medical records, brain scans, and cognitive test results.

After adjusting for lifestyle factors such as physical activity, diet, smoking, and alcohol consumption, the researchers found that people who ate 50 grams of cheese (with more than 20 percent fat) daily had a 13 percent lower risk of developing dementia than those who ate less than 15 grams daily. 50 grams is equivalent to about five regular slices of cheese. In total, about a quarter of the participants ate more than 50 grams or more daily.

”When we went on to look at specific types of dementia, we found that there was a 29 percent lower risk of vascular dementia in people who ate more full-fat cheese. We also saw a lower risk of Alzheimer’s disease, but only among those who did not carry the APOE e4 gene variant—a genetic risk factor for Alzheimer’s disease.”

The researchers also investigated the link between high-fat cream (30-40 percent fat) and dementia. People who consumed 20 grams or more daily had a 16 percent lower risk of dementia than those who did not consume any at all. 

The results of the cheese studies support the link between vascular health and brain health.

”The updated dietary guidelines in Sweden from this year say that we can eat dairy products every day, preferably fermented varieties such as yogurt or kefir. Both we and other researchers have found in observational studies that fermented dairy products in particular may be linked to a slightly reduced risk of cardiovascular disease 2,” says Emily Sonestedt.

In previous studies3, the research team has seen links to vascular health, with cheese and fermented dairy products in particular protecting against cardiovascular disease. 

”Although higher-fat cheese and cream were associated with a reduced risk of dementia, other dairy products and low-fat alternatives did not show the same effect. Therefore, not all dairy products are equal when it comes to brain health. The few studies that have investigated this have found a correlation with cheese, so more research is needed to confirm our results and investigate whether certain high-fat dairy products really do provide some protection for the brain.”

Source: Lund University

  1. The MIND diet stands for Mediterranean–DASH Intervention for Neurodegenerative Delay – a combination of the Mediterranean diet and the DASH diet. DASH (Dietary Approaches to Stop Hypertension) is a diet developed primarily to lower high blood pressure and improve cardiovascular health.
  2. Milk and dairy products – a scoping review for Nordic Nutrition Recommendations 2023
  3. Previous publications: 
    High-fat and low-fat fermented milk and cheese intake, proteomic signatures, and risk of all-cause and cause-specific mortality
    High consumption of dairy products and risk of major adverse coronary events and stroke in a Swedish population
    Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort
    Dairy Consumption, Lactase Persistence, and Mortality Risk in a Cohort From Southern Sweden
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Common Eye Ointment can Damage Glaucoma Implants, Study Warns

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Research shows that petrolatum-based eye ointments can cause the device to swell and potentially rupture, prompting an urgent update to clinical guidance.

Photo by Tima Miroshnichenko


Widely-used eye ointments can cause glaucoma implants to swell and potentially rupture, according to new research from Nagoya University in Japan. This study is the first to show, using clinical and experimental evidence, that petrolatum-based eye ointments can compromise the PRESERFLO® MicroShunt, an implant used in over 60 countries to treat glaucoma.

Glaucoma is an eye disease that damages the optic nerve and can lead to vision loss. It often results from increased intraocular pressure caused by blocked drainage of eye fluid. A recent study estimated that 76 million people globally are affected by glaucoma.

Progression of visual field loss (from left to right) due to glaucoma
(Credit: Ryo Tomita)

MicroShunt is a small filtration device implanted in the eye to improve fluid drainage in glaucoma patients. Compared to traditional surgeries, it lowers post-operative complications and reduces reliance on additional medications.

MicroShunt is made from a styrenic thermoplastic elastomer based on a polystyrene-block-polyisobutylene-block-polystyrene (SIBS) block polymer, which is highly biocompatible, flexible, and less likely to cause inflammation or scarring. However, this material is vulnerable when it comes into contact with hydrocarbon- and oil-based materials. Due to its high oil affinity, exposure to petrolatum-based eye ointments may allow oil components to penetrate the device, causing swelling and potential changes in its shape and flexibility.

