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  • Sandy beaches harbor a surprising source of methane emissions

    Sandy beaches harbor a surprising source of methane emissions

    We usually see the coast as a natural line of defense. Seagrass beds and mangroves are often praised for pulling carbon from the air. But there’s another story unfolding in the sand.

    New research from Monash University shows that sandy coastlines are not silent climate helpers. They also release methane, a greenhouse gas that warms the planet much faster than carbon dioxide.


    The study points to half of the world’s continental margins. These sandy stretches cover vast areas and have gone mostly unnoticed in climate models. They now appear to be an important, and underestimated, source of emissions.

    Sandy coastlines release methane

    Professor Perran Cook, a biogeochemist in the Department of Chemistry at Monash, is the principal investigator of the study.

    “This new finding not only challenges a fundamental assumption in marine science, but calls into question what we thought we knew about the role of sandy coastline ecosystems in greenhouse gas production,” said Professor Cook.

    In simple terms, the sand isn’t just storing carbon. It is leaking methane, and much of it comes from seaweed and seagrass breaking down. This means the gains we credit to coastal ecosystems may be smaller than once thought.

    Sand microbes producing methane

    The researchers worked in Australia’s Port Phillip Bay and Westernport Bay, and in Denmark’s Avernakø region.

    The team found microbes living in sandy sediments that can survive oxygen and keep producing methane. Until now, scientists believed these methanogens could only work in oxygen-free zones.

    Tests revealed two new strains. These microbes feast on the leftovers of decaying seaweed and seagrass. Instead of dying when oxygen floods their habitat, they bounce back quickly and restart methane production within hours. That recovery is much faster than anything seen in soils or rice fields.

    How the microbes make methane

    The microbes use a pathway called methylotrophic methanogenesis. They prefer compounds like trimethylamine, choline, and dimethyl sulfoniopropionate.

    All of these compounds are released when marine plants break down. Other potential food sources, such as acetate or hydrogen, did little to stimulate methane.

    This discovery shows why sandy sediments matter. They sit under mats of seaweed, soak up plant byproducts, and then feed methane straight into the atmosphere. Waves and currents push oxygen into the sand, but the microbes endure.

    Algal blooms make it worse

    Warmer water leads to more algae. The algae wash onto beaches and rot. As they decay, methane escapes into the air. This cycle keeps feeding itself, creating a feedback loop.

    Professor Cook warned that large blooms add fuel to the problem. “With rising sea temperatures, species invasions and increasing nutrient pollution, we’re seeing more frequent algal blooms and biomass accumulation on beaches.”

    “This could lead to larger and more frequent pulses of methane to the atmosphere, which in turn contributes to rising sea temperatures.”

    Sandy beaches match major methane sources

    The researchers calculated methane flux from sandy sediments. In some cases, emissions were as strong as wetlands, which are already known as major methane sources.

    The average methane flux matched mangroves and salt marshes but beat out seagrass meadows.

    Because these sands lie under shallow, turbulent waters, methane doesn’t linger. It escapes quickly instead of breaking down in deeper layers. This rapid release means sandy coasts may punch above their weight in the global methane budget.

    Persistent methane production

    The team isolated methanogen strains from both Australia and Denmark. Belonging to the genus Methanococcoides, they showed surprising resilience. When hit with oxygen, they paused. Once conditions shifted back, they resumed methane production within an hour.

    Genomic analysis revealed why. The microbes carry antioxidant defenses, including enzymes normally linked to oxygen-using organisms. These tools allow them to handle sudden oxygen bursts and keep working in shifting coastal sands.

    Local and seasonal drivers

    Not every coastline behaves the same. Seasonal growth and decay of different seaweed and seagrass species matter. Warm waters, nutrient levels, and grazing pressure also play roles. Tropical and temperate coasts may follow very different emission patterns.

    Human activity adds another layer. Fertilizer runoff and nutrient pollution drive eutrophication, leading to dense blooms.

    As these blooms wash ashore, they deliver more fuel for methane-producing microbes. Climate change then sharpens the cycle further.

    Sandy coastlines as methane sources

    Study first author and Monash Ph.D. candidate Ning Hall emphasized the path forward. “From here, we need to understand this process in more detail,” Hall said.

    Future work will examine how different species of seaweed and local ocean conditions affect emissions. These insights will help refine climate models and give a clearer picture of how much methane coastal zones release.

    The study changes how we see sandy shores. They store carbon but also release methane. Microbes, decaying plants, and shifting ocean conditions decide how much they give or take.

    By pulling this hidden source into focus, researchers show that coasts can’t be counted only as climate allies. They are active, dynamic players in the greenhouse gas puzzle, and they demand a place in future climate strategies.

    The study is published in the journal Nature Geoscience.

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  • Jaguar Land Rover manufacturing and retail ‘severely disrupted’ by cyber incident | Jaguar Land Rover

    Jaguar Land Rover manufacturing and retail ‘severely disrupted’ by cyber incident | Jaguar Land Rover

    Jaguar Land Rover’s manufacturing and retailing activities have been “severely disrupted” by a cyber incident, forcing it to shut down its systems.

