Category: 8. Health

  • Unraveling adult ADHD symptoms through genetics and data science

    Unraveling adult ADHD symptoms through genetics and data science

    Kelli Lehto, Associate Professor of Neuropsychiatric Genomics at the University of Tartu, is leading a prestigious European Research Council (ERC) grant project that brings together genetics, psychology, and data science to investigate the causes of attention deficit hyperactivity disorder (ADHD) in adults and enhance diagnostic methods.

    ADHD is a highly heritable neurodevelopmental condition, which has been primarily diagnosed in children and is characterised by impulsivity, hyperactivity and attention problems. Recently, an increasing number of adults are being diagnosed with ADHD. According to data from the Estonian Biobank over the past five years, the number of ADHD diagnosed among adults has multiplied. This trend is also confirmed by international studies.

    According to Lehto, the rapid increase in the number of diagnoses suggests that symptoms characteristic of ADHD – such as restlessness and difficulties with concentration, planning, and completing tasks – are affecting a growing number of adults. While ADHD has been thoroughly studied in children, the causes and mechanisms behind the increasingly common adult ADHD remain unknown.

    The situation is further complicated by the fact that, in adults, ADHD symptoms often significantly overlap with those of many other mental health issues, such as depression or anxiety. These problems can also arise due to environmental factors like fatigue and stress. “However, existing data suggest that ADHD is associated with a large number of specific gene variants, which are not yet used in diagnosis but could prove to be very helpful,” Lehto explained, referring to the issue that inspired her research project.

    Genetics related to ADHD

    Over the next five years, Lehto’s research group plans to investigate the causes of adult ADHD-related issues using genetic data alongside environmental and lifestyle information, including data on the use of smart devices. In addition to the University of Tartu Estonian Biobank, the analysis will also draw on data from biobanks in Norway, the Netherlands, Sweden, and the United Kingdom. The study will focus on the genetics of ADHD symptoms to determine which traits are most strongly linked to ADHD genetically, and which may stem from other factors.

    Lehto acknowledges that the tools currently available to doctors do not allow for sufficiently accurate differentiation between mental health conditions.

    Currently, no diagnostic biomarkers are used in psychiatry. All diagnoses are still based primarily on what the patient reports.”

    Kelli Lehto, Associate Professor of Neuropsychiatric Genomics, University of Tartu

    More accurate diagnostic methods

    The ultimate goal of the project is to develop an innovative tool for more precise identification of adult ADHD. Using machine learning methods, the team will analyse questionnaire data on hundreds of mental health symptoms, lifestyle and personality traits to identify clusters of symptoms that are strongly associated with genetic risk for ADHD. Based on these findings, the research group aims to create a more accurate screening questionnaire that could help diagnose adult ADHD without the need for costly genetic testing. “This is where the innovation of our project lies. The result will be a novel biology-based assessment tool that will hopefully make it possible to more accurately identify adults who were not diagnosed with ADHD in childhood and who can finally receive the appropriate treatment for their lifelong problems. Even more importantly, this approach could also help to better identify other mental health conditions that are currently difficult to distinguish,” Lehto explained.

    The research project has a budget of nearly €1.5 million, funded by the European Commission. European Research Council grants are among the most prestigious in the scientific world. The competition attracted over 3,928 proposals,12% of which were funded.

    Source:

    Estonian Research Council

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  • Students with overprotective parents are more vulnerable to anxiety during their transition to university, researchers find | Newsroom

    Students with overprotective parents are more vulnerable to anxiety during their transition to university, researchers find | Newsroom

    First-year undergraduates who grew up with overly cautious or controlling parents tend to experience increased anxiety when faced with stresses associated with the transition to university, researchers from McGill University and the University of California (Los Angeles) have found.

    The researchers asked 240 first-year McGill students to fill out several questionnaires in the first six weeks of the fall semester. The questionnaires used well-established scales to measure the parenting style they were raised with, current anxiety symptoms and different types of stressors they encountered during the transition to university, including housing difficulties, personal loss or even life-threatening situations.

    The team then looked at associations among those variables, focusing on how the relationship between exposure to stressors and current experiences of anxiety correlated with different parental behaviours.

    “We found that students whose parents are very protective experience a stronger link between exposure to stressful events and feelings of anxiety,” explained Lidia Panier, the study’s lead author. Panier, a PhD student in the Department of Psychology, is a member of the Translational Research in Affect and Cognition (TRAC) Lab led by Professor Anna Weinberg, the study’s senior author and principal investigator.

