Categories : Emergency MedicineTags :

Case Study: Building a Stronger Emergency Response System in Limpopo

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Strengthening Limpopo’s post-crash emergency response has been one of the most powerful achievements of the Limpopo Road Safety Programme (LRSP). Through a combined focus on updated clinical training, advanced rescue skills and improved operational systems, Projects 12 and 12.1 have reshaped how Emergency Medical Services (EMS) teams respond in the critical minutes after a crash – from the first emergency call to hospital handover.

Updating clinical skills to strengthen frontline emergency care

Across South Africa, the Clinical Practice Guidelines (CPGs) for emergency care have been substantially updated, including a major revision in 2018. These updates incorporated new evidence, improved patient outcomes, and standardised practice across the health system, shifting toward more user-friendly formats such as clinical decision-support tools. For Limpopo’s EMS, this presented both an opportunity and a challenge: although the guidelines were available, many personnel had not yet received training to apply them consistently in the realities of roadside emergencies. Project 12 addressed this need directly, rolling out comprehensive CPG training across all five districts. EMS practitioners were equipped with updated algorithms for trauma, medical, paediatric and obstetric emergencies, along with enhanced assessment, triage and stabilisation skills.

This clinical uplift aligned perfectly with major system improvements. In the 2023/2024 financial year, the Limpopo Department of Health procured more than 500 new, modern ambulances, significantly expanding the provincial fleet. The LRSP ensured this investment translated into real-world impact: EMS personnel were trained not only on updated CPGs but also to use the new vehicles and onboard equipment to their full potential; optimising monitoring, patient loading, scene workflow and en-route care. Modern ambulances combined with modern knowledge dramatically strengthened the quality of emergency care.

By 2025, the system advanced even further with the introduction of a Computer-Aided Dispatch (CAD) system, enabling more efficient call-taking, improved dispatch decision-making, clearer communication and better tracking of EMS resources across districts. The CAD system, together with updated CPGs and a modern ambulance fleet, created a tightly integrated platform for faster, smarter and more coordinated EMS response. For the first time, Limpopo could align clinical best practice, operational intelligence and fleet capacity into one cohesive system.

Introducing advanced rescue skills for high-severity crash scenes

Yet, while clinical updates and dispatch improvements strengthened core EMS response, Limpopo still faced a critical need for specialised capacity at high-severity crash scenes, especially those involving vehicle entrapment. Project 12.1 filled this gap by introducing the province’s first Advanced Vehicle Rescue Short Course, delivered by EPIC EM and the University of Johannesburg. Over seven intensive days, participants trained in vehicle stabilisation, extrication techniques, hydraulic tool use, and multi-casualty scene management, blending theory with realistic, high-pressure simulations. Many described the training as transformative, giving them the competence and confidence to manage complex incidents on Limpopo’s regional and mining routes.

Together, these interventions have created a step change in Limpopo’s post-crash care system. Today, EMS teams arrive at crash scenes equipped with modern ambulances, updated clinical guidance, advanced rescue skills and a CAD-supported operational network that ensures faster and more coordinated response. Patients benefit from safer extrication, quicker stabilisation and better continuity of care during the “golden hour”. Beyond improving skills, the programme has strengthened morale, professionalism and a culture of excellence within EMS.

Projects 12 and 12.1 have left a lasting legacy: a provincial emergency response system that is smarter, faster and better prepared to save lives on Limpopo’s roads.

Categories : VaccinesTags :

World-first Single-dose Dengue Vaccine Approved in Brazil

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Red blood cells and serum separate after spinning in a centrifuge in the UVM Vaccine Testing Center. (Photo: Andy Duback)

The world’s first single-dose vaccine to prevent dengue fever has been approved for licensure in one of the largest countries affected by the disease, following 16 years of research contributions by scientists at the University of Vermont (UVM) Vaccine Testing Center, in partnership with the US National Institutes of Health (NIH) and the Johns Hopkins Bloomberg School of Public Health (JHSPH). 

Dengue is the most common mosquito-borne disease worldwide, with nearly half the world’s population living in places with the risk of dengue. Along with high fever and severe muscle and bone pain, the virus can lead to shock, bleeding, and death. With more than 100 million cases reported annually, dengue poses a growing risk throughout the globe. Brazil recorded 5.9 million cases of dengue and more than 6000 deaths in 2024.