    Britain’s largest carmaker said there was no evidence that any customer data had been stolen.

    “We are now working at pace to restart our global applications in a controlled manner,” JLR said in a brief statement. “At this stage there is no evidence any customer data has been stolen but our retail and production activities have been severely disrupted.”

    JLR said it had “proactively” shut down its systems and taken “immediate action to mitigate [the incident’s] impact”.

    The disruption comes as the luxury carmaker faces falling profits amid the impact of US tariffs and declining sales.

    The business, which is owned by the Indian conglomerate Tata, reported that underlying pre-tax profits fell by 49% to £351m in the three months to June, which included a period when the company temporarily paused exports to the US.

    A subsequent trade deal between the UK and the US cut car export tariffs from 27.5% to 10%. However, the pause contributed to a near £700m drop in revenue, down 9.2% year on year to £6.6bn.

    JLR did not give more details about who was behind the cyber incident, when it was discovered or how long it would take to recover from it.

    In April, Marks & Spencer revealed it had been the victim of a devastating cyber-attack which resulted in the closure of its online store for almost seven weeks and cost it hundreds of millions of pounds. The Co-op was attacked in the same month and forced to shut down parts of its IT system.

    In May, the luxury retailer Harrods said that it had been targeted, and restricted internet access across its websites after attempts to gain unauthorised access to its system. This was followed by Louis Vuitton, part of the French luxury group LVMH, in July, which said the data of some of its UK customers had been stolen.

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    JLR also said in July that it had to delay the planned launches of its new electric Range Rover and electric Jaguar models until 2026, after initially aiming for late 2025. The company told staff over the summer that it would axe up to 500 management jobs in the UK as part of a voluntary redundancy round.

    More than one in four UK businesses had been the victim of a cyber-attack in the past year and many more risked “sleepwalking” into such disruption unless they took urgent action, according to a survey of facilities managers, service providers and consultancies undertaken by the Royal Institution of Chartered Surveyors (Rics).

    More details soon…

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  • Parental controls are coming to ChatGPT ‘within the next month,’ OpenAI says

    Parental controls are coming to ChatGPT ‘within the next month,’ OpenAI says

    EDITOR’S NOTE:  This story contains discussion of suicide. Help is available if you or someone you know is struggling with suicidal thoughts or mental health matters. In the US: Call or text 988, the Suicide & Crisis Lifeline. Globally: The International Association for Suicide Prevention and Befrienders Worldwide have contact information for crisis centers around the world.

    ChatGPT’s parent company, OpenAI, says it plans to launch parental controls for its popular AI assistant “within the next month” following allegations that it and other chatbots have contributed to self-harm or suicide among teens.

    The controls will include the option for parents to link their account with their teen’s account, manage how ChatGPT responds to teen users, disable features like memory and chat history and receive notifications when the system detects “a moment of acute distress” during use. OpenAI previously said it was working on parental controls for ChatGPT, but specified the timeframe for release on Tuesday.

    “These steps are only the beginning,” OpenAI wrote in a blog post on Tuesday. “We will continue learning and strengthening our approach, guided by experts, with the goal of making ChatGPT as helpful as possible.”

    The announcement comes after the parents of 16-year-old Adam Raine filed a lawsuit against OpenAI alleging that ChatGPT advised the teenager on his suicide. Last year, a Florida mother sued chatbot platform Character.AI over its alleged role in her 14-year-old son’s suicide. There have also been growing concerns about users forming emotional attachments to ChatGPT, in some cases resulting in delusional episodes and alienation from family, as reports from The New York Times and CNN have indicated.

    OpenAI didn’t directly tie its new parental controls to these recent reports, but said in a blog post last week that “recent heartbreaking cases of people using ChatGPT in the midst of acute crises” prompted it to share more detail about its approach to safety. ChatGPT already included measures, such as pointing people to crisis helplines and other resources, an OpenAI spokesperson previously said in a statement to CNN.

    But in the statement issued last week in response to Raine’s suicide, the company said its safeguards can sometimes become unreliable when users engage in long conversations with ChatGPT.

    “ChatGPT includes safeguards such as directing people to crisis helplines and referring them to real-world resources,” a company spokesperson said last week. “While these safeguards work best in common, short exchanges, we’ve learned over time that they can sometimes become less reliable in long interactions where parts of the model’s safety training may degrade. Safeguards are strongest when every element works as intended, and we will continually improve on them, guided by experts.”

    In addition to the parental controls announced Tuesday, OpenAI says it will route conversations with signs of “acute stress” to one of its reasoning models, which the company says follows and applies safety guidelines more consistently. It’s also working with experts in “youth development, mental health and human-computer interaction” to develop future safeguards, including parental controls, the company said.

    “While the council will advise on our product, research and policy decisions, OpenAI remains accountable for the choice we make,” the blog post said.