The MicroShunt manufacturer’s instructions state that “the MicroShunt should not be subjected to direct contact with petrolatum-based (ie, petrolatum jelly) materials, such as ointments and dispersions.” But this precaution is not widely recognised or consistently followed in clinical practice.

“Swollen MicroShunts can be structurally fragile,” said ophthalmologist and Assistant Professor Ryo Tomita of Nagoya University Graduate School of Medicine, the study’s first author. “During surgery, I observed a rupture in a swollen MicroShunt. If more clinicians are aware of this risk, they will be able to prevent similar problems.”

Tomita and colleagues, including Assistant Professor Taiga Inooka and Associate Professor Kenya Yuki from Nagoya University Hospital and the Graduate School of Medicine collaborated with Dr. Takato Kajita and Junior Associate Professor Atsushi Noro from the Graduate School of Engineering to examine changes in the MicroShunt after exposure to a petrolatum-based eye ointment.

The medical team reviewed clinical cases, while the engineering team conducted laboratory analyses. The findings were published in Graefe’s Archive for Clinical and Experimental Ophthalmology.

Clinical evidence

The clinical study examined seven glaucoma patients whose MicroShunt implants were later removed for different reasons. The results revealed a clear pattern. In three cases, the MicroShunt was exposed outside the conjunctiva, and patients received a petrolatum-based eye ointment. All three explanted devices showed significant swelling, and two of them ruptured.

In three other cases, the MicroShunt remained covered by the conjunctiva, and no ointment was administered. These devices retained their original structure. Crucially, in one additional case, the MicroShunt was exposed outside the conjunctiva, but no ointment was applied. The device did not swell. This indicates that direct contact with the ointment, rather than conjunctival rupture alone, is the primary cause of swelling.

Photographic comparison of MicroShunt illustrating size changes
Top: MicroShunt explanted from a patient, exhibiting diffuse swelling with fracture and loss of one fin
Middle: MicroShunt explanted from another patient, showing localized swelling around the fin
Bottom: Unused MicroShunt (control)
Scale: 1 division = 1 mm   
(Credit: Ryo Tomita)

Laboratory confirmation

Laboratory experiments confirmed the clinical findings. The team immersed unused MicroShunts in petrolatum-based eye ointment to reproduce the swelling seen in clinical cases. Microscopic measurements showed significant changes. After 24 hours in the ointment, the MicroShunt’s outer diameter increased to 1.44 times its original size, and the fin-like portion widened to 1.29 times its initial value.

Chemical analysis identified the cause of this change. After 24 hours of immersion, oil components made up approximately 45% of the MicroShunt’s total weight, rising to 73% after three months. These results confirmed the primary cause of swelling to be the absorption of oil-based ointment constituents into the material.

Clinical implications

The research team emphasises that clinicians should avoid using petrolatum-based ointments on patients with MicroShunt implants, particularly when the device is exposed outside the conjunctiva. Alternative post-operative treatments should be considered, while further research is needed to assess whether swelling impacts MicroShunt performance even when rupture does not occur.

“Our study found that commonly used medical materials can cause unexpected complications if their chemical properties and usage environments are not fully understood,” Noro stated. “From both medical and engineering perspectives, we emphasise the importance of understanding the chemical properties of medical materials and appropriately managing their usage environments.”

Paper information:

Ryo Tomita, Taiga Inooka, Takato Kajita, Hideyuki Shimizu, Ayana Suzumura, Jun Takeuchi, Tsuyoshi Matsuno, Hidekazu Inami, Koji M. Nishiguchi, Atsushi Noro, and Kenya Yuki. (2026) Petrolatum-based ointment application induces swelling of the PRESERFLO MicroShunt. Graefe’s Archive for Clinical and Experimental Ophthalmology
DOI: 10.1007/s00417-025-07075-2

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Can AI Help Make Prescriptions Safer in South Africa’s Busy Clinics?

