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Methods and Applications: Auxiliary Diagnostic Value of the Interferon Gamma-Induced Protein 10 mRNA Release Assay for Tuberculosis in People Living with HIV/AIDS — Beijing Municipality, China, 2022–2024

Tuberculosis represents a chronic infectious disease whose clinical presentation becomes increasingly complex and atypical in HIV-infected individuals (1). Laboratory detection of Mtb often proves challenging, necessitating the integration of multiple diagnostic techniques to directly or indirectly identify evidence of Mtb infection — a critical step for ensuring timely diagnosis and treatment. Meta-analysis has demonstrated that the aggregated sensitivity of the IP-10 assay reaches 85% (95% CI: 80%–88%), with a specificity of 89% (95% CI: 84%–92%) (13), indicating the substantial potential of IP-10 as a biomarker for auxiliary TB diagnosis. However, evidence supporting effective diagnosis using this method in HIV-infected individuals, particularly those with severe immunosuppression, remains extremely limited.

In this study, we evaluated the diagnostic performance of the IP-10 mRNA release assay in 101 HIV-infected individuals suspected of having TB, categorizing them into 57 cases of pulmonary TB and 29 cases of non-TB based on final diagnosis. When compared with the commonly used immunological assay TB-IGRA, our results demonstrated the sensitivity and specificity of IP-10.TB for diagnosing PTB were 68.4% and 69.0%, respectively. Notably, the sensitivity of IP-10.TB was significantly superior to that of TB-IGRA (P<0.01), while no statistically significant difference in specificity was observed (P=0.07). Meta-analysis has revealed that the aggregated sensitivity of the IP-10 assay reaches 85% (95% CI: 80%–88%), with specificity at 89% (95% CI: 84%–92%) (13), indicating the substantial potential of IP-10 as a biomarker for auxiliary TB diagnosis. However, evidence supporting effective diagnosis using this method in HIV-infected individuals, particularly those with severe immunosuppression, remains extremely limited.

Our findings demonstrate that the IP-10 is predominantly secreted by monocytes and myeloid dendritic cells (14), with its release process being minimally affected by CD4⁺ T cell depletion. Furthermore, previous multicenter studies have indicated that the sensitivity of IP-10 mRNA as a biomarker remains largely uninfluenced by CD4⁺ T cell counts (15). Our results align with these conclusions, demonstrating that IP-10.TB exhibits high diagnostic sensitivity even in severely immunosuppressed populations. This enhanced performance can be attributed to the fundamental differences in detection targets between TB-IGRA and IP-10.TB. The former detects IFN-γ at the protein level, whereas the latter quantifies the transient expression of IP-10 mRNA, a downstream molecule in the IFN-γ signaling pathway (16), thereby substantially improving detection sensitivity.

In our study, IP-10 mRNA release assays demonstrated lower specificity compared to TB-IGRA, although this difference was not statistically significant. This reduced specificity may be attributed to the fact that most participants had CD4⁺ T-cell counts below 200 cells/μL, and this compromised immunity likely increased the prevalence of latent Mtb infection (17). Additionally, the limited sample size of the non-TB group may have further amplified this difference. Furthermore, false-positive cases in the non-TB group consisted mainly of NTM-infected individuals, with a negative detection rate of 52.6% (10/19). The ESAT-6, CFP-10, and PPE antigens utilized in IP-10.TB are derived from the region of difference-1 (RD-1) of Mtb. This region exhibits no cross-reactivity with antigens from BCG or the vast majority of NTM strains, except for a few species such as M. kansasii, M. marinum, and M. szulgai (18). Therefore, it effectively avoids interference from most NTM strains. However, when infected with NTM strains containing ESAT-6, CFP-10, or PPE antigens, these antigenic components may stimulate the host immune system, inducing a T-cell immune response similar to that elicited by Mtb infection. This phenomenon may result in positive IP-10 release assay results, thereby causing false-positive outcomes. False positives may also result from differences in the TB-specific antigens employed: TB-IGRA utilizes ESAT-6 and CFP-10 antigens, whereas IP-10.TB employs ESAT-6, CFP-10, and PPE antigens. However, the precise mechanisms underlying these differences require further investigation. In the present study, concordance between IP-10.TB and TB-IGRA results were poor, which may be attributed to three factors. Firstly, the differences in assay targets and their expression levels (mRNA versus protein). Secondly, a greater variability in HIV-infected individuals with severe immunosuppression. Thirdly, the lower sensitivity of TB-IGRA. Consequently, IP-10.TB may represent an attractive alternative diagnostic method for HIV-infected individuals.