    While cautioning that their study model does not allow them to conclude that overprotective parenting causes anxiety in children, the researchers note that such a conclusion would be consistent with the existing body of research.

    “Previous findings show that overprotective parenting leads to insecure attachment and poorer emotion regulation, both of which are linked to greater vulnerability to anxiety,” Panier said.

    She said she believes overprotective parenting in childhood and adolescence may not be helpful in teaching kids how to adapt to stressful situations in the long term. At the same time, she noted that the overprotective parenting might in some cases be a response to a child’s anxious behaviours: parents might develop watchful attitudes or controlling habits to protect a child who often appears fearful.

    “These interpretations are not mutually exclusive,” explained Panier. “A bi-directional dynamic where child behaviours influence parenting, which then affects child development, is also well-supported in the literature.”

    The researcher said she hopes that future studies can clarify these links, as well as explore ways to better support young adults experiencing anxiety, especially during key transitional periods.

    “It would be interesting to see if these patterns can change over time, such as whether supportive peer relationships in university can help young adults become more resilient, even if they experienced overprotective parenting,” she said.

    About the study

    “Parental overprotection moderates the association between recent stressor exposure and anxiety during the transition to university” by Lidia Panier et al. was published in Development and Psychopathology.

    This research was supported by the Canada Research Chair in Clinical Neuroscience, the Canadian Institutes of Health Research (CIHR), the California Governor’s Office of Planning and Research/California Initiative to Advance Precision Medicine and the California Department of Health Care Services.

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  • One Diet Can Lower Genetic Risk For Alzheimer’s, Scientists Discover : ScienceAlert

    One Diet Can Lower Genetic Risk For Alzheimer’s, Scientists Discover : ScienceAlert

    Adhering to a Mediterranean diet has been found to reduce the risk of Alzheimer’s disease even among individuals who are genetically predisposed to developing the neurodegenerative condition, according to a study by researchers in the US.

    Deriving its name from the region where it’s popular, the diet prioritizes fruit and vegetables, as well as olive oil, fish, nuts, and whole grains. Red meat, processed foods, and sweets are kept to a minimum.

    While variations of the Mediterranean diet have been linked to reduced dementia risk before, a team led by researchers from the Harvard T.H. Chan School of Public Health found that it could be especially protective for people with two copies of the APOE4 gene variant, almost acting as a countermeasure.

    Related: Vegetarian Diets Can Slash Cancer Risk by Up to 45%, Large Study Finds

    “One reason we wanted to study the Mediterranean diet is because it is the only dietary pattern that has been causally linked to cognitive benefits in a randomized trial,” says epidemiologist Yuxi Liu, from the Harvard Chan School.

    Alzheimer’s is a complex condition, with risk factors known to include sleep quality, diet, and mental health. There’s also a genetic element, because having one or two copies of the APOE gene significantly increases the chances of getting the disease.

    The researchers investigated the Mediterranean diet in people with specific genetic backgrounds, while also analyzing blood metabolites: molecules that can act as indicators of how the body is functioning and processing food.

    The study combined data on diet, cognition, and genetics. (Liu et al., Nat. Med., 2025)

    Data from 4,215 women (logged between 1989 to 2023) and 1,490 men (logged between 1993 and 2023) were analyzed, with cross-referencing done on dementia diagnoses, dietary habits, and genetic information.

    Those that most closely followed the Mediterranean diet were least likely to show signs of cognitive decline or develop dementia, the researchers found – but the biggest difference was in the group at most risk, in terms of their genetics.

    What’s more, the researchers found the Mediterranean diet regulated metabolites related to dementia, particularly in participants whose genes put them at high risk of Alzheimer’s. This could give us a greater understanding of how Alzheimer’s risk factors influence each other.

    “These findings suggest that dietary strategies, specifically the Mediterranean diet, could help reduce the risk of cognitive decline and stave off dementia by broadly influencing key metabolic pathways,” says Liu.

    “This recommendation applies broadly, but it may be even more important for individuals at a higher genetic risk, such as those carrying two copies of the APOE4 genetic variant.”

    While the association is significant, the findings are based on well-educated individuals of European ancestry, and don’t show direct cause and effect, suggesting there may be unknown factors having an impact.

    In addition, the metabolite markers were only measured once, so the researchers don’t have a full picture of how diet or the symptoms of dementia might have changed them over time.

    In the future, metabolite markers might be used to evaluate dementia risk and to target specific biological pathways for treatment.

    “In future research, we hope to explore whether targeting specific metabolites through diet or other interventions could provide a more personalized approach to reducing dementia risk,” says Liu.