The new vaccine has now been licensed for use in Brazil under the name Butantan-TV. On November 26 the Instituto Butantan, a biologic research centre in São Paulo, announced that the vaccine will be incorporated into Brazil’s national immunisation program. Additional global approvals are anticipated as the vaccine is developed through other pharmaceutical partners including Merck and the Serum Institute of India.

In addition to the vaccine approval, a promising new antiviral medication designed to prevent infection and illness in individuals exposed to dengue virus will now advance, thanks to clinical trials at the UVM Vaccine Testing Center and JHSPH. The findings were published in the November 26 issue of the New England Journal of Medicine (NEJM).

“These milestones represent a turning point in global dengue prevention and treatment,” said UVM Vaccine Testing Center founder Beth Kirkpatrick, M.D., professor and chair of the Department of Microbiology and Molecular Genetics at the Robert Larner, M.D. College of Medicine at the University of Vermont. “We are proud of the role UVM has played in advancing science that will save lives worldwide.”

Kirkpatrick served as principal investigator for the umbrella research funding award that supported early-stage clinical trials and immunology research on the vaccine at UVM. Kirkpatrick and colleagues began studying the candidate tetravalent (four-serotype) dengue vaccine in 2009 in collaboration with leaders in the dengue field: JHSPH professor Anna Durbin, M.D., and NIH virologist Steven Whitehead, Ph.D. Whitehead and colleagues at the NIH designed the candidate vaccine. Since 2009, more than 27 clinical trials have been conducted at UVM and JHSPH to develop this vaccine, yielding many major scientific and immunologic insights. 

At UVM, the new dengue antiviral treatment investigation was led by Kristen Pierce, MD, co-director of the Vaccine Testing Center and professor of medicine, and by Durbin’s team at JHSPH. About 80 volunteers participated in clinical trials at the two sites. 

The volunteers were randomly assigned to receive either the treatment or a placebo prior to receiving a dose of a mild strain of dengue virus. The study data published in NEJM showed that the treatment, an oral pan-dengue small molecular antiviral called Mosnodenivir, inhibits replication of dengue virus and prevents infection. An oral antiviral drug would be extremely useful during outbreaks and could be utilized by travelers and persons who are not able to receive a vaccine. 

Categories : Gastrointestinal Lab Tests and ImagingTags :

New Optical Tool Lights up IBD Biomarkers

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A test that rapidly detects signs of inflammatory bowel disease (IBD) in stool samples could improve future diagnosis and monitoring of the condition, a study suggests.

Microscopy images of colon tissue samples from IBD patients under remission (left) and with active disease (right). Granzyme A, indicated by green fluorescence, is elevated in the intestinal tract of IBD patients with active disease. Credit: Emily Thompson.

Scientists have developed a tool to measure the activity of a molecule linked to gut inflammation within faecal samples. The optical tool, known as a luminescent reporter, lights up when it detects the molecule, with higher readouts indicating increased activity and inflammation.

The new technique could boost the accuracy of stool sample tests for IBD, reducing the need for invasive, expensive procedures, experts say.

Gut inflammation

IBD is a chronic illness where the body’s immune system mistakenly attacks the digestive tract, leading to long-lasting inflammation. Diagnosis and monitoring of the condition often rely on colonoscopies, where a small camera is used to examine the gut.

Current IBD stool tests measure general markers of inflammation, such as the protein calprotectin, so a positive result requires further investigation to confirm the source. 

University of Edinburgh researchers studied gut tissue from IBD patients and identified high levels of an enzyme – a molecule that speeds up chemical reactions in cells – called granzyme A (GzmA) in inflamed gut tissue compared with non-inflamed tissues. 

Enzyme activity

GzmA is released by T cells; in IBD, T cells mistakenly see the gut as a threat and become overactive, which can lead to tissue damage and inflammation.

The research team developed a luminescent reporter to measure the activity of GzmA in stool samples. The reporter tool was tested on 150 samples from both IBD and healthy patients. 

Combining the new reporting tool with the current common testing of faecal calprotectin levels was more successful in identifying IBD in patients than using faecal calprotectin scores alone.

Researchers say the ability to identify gut-specific inflammation is a step forward for IBD diagnosis, but caution further research is needed before it can be used in a clinical setting.

Spin-out company

The tool will form part of the assets of a new company in the process of spinning out of the University of Edinburgh, called IDXSense, supported by Edinburgh Innovations, the University’s commercialisation service. 

The technique could also support the development of personalised IBD treatments in the future, with the ability to rapidly and accurately monitor gut inflammation levels in response to different therapies, experts say.