    OpenAI has been at the center of the AI boom, with ChatGPT being one of the most widely used AI services with 700 million weekly active users. But it’s been facing increased pressure to ensure the safety of its platform; senators in July wrote a letter to the company demanding information about its efforts in that regard, according to The Washington Post. And advocacy group Common Sense Media said in April that teens under 18 shouldn’t be allowed to use AI “companion” apps because they pose “unacceptable risks.”

    The company has also grappled with criticism around ChatGPT’s manner and tone in interactions; in April it rolled back an update that made the chatbot “overly flattering or agreeable.” Last month, it reintroduced the option to switch to older models after users criticized the latest version, GPT-5, for its lack of personality. Former OpenAI executives have also accused the company of paring back safety resources in the past.

    OpenAI said it will roll out additional safety measures over the next 120 days, adding that this work has been underway prior to Tuesday’s announcement.

    “This work will continue well beyond this period of time, but we’re making a focused effort to launch as many of these improvements as possible this year,” it said.


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  • 36 Throwback Photos Of Sofia Coppola, The Queen Of ’90s Minimalism

    36 Throwback Photos Of Sofia Coppola, The Queen Of ’90s Minimalism

    Growing up, there was no one that I was more obsessed with than Sofia Coppola. The New York-born daughter of Hollywood legends Francis Ford and Eleanor Coppola had directed some of my favorite films as a teenager: The Virgin Suicides, Lost in Translation, Marie Antoinette, Somewhere. She was also the reason I aspired to be a director, and actually thought it was possible as a woman, in a world before Kathryn Bigelow became the first woman to win the best-director Oscar.

    But there was also the matter of her style. Here was an It-girl who shrugged off that mantle—one with a penchant for laidback, understated looks, who also always had a certain polish and never-less-than-impeccable taste. Through the ’90s, she lived in silk slip dresses, turning up to glitzy LA premieres in flats and running back to New York as soon as she could to stroll the city in denim and cashmere. There was an ease to her ensembles, a kind of careless intellectualism, but also a very precise understanding of and appreciation for fashion.

    This comparatively carefree heyday is about to be revisited in Marc by Sofia, the auteur’s first-ever documentary, which will chronicle the rise of her longtime friend and collaborator Marc Jacobs. Billed as both a highly personal love letter and an ode to ’90s New York, it’s sure to be crammed with swoon-worthy fashion moments, courtesy of the pair and their glittering circle of friends.

    Ahead of its premiere at the Venice Film Festival, we revisit 36 of the best throwback photos of Sofia, tracking her evolution from industry scion to stylish young actor, model, and designer, and eventually, one of the most accomplished filmmakers of her generation.

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  • Ultra-processed foods linked to weight gain, hormone disruption and lower sperm quality in men

    Ultra-processed foods linked to weight gain, hormone disruption and lower sperm quality in men

    International scientists speculate that the rise of ultra-processed foods (UPFs) is linked to a diversity of poor health outcomes in men, highlighting that rates of obesity and type-2 diabetes have soared, while sperm quality has plummeted over the past 50 years.

    The study revealed that men gained more weight on ultra-processed meals than on minimally processed foods, even when both diets contained the same number of calories.

    Additionally, it flags that diets high in ultra-processed foods expose consumers to higher levels of plastic-based pollutants that may impact sperm quality.

    However, the researchers cannot confirm whether these impacts are attributed to the industrial nature of the food ingredients themselves, the processing of the foods, or because they lead people to eat more than they should.

    “Our results prove that ultra-processed foods harm our reproductive and metabolic health, even if they’re not eaten in excess. This indicates that it is the processed nature of these foods that makes them harmful,” says Jessica Preston, lead author of the study, who carried out the research during her PhD at the University of Copenhagen’s NNF Center for Basic Metabolic Research (CBMR), Denmark.

    Ultra-processed weight gain

    The researchers cross-examined the health impact of unprocessed and ultra-processed diets on each individual. Their study involved 43 male participants aged 20 to 35, who spent three weeks on each of the two diets, with a three-month “washout” period in between.

    Half of the group began with the ultra-processed diet, while the other was assigned an unprocessed diet.

    The participants were not informed which diet they were assigned. Both the unprocessed and ultra-processed diets had the same amount of calories, protein, carbs, and fats.

    Additionally, half of the men also received a high-calorie diet with an extra 500 daily calories, while half received the normal amount of calories for their size, age, and physical activity levels.

    Regardless of whether they were on the normal or excess calorie diet, participants fed ultra-processed foods gained around 1 kg more of fat mass compared to the unprocessed diet.

    In terms of metabolism, participants’ daily energy intake was approximately 500–800 kcal higher when consuming ultra-processed foods compared to an unprocessed diet. However, it’s still unclear if the negative health effects are solely from the extra calories or if the foods are inherently harmful.

    Exposure to endocrine disruptors

    The study published in Cell Metabolism warns of a “worrying increase” in the amounts of the hormone-disrupting phthalate cxMINP — a substance used in plastics — in men on the ultra-processed diet.

    Men on this diet also recorded lower levels of testosterone and follicle-stimulating hormone, which are crucial for sperm production.