    The research has been published in Nature Medicine.

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  • Metformin Trial Shows Benefits in Prostate Cancer Therapy

    Metformin Trial Shows Benefits in Prostate Cancer Therapy


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    The multi-arm, multi-stage prostate cancer clinical trial, STAMPEDE, has evaluated the clinical benefits of adding various drugs to the standard of care treatment for men with newly diagnosed metastatic prostate cancer.

    One of the trials within this platform tested whether the diabetes drug metformin could improve survival and/or reduce the severity of common and unpleasant side effects associated with treatment.


    Results published in Lancet Oncology show that metformin significantly decreases the metabolic side effects associated with standard of care prostate cancer therapy. The Phase III trial was co-led by Professor Noel W. Clarke (The Christie NHS Foundation Trust) and Professor Silke Gillessen (Oncology Institute of Southern Switzerland).

    Prostate cancer standard of care drives major side effects

    The standard of care for advanced metastatic prostate cancer is lifelong androgen deprivation therapy (ADT), with or without radiation therapy and other systemic treatments. ADT is a type of hormone therapy that lowers testosterone levels, and since most prostate cancer cells rely on testosterone to grow, lowering testosterone can slow cancer progression.


    However, ADT can also drive metabolic side effects, including increased fat mass and weight, decreased insulin sensitivity and altered lipid profiles. These issues can lead to metabolic syndrome, a cluster of conditions that raise the risk of heart disease and type 2 diabetes.


    Prior small-scale trials have hinted that metformin has anticancer properties, for example by improving castration-resistant prostate cancer-free survival. Furthermore, epidemiological evidence suggests that metformin use can reduce cancer risk and cancer deaths among people with diabetes. Metformin was therefore included as an arm of the STAMPEDE study due to its demonstrated anticancer activity in several malignancies, including prostate cancer, and to evaluate its potential in mitigating the metabolic side effects associated with ADT.

    Metformin mitigates metabolic effects of hormone therapy

    Between 2016 and 2023, 1,874 patients with metastatic prostate cancer were randomly assigned either:

    • Standard of care treatment, or
    • Standard of care plus metformin

    Most participants had synchronous metastatic disease, where metastases are diagnosed at the same time as the primary tumor, while a small subset (6%) had metachronous relapsing disease, where metastases developed after initial treatment for localized prostate cancer. Standard of care was long-term ADT for all patients, with additional treatments including radiation therapy, docetaxel or androgen receptor pathway inhibitors.


    The key findings of the paper were:

    • Patients receiving metformin gained only 2 kg, compared to 4.4 kg gained by the control group.
    • Total cholesterol, blood sugar and waist measurements were all significantly lower in the metformin group.
    • Fewer patients reported signs of metabolic syndrome.
    • Metformin was generally well tolerated, with diarrhea being the most common side effect.
    • There was no significant evidence of an overall survival benefit of adding metformin to standard of care in the overall population of patients. However, there was some indication of potential oncological benefit observed in patients with high-volume disease.

    Improving quality of life and possible benefits in high-volume disease

    Morphometric and metabolic outcomes from metformin use in the STAMPEDE trial showed that it does significantly reduce the adverse metabolic side effects associated with ADT use.

    While metformin didn’t show significant overall survival benefits, the study also found evidence that metformin may have a greater benefit for patients with high-volume disease, where the cancer has spread more extensively through the body. In the high-volume disease subgroup, there was a 10-month improvement in overall survival with the addition of metformin. However, the study was not sufficiently powered to draw conclusions between disease subgroups.


    One of the proposed mechanisms by which metformin confers anticancer properties is by activation of adenosine monophosphate-activated protein kinase (AMPK), a key regulator of cellular energy use. AMPK activation results in mammalian target of rapamycin (mTOR) inhibition, leading to reduced cell growth, proliferation and metabolic activity – all processes necessary for cancer development and progression.


    Together, data from this trial suggest potential for a personalized treatment approach, where patients with higher disease burden may benefit most from metformin. Moreover, the results underscore the broader therapeutic potential of metabolically targeted agents in this disease setting.


    For many people with prostate cancer, ADT is a long-term or even lifelong treatment. Therefore, even moderate improvements in side-effect profiles can significantly improve quality of life. By reducing the risk of metabolic syndrome, metformin may also lower the need for additional interventions such as diabetes or heart disease management, lessening healthcare system burdens.

    Crucially, metformin is well tolerated and inexpensive, making it an accessible addition to standard of care treatment to reduce side effects and improve quality of life in patients.