Source: The University of Edinburgh

Categories : GeneticsTags :

Two Wrongs Make a Right: How Two Harmful Variants Can Counteract Each Other

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Photo by Sangharsh Lohakare on Unsplash

In a groundbreaking study published in the Proceedings of the National Academy of Sciences (PNAS), scientists at Pacific Northwest Research Institute (PNRI) have overturned a long-held belief in genetics: that inheriting two harmful variants in the same gene always worsens disease. Instead, the team found that, in many cases, two harmful variants can actually restore normal protein function.

The research focused on a human enzyme called argininosuccinate lyase (ASL), which plays a critical role in removing toxic ammonia from the body. Variants in ASL that decrease its activity cause one of the urea cycle disorders, a set of rare and potentially life-threatening metabolic diseases.

By experimentally measuring the functional impact of several thousand individual variants and variant combinations, PNRI researchers discovered that over 60% of pairs that were individually damaging could, together, bring enzyme activity back to healthy levels.

“This work shows that genetic variants don’t act independently in many important cases,” said Michelle Tang, PhD, PNRI Staff Scientist and lead author of the study. “For a defined group of genes, the default assumptions we use to predict disease risk simply don’t hold.”

This phenomenon is known as intragenic complementation. It occurs when damage caused by one variant is offset by another variant in a different part of the same protein. The mechanism was first proposed in 1964 by Francis Crick and Leslie Orgel, but until now had not been tested systematically or shown to be common or predictable at scale.

The study was led by scientists in the Dudley Lab at PNRI, in collaboration with clinicians and researchers at Children’s National Hospital, St. Jude Children’s Research Hospital, George Mason University, and the University of Washington.

To make these interactions predictable, the research team developed an AI-based model that accurately forecasted whether two variants would restore protein function. The model achieved nearly 100% accuracy in predicting intragenic complementation in ASL as well as in a second human enzyme, fumarase, suggesting these rules apply broadly across the human genome.

“We’ve shown that, in many cases, two damaging variants can work together to restore protein function,“ said Aimée Dudley, PhD, PNRI Senior Investigator who led the study. “This kind of genetic interaction is not an isolated exception, but a widespread and underappreciated way that variants can interact, especially in rare disease contexts.”

The researchers estimate that approximately 4% of human genes have the structural features that allow this type of interaction. For these genes, standard genetic predictions can overestimate disease risk, particularly for people who carry two different variants in the same gene.

Source: Pacific Northwest Research Institute

Categories : Diet and Nutrition PaediatricsTags :

Major Study Highlights Benefits – and Risks – of Plant-based Diets in Children

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Photo by cottonbro studio

Vegetarian and vegan diets can support healthy growth when carefully planned with appropriate supplementation, finds a major new meta-analysis – the most comprehensive study to-date of plant-based diets in children.

A team of researchers, from Italy, USA and Australia, analysed data from over 48 000 children and adolescents worldwide who followed different dietary patterns, examining health outcomes, growth and nutritional adequacy. They found that vegan and vegetarian diets can be nutrient-rich and support healthy growth, but also carry a risk of deficiencies if key nutrients are not obtained through fortified foods or supplements.

The peer-reviewed study, published in Critical Reviews in Food Science and Nutrition, also suggests that plant-based diets may offer additional health benefits for children – including improved cardiovascular risk profiles – compared with omnivorous diets that include meat, fish and other animal-derived foods.

This large meta-analysis is the most comprehensive study to date of plant-based diets in children under 18 years of age, examining data from 59 studies across 18 countries. It compared lacto-ovo-vegetarian (which include dairy products and eggs, but exclude meat, fish and poultry) and vegan diets (which exclude all animal-derived foods) with omnivorous diets across a wide range of nutritional and health outcomes in 7280 lacto-ovo-vegetarians, 1289 vegans and 40 059 omnivores.

The study found that vegetarian children consumed more fibre, iron, folate, vitamin C and magnesium than omnivores, but they had lower intakes of energy, protein, fat, vitamin B12 and zinc. While evidence on vegan diets was more limited, similar patterns emerged.

“Notably, vitamin B12 didn’t reach adequate levels without supplementation or fortified foods, and calcium, iodine and zinc intakes were often at the lower end of recommended ranges, making them important nutrients to consider for children on plant-based diets,” explains the study co-author Dr Jeannette Beasley, an Associate Professor in the Departments of Nutrition and Food Studies and Medicine at New York University.