Compared with traditional IGRAs, the IP-10.TB method requires a shorter incubation time, with results available in as little as six hours. Moreover, the linear detection range of PCR technology is broader than that of ELISA. By leveraging the amplification curves to calculate the results, the variability in result interpretation is reduced, enhancing the objectivity of the detection results. The findings of this study suggest that IP-10.TB has great potential for use in the early diagnosis of tuberculosis in HIV-infected individuals. By optimizing and integrating specific tests, patients with tuberculosis can be identified earlier, thus facilitating early initiation of treatment and potentially reducing the mortality rate associated with the disease.

This study also has some limitations. First, it was a single-center, small-sample study, and the extrapolation of conclusions are challenging. Moreover, the enrolled hospitalized patients were predominantly severely immunocompromised, which may have resulted in selection bias. Lastly, it might be more objective and convincing to use a third alternative method to validate the inconsistency between the IP-10 mRNA release assay and the TB-IGRA test results. This part of our work is in progress.

Therefore, multicenter studies with larger and more diverse samples are necessary to validate the diagnostic performance of IP-10 mRNA release assay. Additionally, although IP-10.TB has a high sensitivity, it is not effective in differentiating between latent infection with Mtb and active tuberculosis, and cannot predict the transition from latent infection to active tuberculosis. Besides, the IP-10.TB results could not reflect the relationship with the Mtb bacterial load, thus limiting its application in evaluating the efficacy of anti-tuberculosis treatment.

IP-10 mRNA release assays have significant clinical value and potential as an auxiliary tool for diagnosing TB in HIV-infected individuals. Furthermore, the combined use of IP-10.TB and Xpert MTB/RIF can increase the diagnostic efficacy of TB. In the cases of EPTB with insufficient diagnostic evidence, IP-10 mRNA release assays provide complementary and auxiliary diagnostic benefits.

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August 22, 2025
Noel Clarke loses libel case against Guardian over sexual misconduct investigation | The Guardian
The Guardian has successfully defended a libel action brought by the actor Noel Clarke over an investigation by the newspaper in which he was accused of sexual misconduct by more than 20 women.

In a high court judgment handed down on Friday, Mrs Justice Steyn rejected Clarke’s claim. He had said the allegations set out in the Guardian’s investigation were false and that he had been the victim of an unlawful conspiracy.

Clarke, 49, had said he would seek £70m in damages if successful.

The Guardian relied on testimony from almost 30 people, 18 of whom gave accounts in court about their experiences of working with Clarke, a former star of Doctor Who.

Many said they had been directly affected by Clarke, while others said they had witnessed inappropriate behaviour.

The Guardian argued the allegations were true and that the articles and podcast about him were in the public interest.

The writer and producer of the Kidulthood trilogy sued Guardian News & Media (GNM) over seven articles and a podcast published between April 2021 and March 2022 in which more than 20 women accused him of sexual misconduct.

The allegations against Clarke were made up of the following elements:
- There were strong grounds to believe that over 15 years, he used his power to prey on and harass female colleagues.
- He sometimes bullied female colleagues.
- He engaged in unwanted sexual contact, kissing, touching or groping.
- He engaged in sexually inappropriate behaviour and comments.
- He was involved in professional misconduct.
- He took and shared explicit pictures and videos without consent, including secretly filming a young actor’s naked audition.
In closing submissions, Gavin Millar KC, for the Guardian, said Clarke had been forced to come up with an “elaborate conspiracy theory” to try to rebut the “overwhelming evidence” against him.

Clarke had been shown to be “precisely the man” depicted in the Guardian’s articles accusing him of sexual misconduct, vindicating its journalism, the high court heard.