    Surprisingly, when participants switched over to an unprocessed diet, they exhibited a short-term increase in inflammation.

    The researchers believe this happened because the participants were already lean and used to a diet with many UPFs. The sudden change to an unprocessed diet may have triggered a temporary stress response, causing this unusual inflammatory reaction.

    “We were shocked by how many body functions were disrupted by ultra-processed foods, even in healthy young men,” says the study’s senior author, professor Romain Barrès from the University of Copenhagen’s NNF Center for Basic Metabolic Research and the Université Côte d’Azur, France.

    “The long-term implications are alarming and highlight the need to revise nutritional guidelines to better protect against chronic disease.”

    Nuance is needed in UPF research

    UPF consumption has been linked to a range of negative health outcomes independent of caloric intake. Investigations into this topic have highlighted their potential links to overall weight gain, early-onset Parkinson’s disease, and increased intramuscular fat content.

    However, experts urge a more nuanced approach to investigating the effects of UPFs, warning against blanket regulatory policies restricting their consumption. They advocate more emphasis on avoiding nutrient-poor UPFs in dietary guidance, rather than avoiding all types of UPFs.

    The Physicians Committee for Responsible Medicine cautions that few US consumers can identify healthy UPFs, with 39% of poll respondents believing all types of processed foods are unhealthy.

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  • Vit C and E may boost muscle strength in older women

    Vit C and E may boost muscle strength in older women

    Writing in the journal Medicine, researchers from Liaoning University of Traditional Chinese Medicine and other institutions in China suggested that the underlying mechanism may be related to the alleviation of oxidative stress and inflammation.

    “Emerging evidence suggests that targeted nutritional supplementation may mitigate oxidative stress by augmenting antioxidant defense mechanisms,” they wrote.

    “Among dietary antioxidants, vitamins C and E have demonstrated particular promise in attenuating oxidative damage through free radical scavenging and lipid peroxidation inhibition.”

    Sanofi-Aventis Healthcare Pty Ltd, Australia provided the vitamins used in the study.

    Targeted nutrition for sarcopenia

    Sarcopenia is the progressive loss of muscle mass and strength, primarily affecting older ad. It is estimated to affect approximately 10% of individuals over the age of 60.

    The condition can lead to a reduced quality of life and independence, an increased incidence of falls and a higher risk of fractures.

    Physical activity, particularly resistance training, is the primary strategy for preventing and managing sarcopenia. In addition, nutritional interventions, such as increasing protein intake, are also recommended.

    Oxidative stress plays a central role in the pathophysiology of sarcopenia. As people age, reduced levels of antioxidant enzymes in muscles and inadequate micronutrient intake in the diet can contribute to increased inflammation. Furthermore, while resistance training is beneficial, it can also generate reactive oxygen species, potentially exacerbating oxidative stress if not properly managed.

    As antioxidants, vitamins C and E may help to counteract oxidative stress. However, the researchers noted that previous studies indicate that supplementation can impede muscular adaptations depending on an individual’s redox state.

    “This dichotomy underscores the importance of precision nutrition strategies, wherein antioxidant supplementation is tailored to address specific deficiencies, thereby optimizing exercise benefits,” they wrote.

    Study details

    The researchers randomly assigned sixty women between the ages of 60 and 75 with sarcopenia to consume either 1,000 mg of vitamin C and 335 mg of vitamin E or a placebo daily for 12 weeks.

    Participants also attended three 50-minute training sessions a week involving elastic band resistance exercises targeting different parts of the body.

    While both groups increased their muscle mass, strength and physical performance after 12 weeks, participants in the antioxidant group had larger increases in arm lean mass, skeletal muscle mass index, handgrip strength and knee extension strength.

    The researchers did not observe a significant difference in physical performance between the two groups.

    The findings indicated that serum vitamin C and E levels at the end of the study were adequate in the supplement group but not in the placebo group. In addition, “changes in blood biomarkers proved the beneficial effects of vitamins C and E supplementation on physiological adaptation to RT [resistance training],” the researchers wrote.

    They reported that reduced glutathione (GSH) and the reduced glutathione/oxidized glutathione (GSH/GSSG) ratio increased in the supplement group, which they noted may be attributed to the synergistic effects of the vitamins promoting GSH synthesis, regeneration and reduced consumption.

    “Elevated serum GSH levels are particularly significant, as skeletal muscles can deliver GSH to the circulation, and increased serum GSH reflects positive muscle adaptations to exercise training,” the researchers wrote.

    They also found significantly lower levels of IL-6, leading them to hypothesize that the vitamins improved the redox state or exerted anti-inflammatory effects.

    “It has been reported that reduced circulating levels of IL-6 play an important role in mitigating muscle mass and strength loss in sarcopenia,” they wrote.

    The study recommended future research to explore whether longer-term interventions could lead to further improvements in physical performance.

    Source: Medicine 104(34) p. e43976, Aug. 22, 2025. | doi: 10.1097/MD.0000000000043976 “Effects of vitamins C and E supplementation combined with 12-week resistance training in older women with sarcopenia: A randomized, double-blind, placebo-controlled trial.” Authors: X. Liu et al.