    It should be noted that the population of patients in the study was a limitation, with most patients having synchronous disease, making extrapolation of data to metachronous disease difficult. Additionally, the trial was open-label rather than blinded, although survival outcomes and metabolic parameters are unlikely to be affected by clinicians’ or patients’ knowledge of metformin use.

    Identifying patient subsets for metformin-based cancer therapy

    Future work will be necessary to elucidate the potential anticancer effects observed in patients with high-volume disease fully and determine exactly which subset of patients metformin could benefit. This objective aligns closely with the aims of the translational program associated with the metformin trial, currently being conducted through the University of Manchester.


    Reference: Gillessen S, Murphy L, James ND, et al. Metformin for patients with metastatic prostate cancer starting androgen deprivation therapy: a randomized phase 3 trial of the STAMPEDE platform protocol. Lancet Oncol. 2025;26(8):1018-1030. doi:10.1016/S1470-2045(25)00231-1 

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  • Bimekizumab Outperforms Active Comparators in Clearing Skin, Nail Psoriasis

    Bimekizumab Outperforms Active Comparators in Clearing Skin, Nail Psoriasis

    Joseph F. Merola, MD, MMSc

    Credit: dermrefoundation.org

    Bimekizumab therapy may lead to greater numbers of individuals attaining complete clearance of psoriasis across both skin and nails, compared with ustekinumab, adalimumab, and secukinumab, among patients with nail psoriasis at baseline, new data suggest.1

    These new findings highlighting bimekizumab’s efficacy among such patients were the result of a recent evaluation of concurrent nail clearance and complete skin clearance among those with moderate-to-severe plaque psoriasis who were treated with bimekizumab or active comparators. Joseph F. Merola, MD, MMSc, from the Department of Dermatology and Department of Medicine at UT Southwestern Medical Center, Dallas a team of investigators in conducting this analysis.

    Merola and coauthors highlighted that approximately 1 of every 3 with psoriasis progress to psoriatic arthritis (PsA) over the course of their skin disease.2 Consequently, they pointed to a need for understanding of nail disease among clinicians to improve the identification high risk patients who may see their disease progress to PsA.

    “To evaluate the efficacy of bimekizumab in different domains of psoriatic disease at the same time, we assessed concurrent clearance of both skin and nails at any given timepoint post hoc in patients with moderate-to-severe plaque psoriasis treated with bimekizumab versus adalimumab, ustekinumab, and secukinumab during head-to-head phase III trials,” Merola et al wrote.1

    The investigative team’s analyses included findings from several different studies, including the phase 3 BE SURE and BE VIVID trials. The team also looked at these studies’ open-label extension study BE BRIGHT in addition to the phase 3b BE RADIANT trial and its extension phase.

    Those who had taken part were adults living with moderate-to-severe plaque psoriasis, defined by baseline criteria of Psoriasis Area and Severity Index (PASI) ≥12 as well as ≥10% body surface area involvement, and an Investigator’s Global Assessment score ≥3 on a 5-point scale. Merola and colleagues would only evaluate individuals showing baseline nail involvement, determined by a modified Nail Psoriasis Severity Index (mNAPSI) score of >0, who proceeded into their respective extension studies.

    The outcomes reported by the investigators were aimed at the proportion of patients who attained simultaneous clearance of their skin, determined through 100% Psoriasis Area and Severity Index score improvement from baseline (PASI 100) and clearance of their nails (mNAPSI 0). These data were presented for participants treated with bimekizumab compared with active comparators during the randomized trial phases, and for those on continuous bimekizumab therapy or switched from comparators at the time of the extension phases. The findings were analyzed using modified non-responder imputation.

    Statistical analyses were highlighted by Merola and coauthors as descriptive in nature, and they were applied across all endpoints. These endpoints included those in the electronic supplementary material. There was no hypothesis testing conducted for post hoc assessments. During the conclusion of the comparator-controlled study periods, the investigative team determined that concurrent achievement of PASI 100 and mNAPSI 0 was seen in:

    • 45.8% of individuals on bimekizumab (N = 151) compared with 18.3% treated with adalimumab (N = 91) by the 24-week mark in BE SURE
    • 51.1% of individuals on bimekizumab (N = 169) compared with 26.5% treated with ustekinumab (N = 92) by the 52-week mark in BE VIVID
    • 63.3% of individuals on bimekizumab (N = 182) compared with 36.1% treated with secukinumab (N = 155) by the 48-week mark in BE RADIANT