The actor had denied all the allegations and variously claimed that his accusers were lying, embellishing incidents, motivated by grudges and that there was a conspiracy against him.

At the conclusion of the trial, Philip Williams, representing Clarke, argued that his client was the victim of an industry attempting a “purge” in the wake of the #MeToo movement. He highlighted the Benny Hill and Little Britain series and Carry On films as productions that would now be considered “inappropriate”, and said the treatment of Clarke “represents illiterate historical revisionism and completely ignores any nuance or context”.

Millar said Clarke had “made unpersuasive but revealing efforts to normalise and/or excuse conduct that most people would find – and would have found, whether 10 or 20 years ago – offensive and unacceptable”.

Steyn’s judgment means Clarke, who said his career had collapsed as a result of the articles, faces a hefty legal bill and may also be required to pay the bulk of the Guardian’s legal costs.

The trial was a rare case of #MeToo-type allegations published by a UK newspaper going to trial. A victory for Clarke would have been likely to make the press rethink future reporting on such issues.

After the publication of the Guardian’s first report on Clarke, Bafta suspended a lifetime achievement award that it had given him the previous week and ITV declined to broadcast the final episode of the thriller Viewpoint, in which he was starring.

Additionally, Sky cancelled the award-winning police show Bulletproof, which was created by and starred Clarke. He also left Unstoppable Film and TV, the production company he co-founded and which produced Bulletproof.
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August 22, 2025
Famine declared in Gaza City – and projected to expand to two other areas in the next month | World News

A famine has officially been declared in Gaza City and the surrounding neighbourhoods, according to a UN-backed group.

The Integrated Food Security Phase Classification (IPC) – a globally recognised system for classifying the severity of food insecurity and malnutrition – has confirmed just four famines since it was established in 2004.

These were in Somalia in 2011, and in Sudan in 2017, 2020, and 2024.

The confirmation of famine in Gaza City is the IPC’s first outside of Africa.

“After 22 months of relentless conflict, over half a million people in the Gaza Strip are facing catastrophic conditions characterised by starvation, destitution and death,” the report said, adding that more than a million other people face a severe level of food insecurity.

Over the next month conditions are also expected to worsen, with the famine projected to expand to Deir al-Balah and Khan Younis, the report said.

Nearly a third of the population (641,000 people) are expected to face catastrophic conditions while acute malnutrition is projected to continue getting worse rapidly.

What is famine?

The IPC defines famine as a situation in which at least one in five households has an extreme lack of food and face starvation and destitution, resulting in extremely critical levels of acute malnutrition and death.

Famine is when an area has:

– More than 20% of households facing extreme food shortages.

– More than 30% of children suffering from acute malnutrition.

– A daily mortality rate that exceeds two per 10,000 people, or four per 10,000 children under five.

Over the next year, the report said at least 132,000 children will suffer from acute malnutrition – double the organisation’s estimates from May 2024.

Israel says no famine in Gaza

Volker Turk, the UN Human Rights chief, said the famine is the direct result of actions taken by the Israeli government.

“It is a war crime to use starvation as method of warfare, and the resulting deaths may also amount to the war crime of wilful killing,” he said.

COGAT, the Israeli military agency that coordinates aid, has rejected the findings.

Israel’s foreign ministry said there is no famine in Gaza: “Over 100,000 trucks of aid have entered Gaza since the start of the war, and in recent weeks a massive influx of aid has flooded the Strip with staple foods and caused a sharp decline in food prices, which have plummeted in the markets.”

Another UN chief made a desperate plea to Israel’s prime minister to declare a ceasefire in the wake of the famine announcement.

Tom Fletcher, UN under-secretary general for humanitarian affairs, said famine could have been prevented in the strip if there hadn’t been a “systematic obstruction” of aid deliveries.

“My ask, my plea, my demand to Prime Minister Netanyahu and anyone who can reach him. Enough. Ceasefire. Open the crossings, north and south, all of them,” he said.

The IPC had previously warned famine was imminent in parts of Gaza, but had stopped short of a formal declaration.