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AI image created with Gencraft

By Henry Adams, Country Manager, InterSystems South Africa

Across South Africa, nurses and doctors in public clinics make hundreds of important decisions every day, often under enormous pressure. They’re short on time, juggling long queues, and sometimes working with incomplete information. In those conditions, even the most experienced professionals can make mistakes. It’s human.

The truth is, our healthcare system is stretched thin, and people can only do so much. That’s why I see real potential for AI to step in as a kind of virtual pharmacist. Not to replace anyone, but to back them up by checking prescriptions, catching errors, and helping ensure patients get the right treatment quickly and safely.

From data to decision support

I’m often asked how AI can make a real difference in healthcare right now. One area where it can have an immediate impact is in prescriptions. AI-assisted systems help doctors and nurses make safer, faster decisions by analysing medical data in real time. They can check a patient’s history, allergies, and possible drug interactions in seconds, flagging risks before they become problems.

Of course, because we’re dealing with sensitive medical information, trust and data quality are crucial. These systems only work when they’re built on accurate, connected data that healthcare professionals can rely on.

That’s where the latest health technology partnerships come in. By linking proven data platforms with smart AI tools, we’re already seeing real improvements overseas. In Europe, for example, these systems are helping clinicians catch potential drug errors early and prescribe with greater confidence.

There’s no reason South Africa can’t benefit in the same way. With clinics under pressure and resources stretched, technology that connects clean, reliable data with practical AI support could help reduce errors, save time, and make care safer for everyone.

Addressing local challenges

Medication errors can happen anywhere, but in South Africa the stakes are often higher. Our public clinics are exceptionally busy, staff are stretched, and doctors and nurses are doing their best under tough conditions. When you’re working under that kind of pressure, even a small mistake in a prescription can have serious consequences for a patient.

This is where AI can really help. Imagine a system that double-checks every prescription in real time, flagging possible drug interactions, incorrect dosages, or missing information before the medicine ever reaches the patient. It’s like having an extra set of expert eyes that never get tired. Instead of slowing things down, it speeds them up and gives clinicians peace of mind knowing they’re making the safest call for each patient.

For that to work, though, the data behind the system must be reliable and up to date. As South Africa moves toward a unified digital health record, the ability for these systems to connect to existing patient information becomes crucial. When healthcare professionals can trust the data they see on screen, AI becomes a genuine partner in care, helping them work faster, smarter, and safer.

Building confidence in AI

For AI to really work in healthcare, it must be clear and trustworthy. Doctors and nurses need to know why the system is recommending a specific drug or warning about a potential issue. If it can’t explain itself, people won’t use it, and rightly so.

That’s why transparency matters. The best AI tools don’t make decisions behind closed doors; they show their reasoning and help clinicians understand what’s happening in the background. When that’s combined with reliable, well-managed data, you start to build real confidence in the system.

It’s that trust, knowing the technology supports rather than replaces clinical judgment, that will make AI-assisted prescriptions part of everyday care, not just an interesting experiment.

A collaborative path forward

Technology on its own won’t fix South Africa’s healthcare challenges, but it can make a big difference in helping people do their jobs better. AI-assisted prescriptions are a good example of how smart tools can take some of the pressure off clinicians, reduce paperwork, and help patients get safer, faster care.

What excites me most is how practical this can be. Picture a nurse in a rural clinic who needs to prescribe medication but doesn’t have easy access to a specialist. With AI support, she can get accurate, instant guidance and know her patient is getting the right treatment. Or think about a busy hospital pharmacy, where an AI system automatically checks for drug interactions across hundreds of files in seconds, preventing errors before they happen.

This isn’t some far-off idea. The technology already exists and is being used successfully elsewhere. The goal now is to make sure it’s used in a way that supports our healthcare professionals, not replaces them. They are, and always will be, at the centre of care. If we get this right, AI can become a real partner in healthcare.