“Vegan children, in particular, had especially low calcium intake.”

Health benefits

Despite these risks, both vegan and vegetarian children displayed more favourable cardiovascular health profiles than omnivores, with lower total and low-density lipoprotein (LDL) cholesterol – the “unhealthy” form of cholesterol.

Growth and body composition measures indicated that children on plant-based diets tended to be leaner than omnivores: vegetarian children were slightly shorter and lighter, with lower body mass index (BMI), fat mass and bone mineral content. Vegan children also had shorter stature and lower BMI scores.

“Our analysis of current evidence suggests that well-planned and appropriately supplemented vegetarian and vegan diets can meet nutritional requirements and support healthy growth in children,” states lead-author Dr Monica Dinu, who focuses on exploring how nutrition shapes health and well-being at the Department of Experimental and Clinical Medicine, at the University of Florence, in Italy.

Parents: take an informed approach

Plant based diets remain entirely achievable for children and can offer environmental advantages as well as health benefits. The authors stress that families should not be discouraged from choosing vegetarian or vegan diets for ethical, environmental or health reasons. Instead, they recommend that parents approach these diets with informed planning and, where possible, seek support from clinicians such as dietitians and paediatric health professionals. With attention to a few key nutrients, these diets can fully meet children’s needs during periods of rapid growth while reducing nutritional risks.

“We hope these findings offer clearer guidance on both the benefits and potential risks of plant-based diets, helping the growing number of parents choosing these diets for health, ethical or environmental reasons,” Dr Dinu adds.

More research needed, but balance is key

The authors also emphasise the need for clear, evidence-based guidance to support families with planning healthy plant-based diets for children, who may have higher nutritional needs during periods of rapid growth and development.

However, the researchers caution that these results are limited by the cross-sectional design of most included studies, variability in methods and populations, and challenges in accurately assessing children’s dietary intake.

“In conclusion,” says fellow co-author Dr Wolfgang Marx, from the Food & Mood Centre, at Deakin University, Australia, “while well-planned vegetarian and vegan diets are nutritionally adequate and beneficial for adults, there is far less clarity about their suitability for children – leading to inconsistent or even conflicting advice for parents.

“Our findings suggest that a balanced approach is essential, with families paying close attention to certain nutrients – particularly vitamin B12, calcium, iodine, iron and zinc – to ensure their children get everything they need to thrive.”

Source: Taylor & Francis

Categories : Cancer Lab Tests and ImagingTags :

Diagnostic Breast MRI may be Unnecessary for Some Patients with Early-stage Breast Cancer

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Adding breast magnetic resonance imaging (MRI) to a diagnostic mammogram did not reduce five-year cancer recurrence rates for patients with stage I/II hormone receptor (HR)-negative breast cancer, according to researchers at The University of Texas MD Anderson Cancer Center. 

The Phase III Alliance A011104/ACRIN6694 trial found that five-year locoregional recurrence rates were 6.8% in patients who received an MRI as part of a diagnostic work-up and 4.3% in those who did not. These data were presented today at the San Antonio Breast Cancer Symposium (SABCS) by principal investigator Isabelle Bedrosian, MD, professor of Breast Surgical Oncology (Abstract GS2-07).

“We have long assumed that finding more breast cancer on an MRI and removing it with surgery would help lower the chance of a patient’s cancer coming back,” Bedrosian said. “When you look at our findings alongside earlier trials, the message is clear: adding MRI before surgery doesn’t improve results for patients – and may not have to be used as a standard part of the diagnostic process.”

No additional MRI benefit in this group

The trial enrolled 319 patients between 2014 and 2018 with newly diagnosed stage I or II HR-negative breast cancer. These patients were eligible for lumpectomy and did not have germline BRCA1/2 mutations, bilateral breast cancer or a history of prior breast cancer. All patients had undergone diagnostic mammography with or without ultrasound prior to trial enrolment.  Patients were randomly assigned to undergo additional imaging by breast MRI (161 patients) or to receive no further imaging (158 patients).

Not only did breast MRI not impact five-year recurrence rates, but there were also not significant differences between groups for five-year distant recurrence-free survival nor overall survival. 

A small subset of patients with tumour subtypes (HR- HER2+ and HR-HER2-) and those over the age of 50 at diagnosis also showed no benefit to MRI.