Image:
Palestinians struggle to get aid at a community kitchen in Gaza City. Pic: AP

Israel will blame Hamas

By Adam Parsons, Middle East correspondent

This is only the fifth time in the past two decades that the IPC system has been used to confirm a famine – and the first outside Africa. It’s not a threshold that is easily passed.

So what will happen? In fact, better to start with what won’t happen. There will be no sympathetic “mea culpa” from the Israeli government.

It will inevitably blame Hamas for starting a war that has led to a shortage of food, say that agencies are refusing to distribute aid, and further claim that Hamas is now stealing a big proportion of the aid that gets into the Gaza Strip.

More fundamentally, there will be those who allege that the United Nations is being played – saying that there is no famine, but rather a shortage of food that exacerbates existing health conditions.

In fact, it is a classic sign of famine that vulnerable people are the first to suffer.

And then the government will probably accuse the world of double standards – shocked by the plight of Gazans but not fighting to get aid to the 20 hostages who are still believed to be alive and in captivity in Gaza.

The Israelis already believe they have only one steadfast supporter left in the world, and that is the United States – the one friend they really couldn’t do without.

So far, there are no signs that America’s support is fading. Ambassador Mike Huckabee has laid the blame for hunger entirely on Hamas.

The latest report on Gaza from the UN Office for the Coordination of Humanitarian Affairs (OCHA) says there were almost 13,000 new admissions of children for acute malnutrition recorded in July.

The latest numbers from the Gaza health ministry are 251 dead as a result of famine and malnutrition, including 108 children.

But Israel has previously accused Hamas of inflating these figures, saying that most of the children who died had pre-existing health conditions.

This breaking news story is being updated and more details will be published shortly.

Please refresh the page for the latest version.

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August 22, 2025
7 drivers with 14 world titles – F1 legends relive their careers together in a special roundtable chat

In honour of the sport’s 75th anniversary year, F1 gathered a group of legendary former drivers for a very special roundtable conversation.

During the recent Goodwood Festival of Speed, Alain Prost, Jackie Stewart, Emerson Fittipaldi, Mika Hakkinen, Mario Andretti, Nigel Mansell and Jacques Villeneuve – who share a whopping 14 World Championships between them – sat down to answer a series of questions about F1.

Needless to say, the group told some fascinating stories from their respective eras in the sport, as well as reflecting on safety improvements over the years, the drivers who inspired them as youngsters, and the qualities they admired in each other.

Hit go on the video player above to watch the F1 legends’ roundtable.

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August 22, 2025
New scientific reviews highlight tocotrienols’ potent neuroprotective effects

A new scoping review published in the International Journal of Molecular Sciences highlights the growing scientific evidence that tocotrienols – the more potent form of vitamin E mainly extracted from palm fruits – play a unique role as natural neuroprotective agents supporting brain and cognitive as well as healthy aeging.1

The first review, led by researchers from the National University of Malaysia was conducted using the Arksey and O’Malley framework and PRISMA-ScR guidelines. By systematically searching PubMed, Scopus and Web of Science, the team identified and analysed 24 eligible articles of experimental studies to evaluate the neuroprotective effects of tocotrienols on the brain. Their findings revealed that tocotrienols exerts multiple unique protective mechanisms, including:

Antioxidant and anti-inflammatory effects – reducing oxidative stress, lipid peroxidation and inflammatory markers.

Regulation of gene and protein expression – modulating key molecular pathways linked to stroke-induced injutries, brain health and resilience.

Enhancement of memory and cognitive function – supporting learning, memory and behavorial performance in aging and neurodegeneration models.

Preservation of cell and organelle morphology – protecting neuronal structure and maintaining mitochondrial integrity.

A second review, published in June 2025, compared the distinct roles of tocopherols and tocotrienols in brain health2. The authors highlighted that while α-tocopherol remains the most widely studied, tocotrienols show stronger anti-inflammatory and antioxidative capacities and hold promise in preserving white matter integrity and modulating neurodegenerative pathways. Together, both forms of vitamin E may provide complementary benefits for cognitive performance, neuroinflammation, and structural brain protection.