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  • Capcom’s president says high price of PS5 has contributed to low sales of Monster Hunter Wilds

    Capcom’s president says high price of PS5 has contributed to low sales of Monster Hunter Wilds

    Capcom president Haruhiro Tsujimoto has attributed the high price of the PlayStation 5 as a reason for low sales of Monster Hunter Wilds.

    During an interview with Nikkei Gaming (translated by ResetEra), Tsujimoto discussed the immediate success of the title, which sold eight million copies in three days making it the fastest-selling title in Capcom’s history.

    However, in its most recent financial results Capcom described sales of Monster Hunter Wilds as “soft” having moved 477,000 units in Q1 2025, bringing its total sales to 10.6 million units.

    Tsujimoto attributed this drop to the high price of the PlayStation 5 and subscriptions, along with the $70 game price tag, as a barrier for most consumers.

    “The console costs about ¥80,000 ($538),” he noted. “When you factor in the cost of software and monthly subscriptions, it comes to about ¥100,000 ($672) at the time of purchase.

    “This is not an amount that can be easily reached, especially for younger generations. This situation is not limited to Japan, but is similar overseas as well.”

    Capcom’s president said it is “currently formulating a strategy” to “boost sales” of Monster Hunter Wilds throughout the rest of the year.

    Elsewhere in the interview, Tsujimoto also highlighted the success of the Switch 2 and its price tag ¥48,980 ($329). “The response was better than we had expected,” he said.

    “While prices vary by country, this reaffirmed the high level of cost-consciousness among ordinary consumers.”

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  • Lady Macbeth of the Mtsensk District review – semi-staged Shostakovich is vivid and claustrophobic | Proms 2025

    Lady Macbeth of the Mtsensk District review – semi-staged Shostakovich is vivid and claustrophobic | Proms 2025

    Bullying, sexual violence, love-starved relationships, murder and desperate, unending boredom. Never mind trigger warnings: these are the narrative pillars of Shostakovich’s Lady Macbeth of the Mtsensk District, the opera decried by Stalin as “muddle instead of music”. Stalin’s sudden condemnation was thoroughly political, of course – but British music critics were similarly taken aback after the first UK performance in 1936. “Some of it is clever parody, but much of it is crude,” sniffed the Daily Mail. Almost 90 years later, the opera remains unequivocally grim.

    Like its UK premiere, this Proms outing was a concert performance in English translation. Without the trappings of a full staging or the linguistic buffer of the original Russian libretto, the nastiness of this tale of a rape that starts an affair that leads to two murders seemed even more inescapable than usual. Ruth Knight’s semi-staging involved minimal paraphernalia – an iron bed, a small table, a wooden witness box – but used lighting to melodramatic effect. Harsh spotlights isolated characters. The digital screens behind the performers switched several times to blinding white, transforming the Chorus of English National Opera Chorus into a mob in silhouette. The entire stage was bathed periodically in red.

    Shostakovich’s Lady Macbeth at the BBC Proms. Photograph: Andy Paradise

    No wonder the audience giggled as Nicky Spence’s Sergey muttered “Now we’re really in the shit,” as the betrayed husband approached the lovers’ bedroom: light relief was in distinctly short supply. For all that Shostakovich called the piece a “tragic satire” and included numerous lively musical parodies – of ballroom dances and operetta, circus music and brass-band oompah – conductor John Storgårds kept the BBC Philharmonic deadly serious. There were rude bassoons (grittily flatulent in their lowest register) and even ruder, detumescent trombones, strings that waltzed and woodwind that fidgeted. But Storgårds allowed no levity. Long stretches of the score function as mid-century modern wallpaper, the orchestra ticking over in the background, as restless as the heroine. Occasionally, Storgårds coaxed quiet passages of stunning tenderness; but climaxes crashed relentlessly in vast waves of blaring brass and vicious timpani strokes.

    That the solo voices struggled at times to compete only added to the performance’s increasingly acute claustrophobia. Brindley Sherratt was on rich-voiced, characterful form as Boris, the piece’s appalling patriarch. As his son and the heroine’s husband, John Findon had both the vocal power and imposing stage presence to resist any suspicion that the character is purely a pushover. There were impressive contributions from Ava Dodd and Niamh O’Sullivan as alternative lust-objects. But nothing was more striking or disturbing than the interaction between Spence’s Sergey and Amanda Majeski’s Katerina: the former heroically clarion even while dramatically faithless, the latter a terrifyingly lyrical portrait of a woman “so bored I could hang myself” – or, as it turns out, commit murder.

    Listen again on BBC Sounds until 12 October. The Proms continue until 13 September.