Pre-op MRI not finding anything important

Breast MRI is a common part of the diagnostic evaluation because it can reveal cancer that mammography might not detect. However, the evidence that it improves surgical outcomes for patients has been limited.

“We believe the reason MRI did not reduce recurrence rates may be twofold,” Bedrosian said. “It is possible that MRI didn’t uncover many lesions that mammography hadn’t already found, or perhaps identifying and surgically removing those additional lesions was not important to reducing risk of the cancer coming back. It’s possible that in the group that did not receive MRI, radiation and chemotherapy effectively treated the occult areas of disease”. 

Experts are now analysing how often breast MRI identified additional lesions in the trial population to better understand why breast MRI did not impact oncologic outcomes.

Study limitations 

Limitations included that most patients involved in the trial had breast cancer that hadn’t spread to their lymph nodes, which may partly explain why recurrence rates were low overall. Despite being open to women of all ages, the study enrolled mostly older women who may have been less likely to benefit from breast MRI. 

Categories : NeurologyTags :

Microbes May Hold the Key to the Brain’s Evolution

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First-of-its-kind study offers evidence that microbes from different primate species influence physiology in ways linked to brain size and function

Source: Pixabay

Humans have the largest relative brain size of any primate, but little is known about how mammals with larger brains evolved to meet the intense energy demands required to support brain growth and maintenance.

A new study from Northwestern University provides the first empirical data showing the direct role the gut microbiome plays in shaping differences in the way the brain functions across different primate species.

“Our study shows that microbes are acting on traits that are relevant to our understanding of evolution, and particularly the evolution of human brains,” said Katie Amato, associate professor of biological anthropology and principal investigator of the study, which was published in PNAS. 

The study builds upon previous findings from Amato’s lab that showed the microbes of larger-brained primates, when introduced in host mice,  produced more metabolic energy in the microbiome of the host – a prerequisite for larger brains, which are energetically costly to develop and function. This time, the researchers wanted to look at the brain itself to see if the microbes from different primates with different relative brain sizes would change how the brains of host mice functioned. 

What they found

In a controlled lab experiment, the researchers implanted gut microbes from two large-brain primate species (human and squirrel monkey) and one small-brain primate species (macaque) into microbe-free mice.  

Within eight weeks of making changes to the hosts’ microbiomes, they observed that the brains of mice with microbes from small-brain primates were indeed working differently than the brains of mice with microbes from large-brain primates. 

In the mice with large-brain primate microbes, the researchers found increased expression of genes associated with energy production and synaptic plasticity, the physical process of learning in the brain. In the mice with smaller-brain primate microbes, there was less expression of these processes. 

“What was super interesting is we were able to compare data we had from the brains of the host mice with data from actual macaque and human brains, and to our surprise, many of the patterns we saw in brain gene expression of the mice were the same patterns seen in the actual primates themselves,” Amato said. “In other words, we were able to make the brains of mice look like the brains of the actual primates the microbes came from.”

Another surprising discovery the researchers made was a pattern of gene expression associated with ADHD, schizophrenia, bipolar and autism in the genes of the mice with the microbes from smaller-brained primates. 

While there is existing evidence showing correlations between conditions like autism and the composition of the gut microbiome, there is a lack of data showing the gut microbes contribute to these conditions. 

“This study provides more evidence that microbes may causally contribute to these disorders —specifically, the gut microbiome is shaping brain function during development,” Amato said. “Based on our findings, we can speculate that if the human brain is exposed to the actions of the ‘wrong’ microbes, its development will change, and we will see symptoms of these disorders, i.e., if you don’t get exposed to the ‘right’ human microbes in early life, your brain will work differently, and this may lead to symptoms of these conditions.” 

Implications and next steps

Amato sees clinical implications for further exploration of the origins of some psychological disorders and for taking an evolutionary perspective on the way microbes affect brain physiology.

“It’s interesting to think about brain development in species and individuals and investigating whether we can look at cross-sectional, cross-species differences in patterns and discover rules for the way microbes are interacting with the brain, and whether the rules can be translated into development as well.

“Primate gut microbiota induce evolutionarily salient changes in mouse neurodevelopment” was published by the Proceedings of the National Academy of Sciences on Jan. 5.

Source: Northwestern University

Categories : NeurologyTags :

Post-stroke Injection of Nanomaterials Protects the Brain in Preclinical Study

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Ischaemic and haemorrhagic stroke. Credit: Scientific Animations CC4.0

When a person suffers a stroke, physicians must restore blood flow to the brain as quickly as possible to save their life. But, ironically, that life-saving rush of blood can also trigger a second wave of damage — killing brain cells, fuelling inflammation and increasing the odds of long-term disability.