Tocotrienol’s antioxidant and neuroprotective activities have been reported to be 40-60 and 1000 times respectively more potent than regular vitamin E tocopherol3,4. Taken collectively, these findings underscore tocotrienol’s unique potential as the next generation of vitamin E, particularly in supporting brain function and promoting healthy ageing.

“Backed by growing scientific evidence, tocotrienols are emerging as promising neuroprotective agents that support and protect brain cells, cognitive functions and memory as well as healthier aging,” said Dr Ariati Aris, Scientific Affairs Specialist at PhytoGaia. “A recent published clinical study shows that TocoGaiaTM enhances psychological well-being, modulates oxidative stress, and supports genomic stability in aging populations5. Building on this, we are now planning a new randomized-controlled trial with TocoGaiaTM for cognitive health, which we believe will further validate tocotrienols’ role as next-generation brain phytonutrient,” added Dr Aris.

“At PhytoGaia, we are a proud supplier of TocoGaiaTM – full spectrum tocotrienol complex that is backed by robust science and uncompromising quality,” said Mr Bryan See, Vice President of PhytoGaia. “For our partners and brand owners, TocoGaia™ offers a unique opportunity to differentiate their formulations with a next-generation vitamin E that delivers more than conventional tocopherols. With the latest science reinforcing tocotrienols’ potent neuroprotective potential, TocoGaiaTM is the perfect ingredient for companies looking to innovate and create value in areas such as in brain & cognitive health, healthy aging and functional nutrition.”

Disclaimer: The statements in the above article have not been evaluated by the Food and Drug Administration. They are not intended to diagnose, treat, cure or prevent any disease.

References:

Yunita, E. et al. (2025). Scoping Review: The Role of Tocotrienol-Rich Fraction as a Potent Neuroprotective Agent. International Journal of Molecular Sciences, 26(16), 7691.

Razali, RA. et al. (2025). Shifting Perspectives on the Role of Tocotrienol vs. Tocopherol in Brain Health: A Scoping Review. International Journal of Molecular Sciences, 26(13), 6339.

Serbinova, E. et al. (1991). Free radical recycling and intramembrane mobility in the antioxidant properties of alpha-tocopherol and alpha-tocotrienol. Free Radic Biol Med, 10(5), 263-275.

Sen, CK. et al. (2000). Molecular basis of vitamin E action. Tocotrienol potently inhibits glutamate-induced pp60(c-Src) kinase activation and death of HT4 neuronal cells. J Biol Chem, 275(17):13049-55.

Sharif, R. et al. (2025). Tocotrienol-Enriched Beverage Enhances Psychological Well-Being, Antioxidant Defense, and Genomic Stability in Older Adults: A Randomized Controlled Trial. Nutrients. Jun 30;17(13):2179.

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August 22, 2025
Scientists Find a New Moon Orbiting Uranus

A team of astronomers has found what appears to be a previously undiscovered moon orbiting Uranus. If confirmed, this finding would mean the gigantic blue-green ice planet would have 29 moons. The discovery was made using the James Webb Space Telescope (JWST), extending the instrument’s list of achievements and raising expectations that other new discoveries might be made within the solar system.

With JWST’s infrared camera, the researchers took ten 40-minute exposures of Uranus and detected a tiny, fuzzy dot accompanying the icy giant’s other moons. With the preliminary information gathered, the researchers estimate that it is a body of about 10 kilometers in diameter, located 56,000 kilometers from the center of the planet.

This new satellite is part of Uranus’ group of 13 inner moons, which are characterized by their irregular shapes and low brightness. It orbits just beyond the outer edge of the planet’s main ring system, along with other nearby moons such as Mab, Cordelia, and Ophelia.

At the moment, the object has the code name S/2025 U1. To confirm its status as a natural satellite, the team plans to make further observations; if its status as a moon is confirmed, it will then be given an official name. Traditionally, Uranus’ moons have been named after characters from works by William Shakespeare or Alexander Pope—such as Francisco, Stefano, Miranda, Trinculo, Ariel, and so on. Any new name for it or any other newly discovered satellite must be approved by the International Astronomical Union.