    In their evaluation of those on long-term therapy, Merola et al found that the proportions of participants attaining both PASI 100 and mNAPSI 0 were shown to be:

    • 57.7% of individuals who switched from adalimumab and 49.1% of those who were on continuous bimekizumab at by the 4-year mark in BE SURE/BE BRIGHT
    • 52.2% of individuals who switched from ustekinumab and 48.3% of those maintained on bimekizumab at the 4-year mark in BE VIVID/BE BRIGHT
    • 51.9% of individuals who switched from secukinumab and 57.4% of those on continuous bimekizumab at the 3-year mark in BE RADIANT

    “Patients switching from comparators to bimekizumab demonstrated further improvement in skin and nail symptoms, and sustained complete clearance of both in the long term, similar to those continuously treated with bimekizumab,” Merola et al concluded.1 “The ability of bimekizumab to treat multiple domains of psoriatic disease could be highly advantageous to patients with psoriasis who are candidates for systemic therapy.”

    References

    1. Merola JF, Warren RB, Gisondi P, et al. Bimekizumab Complete Clearance of Both Skin and Nail Psoriasis: Comparative Efficacy in Phase III/IIIb Studies. Am J Clin Dermatol. 2025 Aug 31. doi: 10.1007/s40257-025-00968-2. Epub ahead of print. PMID: 40886218.
    2. Armstrong AW, Bohannan B, Mburu S, et al. Patient perspectives on psoriatic disease burden: results from the Global Psoriasis and Beyond Survey. Dermatology. 2023;239:621–34. Accessed September 4, 2025. https://doi.org/10.1159/000528945.

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  • Avian influenza outbreaks occur in Germany, Portugal-Xinhua

    PARIS, Sept. 4 (Xinhua) — The World Organization for Animal Health (WOAH), based here, reported on Wednesday that highly pathogenic H5N1 avian influenza virus outbreaks have recently occurred on farms in Germany and Portugal, resulting in the deaths of over 1,000 poultry.

    On Sept. 1, an outbreak of avian influenza or bird flu occurred at a farm in Hadenfeld, northern Germany, affecting 2,800 laying hens. Of these, 100 died, and the rest were culled.

    On Sept. 2, a farm in Samora Correia, near Lisbon, also reported an avian influenza outbreak, affecting over 250,000 fattening ducks, with 1,011 deaths, and the remaining ducks were culled.

    The sources of infection in both outbreaks have not been determined.

    The WOAH said that migratory birds, especially waterfowl, are natural hosts and carriers of the avian influenza virus. Avian influenza is also a major public health concern, as sporadic human cases of avian influenza have been reported. When outbreaks occur in domestic birds, the policy is often to cull all poultry, whether infected or not, in order to contain the spread of the virus.

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  • Advancing Global Awareness and Prevention

    Advancing Global Awareness and Prevention

    World Sexual Health Day – September 4

    Image credits: Chat GPT

    Observed on September 4, World Sexual Health Day highlights sexual health as an essential component of overall well-being. The World Health Organization (WHO) and its Human Reproduction Programme (HRP) reaffirmed their commitment to advancing sexual health, rights, and prevention across the life course.1

    Recent updates include:1

    • HIV prevention: A systematic review of 29 HIV campaigns found that pleasure-based approaches reduced stigma, improved knowledge, and increased safer behaviors such as condom use and HIV testing.
    • Global STI priorities: WHO identified 40 research areas spanning diagnosis, prevention, management, and epidemiology to guide evidence-based interventions.
    • Broad public health focus: WHO’s 2024 Bulletin issue covered HIV prevention, harmful gender norms, menstrual hygiene, and endometriosis, emphasizing human rights–based and inclusive approaches.

    WHO also advanced the SHAPE questionnaire to strengthen countries’ ability to measure and monitor sexual health outcomes. Together, these initiatives highlight sexual health as a critical component of infectious disease prevention and care.1

    Latest News in Sexual Health Awareness

    Aging in HIV: A Review of Common Comorbidities in People Living With HIV

    Antiretroviral therapy (ART) has extended the life expectancy of people living with HIV (PLWHIV), but aging with HIV presents unique clinical challenges that require specialized management. A recent review outlines key comorbidities affecting this population, including cardiovascular disease, metabolic syndrome, renal dysfunction, neurocognitive decline, immunosenescence, low bone mineral density, and frailty. These conditions are influenced by the interplay of chronic HIV infection, long-term ART exposure, and natural aging, often necessitating earlier and more frequent screening compared with the general population. Current guidelines emphasize proactive risk reduction strategies, tailored pharmacologic choices, and multidisciplinary care that incorporates geriatric principles. As the proportion of PLWHIV aged 50 years and older continues to rise, clinicians must integrate HIV-specific considerations into preventive care, treatment, and long-term monitoring to optimize health outcomes and quality of life.