Now, Northwestern University scientists have developed an injectable regenerative nanomaterial that helps protect the brain during this vulnerable window.

In a new preclinical study, the team delivered a single intravenous dose, immediately after restoring blood flow, in a mouse model of ischemic stroke, the most common type of stroke. The therapy successfully crossed the blood-brain barrier — a major challenge for most drugs — to reach and repair brain tissue. The material significantly reduced brain damage and showed no signs of side effects or organ toxicity.

Published in the journal Neurotherapeutics, the findings suggest the new therapy could eventually complement existing stroke treatments by limiting secondary brain injury and supporting recovery.

“Current clinical approaches are entirely focused on blood flow restoration,” said co-corresponding author Dr Ayush Batra, associate professor  at Northwestern and a neurocritical care physician with Northwestern Medicine. “Any treatment that facilitates neuronal recovery and minimises injury would be very powerful, but that holy grail doesn’t yet exist. This study is promising because it’s leading us down a pathway to develop these technologies and therapeutics for this unmet need.”

The injectable therapy is based on supramolecular therapeutic peptides (STPs), a platform developed by Northwestern’s Samuel I. Stupp. A study published in 2021 in the journal Science demonstrated the use of an STP technology — nicknamed “dancing molecules” — because of the highly dynamic nature of its therapeutic agents that could reverse paralysis and repair tissue in mice after a single injection at the site of severe spinal cord injury. The new study found scientists can administer similar dynamic assemblies of molecules intravenously, without requiring surgery or an invasive injection directly into the brain.

“One of the most promising aspects of this study is that we were able to show this therapeutic technology, which has shown incredible promise in spinal cord injury, can now begin to be applied in a stroke model and that it can be delivered systemically,” said Stupp, co-corresponding author. “This systemic delivery mechanism and the ability to cross the blood-brain barrier is a significant advance that could also be useful in treating traumatic brain injuries and neurodegenerative diseases such as ALS.”

Study mimicked real-world stroke treatment

Acute ischaemic stroke is a devastating condition and is one of the leading causes of morbidity and mortality worldwide, Batra said, severely impacting a patient’s quality of life and engagement in society.

“It has not only a significant personal and emotional burden on patients, but also a financial burden on families and communities,” he said. “Reducing this level of disability with a therapy that could potentially help in restoring function and minimising injury would really have a powerful long-term impact.”

The findings are highly relevant for future clinical applications because the scientists tested the approach in a mouse model that closely mimics real-world ischemic stroke treatment, Batra said. They first blocked blood flow to simulate a major ischaemic stroke and then restored it (a process called reperfusion), just as whem doctors restore blood flow acutely for ischaemic stroke patients.

The scientists monitored the mice for seven days and didn’t observe any significant side effects or biocompatibility issues such as toxicity or immune system rejection. They used advanced imaging techniques, such as real-time intravital intracranial microscopy seen in this video, to confirm the therapy localised to the stroke injury site. Compared to untreated mice, those treated with the “dancing molecules” had significantly less brain tissue damage, reduced signs of inflammation and reduced signs of excessive, damaging immune response.

Stupp said the therapy has pro-regenerative and anti-inflammatory properties, both of which contributed to the positive results.

“You get an accumulation of harmful molecules once the blockage occurs and then suddenly you remove the clot and all those ‘bad actors’ get released into the bloodstream, where they cause additional damage,” Stupp said. “But the dancing molecules carry with them some anti-inflammatory activity to counteract these effects and at the same time help repair neural networks.”

Dynamic ‘dancing molecules’ can be dialed down in concentration

The secret behind Stupp’s “dancing molecules” breakthrough therapeutic is tuning the collective motion of molecules, so they can find and properly engage constantly moving cellular receptors. The treatment sends signals that encourage nerve cells to repair themselves. For example, it can help nerve fibres (called axons) grow again and reconnect with other nerve cells, restoring lost communication through neural plasticity.

In previous studies, scientists injected the dancing molecules as a liquid, and when used to treat spinal cord injury, the therapy immediately gels into a complex network of nanofibres that mimic the dense, extracellular matrix of the spinal cord. By matching the matrix’s structure, mimicking the motion of biological molecules and incorporating signals for receptors, the synthetic materials are able to communicate with cells.