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  • Congratulations! Lord Hugh Carnegie, son of the Duke of Fife, ties the knot as his motor car scion bride dons a historic family tiara

    Congratulations! Lord Hugh Carnegie, son of the Duke of Fife, ties the knot as his motor car scion bride dons a historic family tiara

    Kate Morgan, pictured, tied the knot with Lord Hugh Carnegie, son of the Duke of Fife, with a celebration at Kinnaird Castle

    Instagram @paullyonmaris

    Wedding bells rang throughout Kinnaird Castle over the weekend, as Lord Hugh Carnegie, son of the Duke of Fife, celebrated his big day with his bride, Kate Morgan, scion of the Morgan Motor Company. Through his father, who is a third cousin of King Charles, Lord Hugh can trace his lineage back to Queen Victoria. His brothers – Charles, the Earl of Southesk, and George – are both older than the groom, and thus ahead of him in line to inherit the Fife Dukedom.

    All eyes, of course, were on the bride, who wore a historical family heirloom to say her vows. Dazzling in a lace wedding gown, Kate donned the Fife Fringe Tiara, a diamond headpiece that was gifted to Princess Louise of Wales by her parents – later King Edward VII and Queen Alexandra – on the occasion of her wedding to the 1st Duke of Fife in 1889. The tiara has seen a host of historic royal nuptials across the decades, with Princess Louise wearing it as a necklace to the wedding of her brother, the future King George V, and Mary of Teck in 1893. Similarly, Louise, as Princess Royal, wore the jewels around her neck to Windsor Castle when she attended the wedding of her cousin, Princess Margaret of Connaught, to Prince Gustaf Adolf of Sweden in 1905.

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  • Upadacitinib for treatment of severe alopecia areata in adolescent pat

    Upadacitinib for treatment of severe alopecia areata in adolescent pat

    Introduction

    Alopecia areata (AA), a common, immune-mediated, non-scarring form of hair loss, affects up to 2% of the general population in all ethnic-, sex-, and age-based groups.1 Besides patchy loss of head hair, AA may cause varying degrees of eyebrow, eyelash, pubic, and axillary hair loss. It can also cause nail dystrophy in severe cases. Baricitinib, an inhibitor of Janus kinase (JAK)1/2, has been approved for treatment of severe AA in adults by the Food and Drug Administration (FDA).2 However, there is still scanty clinical evidence for the use of JAK inhibitors in adolescents and pediatric patients with severe AA. The impairment of quality of life, urgent need for treatment, frequent relapses, and safety issues around medication make the treatment of adolescent and pediatric AA patients challenging.

    Upadacitinib, a JAK 1 inhibitor, has been used to treat atopic dermatitis in patients aged 12 and older,3 despite its efficacy and safety in adolescents and pediatric patients with severe AA being unclear. Here, we report a case series of upadacitinib treatment of adolescents with severe AA and present the findings of a narrative review.

    Materials and Methods

    Adolescents with severe AA were recruited from the outpatient department of dermatology and completed 6 months of follow-up between November 2023 and December 2024. The inclusion criteria were as follows: (1) age from 12 to 17 years at the time of enrollment; (2) severe AA as evidenced by Severity of Alopecia Tool (SALT) scores over 50; (3) AA refractory to more than 3 consecutive months of at least one type of systemic therapy, including corticosteroids and immunosuppressive agents; and (4) patient strongly desirous of further treatment. The exclusion criteria were as follows: (1) contraindications to upadacitinib such as severe infection, tumor, thrombosis, and allergy; (2) aged less than 12 or over 18 years at the time of enrollment; (3) mild or moderate AA as evidenced by SALT scores less than 50; (4) no systemic therapy before initiation of a JAK inhibitor or treatment course less than 3 months; and (4) failure to attend for follow-up visits. All enrolled patients underwent full laboratory examinations, including antinuclear antibodies, thyroid function, plasma trace elements, immunoglobulin, ferritin, vitamin A, vitamin E, coagulation function, chest radiograph and screening for Hepatitis B virus and tuberculosis. All participants received upadacitinib 15 mg/day orally. SALT scores were used to assess AA severity and activity at monthly follow-ups. Adverse events were recorded during follow-up. The study was approved by the Ethics Committee of Peking Union Medical College Hospital, and complied with the Declaration of Helsinki. Written informed consent for publication was obtained from these patients’ legal guardians.

    We conducted a literature review of the PubMed, Web of Science Core Collection database and Cochrane Library on 14th August 11, 2025. The search terms were ((alopecia areata) OR (alopecia totalis) OR (alopecia universalis)) AND (upadacitinib) AND ((Adolescent) OR (children) OR (pediatric)). Articles that met the following inclusion criteria were analyzed: (1) pediatric and adolescent patients; (2) patients with AA received upadacitinib treatment; and (3) papers written in English. The exclusion criteria were as follows: (1) adult patients who did not meet the age criteria.; (2) incomplete data; and (3) patient with comorbidities that cannot receive upadacitinib treatment. Two authors independently screened and extracted information from the articles.