William Herschel discovered the first two moons of Uranus in 1787—Titania and Oberon—six years after identifying the planet. Dozens of others have since been found. The last time observatories detected an official satellite was in 2003, when Margaret was found using the Hubble telescope. Along with S/2025 U1, there is another unnamed moon also awaiting confirmation, S/2023 U1, which was discovered two years ago. In total, the scientific community has identified 29 moons (including these two awaiting confirmation).

The discovery of S/2025 U1 marks a new step in the observation of the solar system. Neither the Hubble Telescope nor the Voyager 2 probe that flew by Uranus in 1986 were able to find this moon; the fact that the JWST was able to uncover it suggests there is still more complexity to be discovered within Uranus’ ring system, and that thanks to this new tool, more discoveries could follow.

“Looking forward, the discovery of this moon underscores how modern astronomy continues to build upon the legacy of missions like Voyager 2, which flew past Uranus on January 24, 1986, and gave humanity its first close-up look at this mysterious world,” said Maryame El Moutamid, leader of the team that conducted the study, in a NASA statement. “Now, nearly four decades later, the James Webb Space Telescope is pushing that frontier even farther.”

This story originally appeared on WIRED en Español and has been translated from Spanish.

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August 22, 2025
DeepSeek hints latest model supported by China’s ‘next generation’ homegrown AI chips

Anthony Kwan | Getty Images News | Getty Images

Chinese artificial intelligence startup DeepSeek has hinted that China will soon have homegrown “next generation” chips to support its AI models, while announcing an update to one of its large language models.

In a comment under a post on its official WeChat account, DeepSeek said the “UE8M0 FP8” precision format of its newly released model V3.1 is tailored for the next-generation domestically built chips that will be launched soon.

FP8, or 8-bit floating point, is a data processing format that can boost the computational efficiency for training and inference of large deep learning models.

DeepSeek’s mention of China’s coming next-generation chips may signal plans to work more closely with China’s emerging AI chip ecosystem in the face of Washington’s advanced semiconductor export restrictions and Beijing’s push for chip self-sufficiency.

The comments come about two weeks after Beijing reportedly urged Chinese AI developers to use domestic alternatives to Nvidia’s graphics processing units used in AI training. While analysts say China’s domestic AI chipmakers lag behind Nvidia in technological advancement and scale, players like Huawei have been making progress.

In its Thursday post, DeepSeek did not disclose the chips it used to train the V3.1, or what local chips the UE8M0 FP8 might be compatible with.

DeepSeek shook up the tech world earlier this year after it released its R1 reasoning model, which demonstrated capabilities comparable to those of Western competitors like OpenAI, despite U.S. export controls restricting it from using Nvidia’s most advanced AI training chips.

Prior to that, in December, the company released its V3 model, which it said had been trained on about 2,000 of Nvidia’s less advanced chips.

Following DeepSeek’s model breakthroughs, the U.S. further tightened export restrictions in April, effectively banning Nvidia’s H20 chips, which had been specially designed to meet prior export restrictions on China.

Last month, officials from the Trump administration said they planned to allow Nvidia to resume shipping the chips to China. However, the H20s are now being met with scrutiny in China, with regulators reportedly mandating companies against buying the chips until a national security review is completed.

Chip analysts have told CNBC that companies like Huawei that have been seeking to build an alternative AI chip ecosystem in China could benefit from a lack of Nvidia’s H20s in the market.

DeepSeek said Thursday that its V3.1 came with “major changes,” including faster response times, and a hybrid reasoning architecture that allows the model to support both reasoning and non-reasoning modes. Reasoning models can execute more complicated tasks through a step-by-step logical thought process.

Starting Sept. 6, the company will also adjust the pricing for using the model’s API, which allows developers of other apps and web products to integrate DeepSeek on their platforms.

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August 22, 2025
New Guidance on Delayed Cord Clamping for Preemies

The American College of Obstetricians and Gynecologists (ACOG) has issued new guidelines on deferred umbilical cord clamping in preterm babies, based on evidence showing that such delays save lives.