In the new study, the scientists dialled down the concentration of supramolecular peptide assemblies to prevent possible clotting as the therapy enters the bloodstream. Smaller aggregates of peptides easily crossed the blood-brain barrier. Once enough molecules cross, larger nanofibre assemblies can form in brain tissue to produce a more potent therapeutic effect, Stupp said.

“We chose for this stroke study one of the most dynamic therapies we had in terms of its molecular structure so that supramolecular assemblies would have a better probability of crossing the blood-brain barrier,” Stupp said.

Optimiaing therapeutic targeting

The fact that seemingly effective therapies cannot cross the blood-brain barrier has plagued the neuroscience field for decades, Batra said. This new therapy could change that.

When a physician acutely restores blood flow to a region of the brain in a stroke patient, the blood-brain barrier permeability is locally increased, naturally creating a transient opening and opportunity for therapeutic intervention, Batra said.

“Add to that a dynamic peptide that is able to cross more readily, and you’re really optimising the chances that your therapy is going where you want it to go,” Batra said.

Next steps

Further studies will need to assess whether this treatment can support longer-term, functional recovery, Batra said. For instance, many stroke patients suffer from significant cognitive decline throughout the subsequent year after a stroke. The new therapy is primed to address that secondary injury, Batra said, but the studies will require a longer follow-up period and more sophisticated behavioral testing.

In addition, the team is interested in testing whether additional regenerative signals could be incorporated into the therapeutic peptides to produce even better results.

Source: Northwestern University

Categories : HIVTags :

Trial Suggests Simple Treatment Change for HIV-related Sepsis

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Mycobacterium tuberculosis drug susceptibility test. Photo by CDC on Unsplash

A University of Virginia-led team of researchers has made a discovery that may change sepsis treatment for patients in Africa.

Over the course of five years, the researchers studied patients with HIV-related sepsis in eastern Africa, discovering that the most common cause of sepsis was tuberculosis and that treating it immediately, even before a tuberculosis diagnosis was made, significantly improved survival rates. 

Sepsis, or critical illness due to infection, is the leading global cause of death, responsible for an estimated one-fifth of deaths worldwide.

“We designed a trial with colleagues in Tanzania and Uganda to look specifically at people living with HIV, who suffer higher rates of sepsis and are more likely to die when they contract it,” said Dr Scott Heysell, director of the UVA Center for Global Health Equity and the co-lead investigator of the study. “Over half of the people enrolled in this trial were ultimately found to have tuberculosis and, if they immediately received tuberculosis treatment, they were significantly more likely to survive.”

Funded by a grant from the National Institutes of Health, the research, dubbed the “ATLAS study,” was done by a team of nearly 30 doctors, nurses, pharmacists, study coordinators and statisticians, including leading HIV and tuberculosis physician-scientists, Dr Stellah Mpagama from Kibong’oto Infectious Diseases Hospital in Tanzania, and Dr Conrad Muzoora, from the Mbarara University of Science and Technology in Uganda.

“The trial is the culmination of almost 20 years of collaborative work with colleagues in Uganda and Tanzania to better understand, diagnose and manage sepsis,” said co-lead investigator Dr Christopher Moore, professor of medicine and global health equity at the UVA School of Medicine. “The results of ATLAS have broad and significant implications for the treatment of sepsis in Africa, an all too common and deadly illness, which sadly is likely to become even more common with the advent of global public health funding cuts.”

It is often difficult to diagnose tuberculosis, so the team had to use newer and more exhaustive testing, according to Heysell.

“It is a tragedy to be on the front lines and witness the excessive mortality and morbidity from sepsis and tuberculosis, particularly among people with HIV,” said Dr Tania Thomas, a contributing researcher and associate professor of infectious diseases and international health at UVA. “These are treatable conditions, but time is rarely on our side. Until we have more accurate rapid diagnostic tests for tuberculosis, we are pleased to demonstrate that the strategy of immediate tuberculosis treatment can improve survival.”

The team has received additional NIH funding this year to continue its work through a new trial at four hospitals in Tanzania and Uganda to test whether the use of hydrocortisone to reduce inflammation and improve blood pressure, and/or an immediate treatment for tuberculosis and other bacterial pathogens, will improve 28-day mortality from HIV-related sepsis.

“In programmatic settings, tuberculosis treatment was mostly the same as for people without HIV, even though their health needs are more complex,” said Dr Mpagama. “Many of these patients have multiple infections at the same time, which makes their care more challenging.”