    Results

    Case Series

    This is a retrospective case series. The cohort of this case series comprised three adolescents with severe AA (Table 1). Their mean age was 16.33 years (range 15–17 years) and the median duration of disease 6 years (range 1–10 years). None of the patients in this case series had a family history of AA or personal history of atopic dermatitis, allergic rhinitis, or asthma. The immunoglobulin E concentrations of these three patients were all within the normal range. All three had severe AA, with a median SALT score of 86.67 (range: 73–100, all > 50). Besides severe loss of head hair, two of the patients also had loss of eyebrow, eyelash, pubic, and axillary hair; additionally, one had nail dystrophy. The disease of all three patients was refractory to at least one type of systemic therapy, prior treatment having included systemic corticosteroids (n=3), cyclosporine (n=1), glycyrrhizin (n=1), traditional Chinese medicine (n=1), and topical minoxidil (n=3).

    Table 1 The Demographic Data and Clinical Response for Upadacitinib Treatment in This Case Series

    All three participants had received upadacitinib treatment at 15 mg/day for 6 consecutive months (Figure 1). Regrowth of eyebrow and pubic hair occurred earlier than regrowth of head hair, regrowth of eyebrows and pubic hair occurring in the first and second months after upadacitinib treatment, respectively, whereas obvious regeneration of head hair occurred approximately 4 months after initiating upadacitinib treatment. The median SALT score dropped to 36.33 (range: 15–57), representing a reduction of 58.08%, after 6 consecutive months of upadacitinib treatment (Figure 2). Additionally, our patient’s eyelashes regrew later than their head, eyebrow, and pubic hair. However, there was no improvement in nail dystrophy after upadacitinib treatment. All participants in this case series tolerated upadacitinib treatment well. Mild acne was the most common adverse event, developing in all three participants and resolving in response to topical fusidic acid. No moderate or severe adverse events were reported during follow-up. Upadacitinib treatment was continued after 6 months’ treatment.

    Figure 1 The clinical manifestations for severe AA adolescent patients. (A) Patient 1 before treatment; (B) Patient 2 before treatment; (C) Patient 3 before treatment; (D) Patient 1 after 6 months of upadacitinib treatment; (E) Patient 2 after 4 months of upadacitinib treatment; (F) Patient 3 after 1 month of upadacitinib treatment.

    Figure 2 SALT score improvement before and after upadacitinib treatment.

    Literature Review

    A total of seven papers were finally included after implementation of the inclusion and exclusion criteria.4–10 Reported details concerning upadacitinib for treatment of AA in adolescent patients are summarized in Table 2. Up to now, a total of 26 adolescents with AA, including the three in the present study, from five countries, comprising Canada, China, Korea, Italy, and Poland, have reportedly received upadacitinib treatment. The youngest reported patient with severe AA to receive upadacitinib treatment was 9 years old. This patient had significant regrowth of head hair after 3 months’ treatment and stopped upadacitinib treatment without relapse from the 5-month follow-up.9 The most commonly prescribed dosage of upadacitinib in adolescents with severe AA was 15 mg/day. Sporadic hair regeneration has been reported to occur as early as the second week after initiating upadacitinib treatment.9 However, the time of onset of hair regrowth in most reports is 4 to 6 weeks after initiating treatment4,6,8 and the longest period of treatment with upadacitinib is 12 months.5,10 Comorbidities in adolescents with severe AA receiving upadacitinib treatment have included atopic dermatitis (AD, n=10), vitiligo (n=1), thyroiditis (n=1), conjunctivitis (n=2), allergic rhinoconjunctivitis (n=1), Crohn’s disease (n=1) and eosinophilic gastroenteritis (n=1). Additionally, besides inducing significant regrowth of hair, upadacitinib treatment has contributed to improvements in AD, vitiligo, and Crohn’s disease. Our study provides more clinical data on response to upadacitinib treatment in adolescents with severe AA and without comorbidities. Overall, upadacitinib is a well-tolerated and safe treatment in adolescents with severe AA. Mild adverse events have been reported, including increased creatine phosphokinase (n=8), onset or exacerbation of acne (n=6), mild upper respiratory tract infection (n=1), and transient mild leukopenia (n=1). To our knowledge, severe adverse events have not been reported in adolescents with severe AA.

    Table 2 The Literature Review Concerning Upadacitinib for Treatment of AA In Adolescent Patients

    Discussion

    A common autoimmune, non-scarring form of hair loss, AA has a slightly higher prevalence in pediatric and adolescent patients than in adults. It has been estimated that pediatric and adolescent patients with AA are more susceptible to autoimmune and metabolic disorders than are pediatric and adolescent individuals in general.11 AD is one of the most common comorbidities in pediatric and adolescent patients with AA.11 A systematic review found that topical corticosteroids and contact immunotherapy are the first and second commonly preferred treatments for pediatric and adolescent patients with AA.12 However, the management of refractory, severe, or frequently relapsing AA in adolescent is sometimes complex.