    FDA Grants Priority Review for Gepotidacin for Gonorrhea

    The US Food and Drug Administration (FDA) has accepted for priority review GSK’s supplemental new drug application for gepotidacin, a novel oral antibiotic for the treatment of uncomplicated urogenital gonorrhea in patients aged ≥12 years and weighing ≥45 kg, with a decision expected by December 11, 2025. The application is supported by the phase 3 EAGLE-1 trial, which found gepotidacin (2 oral doses of 3000 mg) noninferior to standard intramuscular ceftriaxone plus oral azithromycin, achieving cure rates of 92.6% versus 91.2%, respectively. No bacterial persistence of Neisseria gonorrhoeae was reported, and no serious drug-related adverse events occurred, with most side effects limited to mild-to-moderate gastrointestinal events. If approved, gepotidacin would provide the first new oral option for gonorrhea treatment in decades, complementing its March 2025 FDA approval for uncomplicated urinary tract infections.

    FDA Accepts New Drug Application for Merck’s HIV Treatment, Doravirine/Islatravir

    Merck’s investigational once-daily, two-drug HIV regimen doravirine/islatravir (DOR/ISL) has been accepted by the FDA with a Prescription Drug User Fee Act (PDUFA) target date of April 28, 2026. The application is supported by two phase 3 trials—MK-8591A-051 (open-label) and MK-8591A-052 (double-blind)—which demonstrated that switching virologically suppressed adults from standard baseline antiretroviral therapy (bART) or bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) to DOR/ISL maintained viral suppression at Week 48, meeting noninferiority endpoints in both studies with >90% of participants remaining suppressed. Safety outcomes were comparable across regimens, with no new concerns identified. Doravirine, already FDA approved as Pifeltro, is paired here with islatravir, an investigational nucleoside reverse transcriptase translocation inhibitor (NRTTI) that is also being studied in weekly regimens with lenacapavir (Gilead) and ulonivirine (Merck). If approved, DOR/ISL could provide people living with HIV a simplified oral regimen designed to support long-term management and treatment flexibility.

    Ocular Syphilis and Neurosyphilis in a Patient Living With HIV

    A recent case report describes ocular syphilis with concurrent neurosyphilis in a 50-year-old man living with HIV/AIDS who presented with progressive bilateral vision loss. Despite an initially nonreactive rapid plasma reagin (RPR), dilution testing revealed a titer of 1:4096, consistent with the prozone effect, and cerebrospinal fluid studies confirmed neurosyphilis. The patient received intravenous aqueous penicillin every 4 hours for 14 days, resulting in marked visual improvement prior to discharge. Ocular syphilis, though rare, is a sight-threatening manifestation that is increasingly recognized, particularly among people living with HIV, men who have sex with men, and individuals over 40 years. Rising syphilis rates in the United States highlight the importance of clinician vigilance, timely diagnosis, and multidisciplinary management, as delayed recognition can result in significant morbidity and potential vision loss.

    Gilead Expands Global Access to Lenacapavir With New HIV Prevention Partnership

    Gilead Sciences has announced a partnership with the Global Fund to supply up to 2 million doses of its long-acting injectable HIV prevention drug, lenacapavir, to low- and lower-middle-income countries at no profit over the next three years. Lenacapavir, a capsid inhibitor administered twice yearly, recently received FDA approval based on phase 3 PURPOSE trials showing near-perfect efficacy—100% protection in cisgender women in South Africa and Uganda (PURPOSE 1) and 96% risk reduction among cisgender men and gender-diverse individuals (PURPOSE 2). The initiative is intended to bridge access gaps until licensed generics are available, with the Global Fund prioritizing countries based on epidemiology and readiness. By overcoming barriers such as adherence to daily oral PrEP and limited health infrastructure, this collaboration has the potential to significantly expand prevention coverage and reshape global HIV prevention strategies.

    Reference
    WHO. World Sexual Health Day 2025. September 4, 2025. Accessed Septmeber 4, 2025. https://www.who.int/news-room/events/detail/2025/09/04/default-calendar/world-sexual-health-day-2025

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  • Latvia urges high-risk groups to get Covid-19 vaccine as cases rise-Xinhua

    RIGA, Sept. 4 (Xinhua) — The Latvian Center for Disease Prevention and Control (CDC) on Thursday advised people at high risk of severe illness from Covid-19 to get vaccinated, as the country faces a new rise in infections.