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Immunometabolism Might Hold the Key to Controlling Sepsis

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Metabolic changes that “rewire” part of the immune system can intensify sepsis, the body’s dysregulated response to infection. This discovery may lead to new ways to block metabolic changes contributing to excessive and ineffective inflammation, reset the immune system, and bring sepsis under control, researchers at Vanderbilt Health reported January 15 in the journal Nature Immunology.

“Metabolism is potentially a means by which we could intervene in immune dysfunction in ICU (intensive care unit) patients including those with sepsis,” said the paper’s first and co-corresponding author, Matthew Stier, MD, PhD, assistant professor of Medicine in the Division of Allergy, Pulmonary and Critical Care Medicine at Vanderbilt Health.

“I think we can make great progress and great strides by aligning cutting-edge basic science tools with ICU patient samples to understand these mechanisms and prioritise therapies for future interventions,” he said.

Sepsis is characterised by the massive production and release of inflammatory molecules, including cytokines, that if unchecked, can lead to tissue damage, septic shock, organ failure, and death.

Despite decades of research focused on stopping this “cytokine storm” and hyperinflammation, “we have unfortunately not been able to identify successful drug therapies in sepsis,” said Stier, a physician-scientist who focuses on immunologic and metabolic dysfunction in critical illness. Targeting the inflammatory aspect of sepsis is likely important, but by itself may not be sufficient.

“We provide antibiotics and great supportive care to weather the cytokine storm,” he said, “but that doesn’t fully resolve the problem. It keeps people alive while we wait for their bodies to fix themselves — or not.”

In critical illness, including sepsis, the body’s normal metabolic processes become impaired. This includes immunometabolism, the energy-generating processes that fuel the immune system.

At the same time, the immune system’s protective functions become exhausted, resulting in an acquired immunosuppression, which leaves patients vulnerable to secondary infections, persistent organ dysfunction, repeated hospitalisations and death.

While prior research has defined the characteristics of metabolism and immune dysfunction, this study was among the first to explore the mechanisms of immunometabolic dysfunction in sepsis and their association with immunosuppression, often called “immunoparalysis.”

Stier and his colleagues used cutting-edge technologies, including single-cell sequencing and flow cytometry, to study immune cells collected from the blood of critically ill patients.

The blood samples were collected and stored through the Sepsis Clinical Resource and Biorepository (SCARAB), a unique, highly collaborative ICU biobank developed by Julie Bastarache, MD, and Lorraine Ware, MD, professors of Medicine in the Division of Allergy, Pulmonary and Critical Care Medicine.

Two of the most important elements of the body’s immune responses are CD4+ T “helper” cells, inflammatory “foot soldiers” of the immune system that are distinguished by the CD4 surface protein they express, and regulatory T (Treg or “suppressor”) cells, which guard against over-active immune responses.

To study the impact of critical illness and sepsis on these cells, the Vanderbilt Health team used SCENITH, a flow cytometry-based method developed by French researchers that enables researchers to functionally profile energy metabolism with single-cell resolution.

“This technique allowed us to do something prior studies hadn’t done … to look at the metabolism of every single cell set on its own and identify subset-specific metabolic adaptations,” Stier said.

The key finding: Treg cells undergo metabolic “reprogramming” in patients with critical illness and sepsis, leading to altered tryptophan metabolism and response to reactive oxygen species in a way that enhances their immunosuppressive capability, at the expense of CD4+ T “helper” cells.

“The metabolic turmoil of critical illness appears to give Treg cells a survival and functional advantage, contributing to the harmful immunoparalysis seen in sepsis,” he said.

“This is very much a preclinical paper,” Stier cautioned. Yet it demonstrates the feasibility of deeply dissecting immunometabolic mechanisms using ICU patient biospecimens and highlights the importance of such insights to prioritise future therapeutic targets in critical illness and sepsis, he said.

Source: Vanderbilt University Medical Center