    The inhibitory effect of Janus kinase–signal transducers and activators of transcription signaling pathways is responsible for the favorable efficacy of JAK inhibitors in the treatment of both severe AA and AD. Up to now, there has been limited clinical evidence for the efficacy and safety of JAK inhibitors in adolescent and pediatric AA patients with and without comorbidities such as AD. Atopic diathesis, atopic comorbidities, and high serum concentrations of immunoglobulin E have been identified as risk factors for developing AA, especially coexisting AD. The genetic polymorphism of interleukins 13 and 4 and infiltration of mast cells and eosinophils in skin biopsies of patients with severe AA, and favorable responses to antihistamine and dupilumab therapy suggest that the mechanisms of Th1 and concomitant Th2 involved in AA.13 Our literature review showed that most reported adolescents with severe AA who had received upadacitinib treatment had concomitant AD. In one patient, upadacitinib treatment induced both hair regrowth and improvement in symptoms of AD, as well as relief of vitiligo. Another patient showed relief of symptoms of Crohn’s disease after upadacitinib treatment. The three patients in our study did not have a history of atopic diseases or atopic diathesis and had normal serum concentrations of immunoglobulin E, providing clinical evidence for the therapeutic efficacy of upadacitinib in adolescents with severe AA without AD. All three of our participants, none of whom had atopic comorbidity, responded well to upadacitinib treatment. In these patients, regrowth of eyebrow and pubic hair occurred earlier than did regrowth of head hair, the latter becoming obvious approximately 4 months after initiating treatment. Upadacitinib at 15 mg/day was the most commonly used treatment in reported adolescents with severe AA. Notably, the SALT score of our Patient 3 was still over 50 after 6 months of treatment. We gave further consideration to increasing this patient’s upadacitinib dosage because he weighed 90 kgs. Although one reported 9-year-old patient had significant regrowth of head hair after 3 months’ treatment and stopped upadacitinib treatment without relapse at the 5-month follow-up,9 our patients needed to continue on upadacitinib treatment for more than 6 months.

    A JAK 1 inhibitor, upadacitinib downregulates gamma-interferon signaling by inhibiting JAK activity, thereby preventing breakdown of hair follicles via immune mechanisms. Upadacitinib reportedly induced rapid regrowth of hair and significant improvement in quality of life in a retrospective study of 25 adults with AA.14 The FDA has approved upadacitinib for patients with atopic dermatitis aged 12 and older and provided more clinical and safety evidence to support its application in adolescents with severe AA aged from 12 to 17 years. One study has reported adverse musculoskeletal and skin events in male patients receiving upadacitinib treatment, whereas musculoskeletal issues, infections, and abnormal laboratory tests were prevalent and severe in female patients receiving upadacitinib treatment.15 According to our research and literature review, adverse reactions are mild in adolescents with severe AA receiving upadacitinib treatment. Increased creatine phosphokinase was the most common adverse event recorded in adolescents with severe AA treated with Upadacitinib, followed by onset or exacerbation of acne. Additionally, the adverse reactions did not differ significantly between sexes.

    Two Phase III trials over 52 weeks have found that baricitinib, an inhibitor of JAK 1/2, is an effective treatment for AA.16 The FDA has approved the use of baricitinib in adults with severe AA. There are also case reports supporting the off-label use of baricitinib for treating adolescents with severe AA. Compared with baricitinib, upadacitinib has the following advantages in treatment of adolescents with severe AA. First, upadacitinib more strongly inhibits the effect of JAK1/STAT on transcription than does baricitinib.17 In some studies, upadacitinib has been used as conversion therapy for insufficiently effective responses to baricitinib treatment, indicating the significance of JAK 1 inhibition in management of AA.18,19 Second, upadacitinib has been approved by the FDA for treatment of atopic dermatitis in children aged 12 and older, and it has been demonstrated that it is safer than baricitinib in adolescents aged 12 to 17 years. Third, upadacitinib may have better therapeutic effects on comorbidities of AA. AD has been identified as a risk factor for developing AA and is one of the most common comorbidities in pediatric and adolescent patients with AA. Although various JAK inhibitors have shown some efficacy in the management of AD, a network meta-analysis concluded that upadacitinib is the optimal option according to short-term studies.20 Further research is needed on the efficacy and safety of baricitinib and upadacitinib in the treatment of adolescents with severe AA.

    This study has several limitations. First, as a retrospective case series, future randomized controlled trials with larger sample sizes are warranted to confirm the efficacy and safety of upadacitinib in adolescents with severe AA. Second, while the follow-up period exceeded 6 months, longer-term evaluation is required to comprehensively assess the treatment’s sustained efficacy. Moreover, systematic assessment of disease recurrence following treatment discontinuation should be conducted in subsequent studies.

    Conclusion

    In conclusion, in the present study, we found that upadacitinib at 15 mg/day is an effective and safe treatment option for adolescents with severe AA, both in those with concomitant AD and vitiligo, but also in those without comorbidities. However, further long-term follow-up is warranted.

    Acknowledgments

    The study was approved by the Ethics Committee of Peking Union Medical College Hospital, and complied with the Declaration of Helsinki. Written informed consent for publication was obtained from these patients’ legal guardians.

    Funding

    Beijing Key Clinical Specialty Construction Project; National Key Clinical Specialty Project of China.

    Disclosure

    The authors report no conflicts of interest in this work.

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