The research is part of UVA’s Center for Global Health Equity’s effort to establish meaningful, two-sided research partnerships in Eastern Africa, according to Heysell, who is working to increase educational and research opportunities outside of the US for UVA students. This includes coordinating clinical electives for medical students and other health science students in hospitals and clinics abroad.

To that end, emergency medicine professor Dr Amita Sudhir has been promoted to inaugural director for global health training within the center. Her goal will be to increase abroad opportunities for medical students within existing partnering organisations.

Source: University of Virginia

Categories : Environmental Effects Expert OpinionTags :

Opinion Piece: Can We Trust What Comes out the Tap?

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South Africa’s water quality monitoring gap explained

By Robert Erasmus, Managing Director at Sanitech

Source: Unsplash CC0

Access to safe and clean water remains a critical concern in South Africa. Recent incidents, including a highly contaminated water sample from Secunda that showed extreme levels of E. coli, have highlighted the urgent need for faster and more reliable water quality monitoring across the country. Public health depends on the safety of the water flowing through our rivers, dams and municipal systems, yet current monitoring processes often struggle to detect contamination before it reaches communities. Improving these systems will require a combination of practical testing methods, independent oversight and community involvement.

Why traditional testing cannot keep up
South Africa’s public water testing framework is accurate but slow. When contamination is suspected, samples must be collected, couriered to an accredited laboratory and cultured to detect biological threats such as E. coli. While potential of Hydrogen (pH) and chlorine levels can be measured quickly on site, biological tests take one to two weeks because the organisms must be grown before results can be confirmed. This delay leaves a dangerous gap in which water quality could deteriorate without immediate detection.

The process is also costly. A single accredited test, including logistics, can cost around R5 000, which makes frequent testing inaccessible for households and many community organisations. As a result, many people rely on the assumption that water from the tap is safe. When contamination does occur, individuals may fall ill without realising the cause because there is no real time feedback on water quality.

How in-house testing can speed up detection
Although accredited labs are still required for official reporting, new approaches are emerging that can help organisations identify risks earlier. Some companies are now investing in equipment that allows them to carry out basic testing in house. These tests are not accredited but they give fast, useful readings that act as early warning indicators. If an organisation detects abnormal results, it can immediately escalate the matter to an accredited lab instead of waiting for contamination to spread.

Routine pH and chlorine monitoring also plays a valuable role. These tests are inexpensive, easy to perform and can be carried out continuously within businesses or local facilities. While they cannot detect biological contamination, they help ensure that the chemical balance of the water stays within safe limits. When combined with monthly or cyclical biological testing, this creates a more proactive monitoring system.

This approach recently proved critical in Secunda, where a business conducting its own branch-level testing discovered that municipal water entering the site was contaminated with sewage. The in-house test flagged the issue quickly, prompting further investigation. Without this internal programme, the problem might have gone unnoticed for far longer.

Why collaboration improves water safety
A stronger water monitoring system cannot rely on public authorities alone. Partnerships between municipalities, private companies and communities can help improve both the speed and reliability of responses. Independent testing at business level introduces greater transparency and can highlight water quality issues that may otherwise go unreported. When patterns of poor quality emerge, communities gain evidence to push for corrective action.

Transparency also drives accountability. If businesses in a region consistently report poor water quality, it becomes more difficult for the problem to remain hidden. Public pressure increases and municipalities have a clearer picture of where urgent interventions are needed. This type of shared visibility is essential for strengthening trust and promoting faster action.

Communities have an important role as well. Residents are often the first to notice discolouration, odour or unusual cloudiness in their tap water. Reporting these signs to employers or organisations with the means to test can lead to early detection. Raising issues solely through political channels may not always lead to immediate investigation, but involving local businesses can create quicker pathways to testing and response.

A path toward safer and more reliable water
A safer water future for South Africa will depend on strengthening both formal and informal monitoring systems. Accredited labs remain vital for official results, yet in house testing, routine checks and community reporting can highlight risks long before formal samples are processed. When contamination is confirmed, solutions like filtration, Ultraviolet (UV) treatment or proper chlorination can be deployed quickly to restore safety.

What this shows is simple: the safety of tap water cannot be taken at face value. Consistent monitoring and transparent reporting are key to safeguarding public health. With better coordination between public bodies, private organisations and communities, South Africa can build a water monitoring system that identifies problems early and protects every household.