    According to the CDC, the share of positive Covid-19 tests increased from 8 percent in the first week of August to 17.3 percent by the last week of the month. Hospitalizations have also climbed, with admissions rising from eight patients in early August to 48 by the end of the month.

    Wastewater monitoring results confirmed the growing spread of the virus, showing higher infection levels at the close of summer. Officials noted that a similar uptick was observed last year at the end of summer and the start of autumn.

    Latvia has received updated Comirnaty LP.8.1 vaccines, adjusted to the season’s dominant coronavirus strains, the CDC said.

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  • Semaglutide Shows Safety in Patients with Schizophrenia, Prediabetes, Obesity

    Semaglutide Shows Safety in Patients with Schizophrenia, Prediabetes, Obesity

    Ashok A. Ganeshalingam, MD

    Credit: LinkedIn

    A recent study showed that 30 weeks of semaglutide administration, up to 1.0 mg/week, was safe among patients with schizophrenia, prediabetes, and obesity.1

    “Semaglutide significantly reduced HbA1C, body weight, and metabolic variables and improved physical [quality of life] without affecting mental status,” wrote study investigator Ashok A. Ganeshalingam, MD, from Odense University Hospital in Denmark, and colleagues.1

    Patients with schizophrenia face reduced life expectancy from cardiovascular disease and obesity-related diabetes, risks often worsened by second-generation (SGA) antipsychotics. Existing treatments offer limited effectiveness in managing schizophrenia and mitigating these risks.

    Ganeshalingam and colleagues sought to assess the effect of once-weekly semaglutide, a glucagon-like peptide-1 receptor agonist, in 154 patients aged 18 – 60 years (mean age, 38.3 years; 56.5% females) with schizophrenia, prediabetes, and obesity treated with second-generation antipsychotic medication. The study identified prediabetes as glycosylated hemoglobin A1C [HbA1C], 5.7%-6.4% of total hemoglobin, and overweight or obesity as a body mass index (BMI) of ≥ 27.1

    The primary outcome was the change in HbA1c. Secondary outcomes included changes in body weight, schizophrenia symptoms based on Positive and Negative Syndrome Scale 6 (PANSS-6) score, and physical and mental quality of life (QoL) assessed via the 36-item Short Form Survey, version 2 (SF-36v2).

    The team conducted a placebo-controlled, double-blinded, randomized clinical trial from January 2022 to May 2020, involving participants from regional community-based mental health services in 2 Danish regions: Region of Southern Denmark and Region of Zealand. Investigators randomized participants to semaglutide (titrated up to 1.0 mg/week) or placebo over 8 weeks. The study included a 30-week follow-up, and data were analyzed between May 2024 and January 2024.

    The study found that semaglutide reduced HbA1c by 0.46% of total hemoglobin (95% confidence interval [CI], -0.56% to – 0.36%) and body weight by 9.21 kg (95% CI, -11.68 to -6.75).1

    Investigators noted that they observed less weight loss than in the SELECT trial (7.5% vs 8.5%). SELECT evaluated semaglutide 2.4 mg/week versus placebo over 104 weeks in obese individuals without diabetes.2

    “The difference may be attributed to the higher semaglutide dose and longer treatment duration in the SELECT trial,” investigators explained.1 “Since the cardiovascular risk reduction in the SELECT study was primarily driven by weight loss, we believe weight management — for instance, via treatment with a GLP-1RA — should be part of the preventive intervention for CVD in patients with [schizophrenia spectrum disorders] with antipsychotics-induced prediabetes.”

    Additionally, 81% of patients on semaglutide vs 19% on placebo achieved an HbA1c < 5.7% of total hemoglobin (P < .001). The study also observed patients on semaglutide had improved high-density cholesterol by 10.81 mg/dL (95% CI, 2.7-18.53; P = .007) and triglycerides by -29.20 mg/dL (95% CI, -55.75 to 2.65; P = .03).1

    Moreover, semaglutide improved physical quality of life by 3.75 points on the SF-36v2 (95% CI, 1.52 to 5.98; P = .001). Semaglutide showed no significant effect on mental quality of life scores or PANSS-6 scores.1

    Investigators noted more gastrointestinal symptoms in patients treated with semaglutide. Patients treated with semaglutide were hospitalized more frequently than those treated with placebo, but the number of serious adverse events did not differ between arms.