The Clinical Practice Update recommends clinicians wait at least 60 seconds to clamp the cord for babies born before 37 weeks of gestation who do not require immediate resuscitation. In cases where infants born at 28 0/7-36 6/7 weeks can’t receive the deferral, umbilical cord milking can be used as an alternative to “improve neonatal hematologic outcomes,” the authors wrote.

The guidance incorporates evidence from two systematic reviews and individual participant data meta-analyses published in Lancet in 2023. Containing 48 and 47 randomized controlled trials each and a combined total of 12,461 babies born before 37 weeks of gestation, the research compared immediate with delayed clamping or milking and found dramatic differences in death rates before hospital discharge.

Premature infants whose umbilical cords were clamped between 30 and at least 180 seconds after birth had a 32% lower risk for death before discharge than those whose cords were immediately clamped, defined as within 15 seconds (odds ratio [OR], 0.68; 95% CI, 0.51-0.91).

The research showed that “delayed clamping doesn’t just help with the baby’s transfusion, it actually improves mortality, which is pretty huge,” said Ilina Pluym, MD, a health sciences assistant clinical professor of obstetrics and gynecology at the University of California Los Angeles Health who was not involved in the studies or writing of the Clinical Practice Update.

The reviews included breakdowns of varying cord clamping deferral times, with waits of 120 seconds or more having the best results. The odds of death before discharge were 69% lower in these patients than in those whose cords were immediately clamped (OR, 0.31; 95% CI, 0.11-0.80).

However, evidence demonstrating the benefits of this deferral length occurred in carefully selected clinical trial settings and “may not be generalizable to neonates assessed at birth as requiring immediate resuscitation or to settings in which adequate newborn assessment and support are not available while the cord is intact,” the authors wrote.

Given the limited generalizability of the 120-plus second deferral time, ACOG recommends waiting at least 60 seconds. The guidance is based on a post hoc analysis performed by the International Liaison Committee on Resuscitation Advanced Life Support Task Force.

In the two Lancet reviews, lengths of 15-45 seconds and 45-120 seconds delays in cord clamping did not result in a lowered death rate before discharge compared with immediate clamping. The 60-second plus time frame wasn’t specifically studied.

However, in the post hoc analysis, the task force found that waiting at least 60 seconds reduced mortality by 37% (OR, 0.63; 95% CI, 0.44-0.88).

Deferred clamping of any duration reduced blood transfusion needs in babies born before 32 weeks by 41% (OR, 0.59; 95% CI, 0.47-0.73). No differences were found in rates of intraventricular hemorrhage.

“Now we actually have good, evidence-based recommendations about what to do for delayed cord clamping in preterm babies,” Pluym said. “I think this is something that we’ve all been starting to do more and more regularly but we now have specific ACOG-recommended guidelines.”

The recommendations also reinforce the benefits of cord milking, said Pluym. In the trials, this practice did not result in lower death rates but did reduce the need for blood transfusions in babies born before 32 weeks by 31% (OR, 0.69; 95% CI, 0.51-0.93).

The guidelines show that “if you cannot do the full minute of being patient and just letting the gentle passage of blood happen through regular delayed cord clamping because of the issues listed in the guidelines — like the baby isn’t breathing, the mom is bleeding, the baby really doesn’t have good tone — then you can do cord milking,” she said.

The guidance lists additional circumstances in which clinicians should consider immediate clamping or individualize care, including when the baby is nonvigorous or there are fetal congenital malformations, multiple gestations, fetal growth restriction, or placenta previa, among others.

The authors said that “though these results may prompt changes in clinical protocols guiding duration of cord clamping for selected preterm neonates, such alterations require careful and multidisciplinary collaboration to ensure safe and high-quality care. More evidence is needed before recommending the routine practice of long deferral of cord clamping for 120 seconds or more in preterm newborns.”

Brittany Vargas is a journalist covering medicine, mental health, and wellness.

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August 22, 2025
Ilona Maher toys with idea of pro wrestling

Ilona Maher says she is thinking about wearing a new hat after the Women’s Rugby World Cup – that of a pro wrestler, as ‘Maher-vellous’, she would call herself.

“I’ve been approached before by the WWE,” the centre slash social media magnet told BBC Sport ahead of the World Cup opener between the United States and hosts England on Friday (22 August). “I don’t know if I would. I should think about it, there is great money in it.

“I would love to get into the acting space and the scripted space. I think a Dwayne ‘the Rock’ Johnson, John Cena progression – I would love to do that.

“It would be exciting to see my body type on the screen. I’ll start off small – probably like a hot assassin or something, let’s not get too crazy! I’m not going to be in a rom-com just yet.

“We’ll see. The world is open, but I do see myself coming back to rugby.”

Maher’s popularity already reaches beyond the world of rugby, with almost nine million followers on her social handles combined.

The 29-year-old, however, insists she is a rugby player first and foremost.

She won a bronze medal with the US sevens team at the Paris 2024 Olympic Games, and her debut for Bristol Bears against Gloucester-Hartpury set a new attendance crowd for the Premiership Women’s Rugby of 9,240.

“So many times people forget, but I am a rugby player first,” Maher said. “I do the social media because I have to because it is not sustainable to be a women’s rugby player – I am not going to make money doing it.

“It does irk me at times when people forget that. One comment once was: ‘Are you going to watch the Instagrammer play?’

“I was like, ‘No, I have won a bronze medal, I’ve been to two Olympics, I am a good rugby player who loves the sport.’

“I am proud to do both but I do want to be known as a rugby player.”

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August 22, 2025
FDA Approves New Option for NCFB

The FDA has approved brensocatib tablets in 10-mg and 25-mg doses as once-daily treatment for non-cystic fibrosis bronchiectasis (NCFB) in adults and children aged 12 years or older, according to a press release from manufacturer Insmed.

NCFB affects approximately 500,000 individuals in the US and millions globally, according to the press release. The condition is distinct from other respiratory infections, in that it involves widening of the airways rather than narrowing.

Exacerbations involving coughing, increased mucus, and shortness of breath are common and disruptive, but targeted treatments have been lacking, according to the company. Brensocatib, marketed as Brinsupri, is a first-in-class inhibitor of DPP-1, designed to prevent the activation of neutrophils that drive the chronic airway inflammation in patients with NCFB, according to the press release.

The approval was based on data from a phase 3 study known as ASPEN and a phase 2 study known as WILLOW. In the ASPEN study, patients with NCFB (1689 adults and 41 adolescents) randomized to 10 mg or 25 mg brensocatib daily had a 21.1% and 19.4% reduction in annual exacerbations, respectively, compared to placebo at 52 weeks. Forced expiratory volume in 1 second declined significantly in brensocatib patients compared to placebo patients, and significantly more brensocatib patients on either dose were exacerbation-free at 52 weeks.

The WILLOW study, a 24-week randomized controlled trial, established the drug’s safety and efficacy based on time to first exacerbation. Brensocatib at both the 10-mg and 25-mg doses significantly extended the time to first exacerbation compared to placebo, and safety data showed no obvious relationships to treatment. Adverse events were mild to moderate in 66%, 88%, and 75% of the placebo, 10 mg, and 25 mg groups, respectively, and serious adverse events were similar across the groups. One death caused by progression of bronchiectasis was reported in a patient in the 25 mg brensocatib group.

The approval authorizes the first treatment that directly targets the root cause of NCFB exacerbations, said ASPEN investigator Doreen Addrizzo-Harris, MD, NYU Grossman School of Medicine, New York City, in the press release. “Based on the strength of the data and the impact we’ve seen in patients, I believe this could become the new standard in non-cystic fibrosis bronchiectasis care,” she said.

Brensocatib is indicated for treatment of NCFB at doses of 10 mg or 25 mg once daily in adults and adolescents aged 12 years or older, with no current contraindications, according to the prescribing information.

Brensocatib is now available through a specialty pharmacy network in the US. In addition, brensocatib applications have been accepted by the European Medicines Agency and the Medicines and Healthcare products Regulatory Agency, and filing of an application in Japan is pending, according to the company, which expects commercial launches in these areas in 2026.

The ASPEN and WILLOW studies were funded by brensocatib manufacturer Insmed.

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August 22, 2025