    HbA1c results were comparable to the SELECT study. Baseline HbA1C was similar between studies (5.78% in SELECT), and HbA1C reductions were also comparable (0.32% vs 0.46%).1 This suggests that in SGA-treated patients with schizophrenia, 30 weeks of semaglutide 1 mg/week may achieve HbA1C improvements similar to 104 weeks of semaglutide 2.4 mg/week.

    “On this basis, we speculate that overweight or obese patients without diabetes with [schizophrenia] and SGA treatment have an increased responsiveness to semaglutide, but whether this is caused by reductions in the adverse effects of SGA (eg, appetite) or the psychiatric disease per se remains unknown,” investigators wrote.1

    In addition to lowering HbA1c, semaglutide reduced the proportion of patients with prediabetes by 4-fold—a finding not previously seen in earlier exenatide studies. Investigators emphasize that this finding is clinically meaningful and should inform the management of high-risk patients with schizophrenia to help prevent cardiovascular disease.1

    “Given these benefits, semaglutide should be considered for patients with [schizophrenia], prediabetes, and a BMI of 27 or higher, as the potential for weight loss and prevention of T2D may justify the economic cost of treatment,” investigators concluded.1

    References

    1. Ganeshalingam AA, Uhrenholt N, Arnfred S, et al. Semaglutide Treatment of Antipsychotic-Treated Patients With Schizophrenia, Prediabetes, and Obesity: The HISTORI Randomized Clinical Trial. JAMA Psychiatry. Published online September 3, 2025. doi:10.1001/jamapsychiatry.2025.2332
    2. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563

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  • More Data From Farms Could Help Scientists Better Track Avian Flu, but Privacy Concerns Stand in the Way

    More Data From Farms Could Help Scientists Better Track Avian Flu, but Privacy Concerns Stand in the Way

    For years, veterinary researcher Maurice Pitesky has run up against a roadblock while tracking the rapid spread of avian flu: a lack of public data. He has attempted to obtain — but has repeatedly been denied — state and federal data revealing the location of avian flu outbreaks on U.S. farms. It’s data he says could help inform predictive modeling to warn farmers about a higher risk of avian flu transmission near their property, giving them enough time to tighten biosecurity measures and potentially ward off an outbreak.

    A national predictive surveillance system doesn’t exist yet, but Pitesky thinks it could be very feasible — if only he had access to more precise government data.

    Data revealing the location and other information about the farms with animals that have contracted avian flu has generally been deemed confidential by state and federal government officials. The officials collecting this data do not make it publicly available under most circumstances, citing legal exemptions and agreements with agricultural businesses. The aim is often to protect farmers from economic losses, but in effect, Pitesky says, these decisions are a barrier for scientists scrambling to monitor the evolving, adaptable virus as it circulates in the U.S.

    “The state and the feds have all that data about which farms are positive and which farms are negative,” Pitesky, an associate professor at the UC Davis School of Veterinary Medicine-Cooperative Extension, tells Sentient. “They’ve taken a good idea protecting farmer information to an illogical conclusion — in the sense that you basically have all that data siloed by just a few people who, at this stage, aren’t really doing very much research.”
    Some of this data even originates at Pitesky’s own university. The California Animal Health and Food Safety Laboratory at UC Davis is the only lab in California equipped for high-risk avian flu testing in poultry and cattle — data that is reported to the public by the state and federal government, while stripped of data about the farms.

    The ongoing H5N1 outbreak of highly pathogenic avian influenza (HPAI) was first identified in U.S. commercial poultry in February of 2022. Since then, the novel virus has become the longest, most deadliest animal disease outbreak in U.S. history, and while recorded cases of the virus have lulled, there is no sign of the virus disappearing. As wild birds, the primary reservoir of the virus, migrate again in the fall, some scientists anticipate another surge in the United States.

    Pitesky and other scientists say one key roadblock to slowing the spread of H5N1 is the lack of public disclosure of more granular data, making it more challenging for research scientists to monitor the virus.

    “One of the real failures is this inability to collaborate, inability to share information and the siloing of data where it should be, ultimately a collaborative process where we’re really identifying risk factors,” says Pitesky. “But we’re just not there yet for some reason.”

    It’s a barrier that Andrew Pekosz, a virologist and the co-director of the Johns Hopkins Center of Excellence for Influenza Research and Surveillance, has also faced in his research monitoring how H5N1 spreads and mutates.

    “It’s very challenging to get a complete data set that includes, for instance, right numbers of animals dead, the sequence of the virus that was present in there, the date and the precise location of the farm — all those things that you would need to do an epidemiological study to see how things are moving,” says Pekosz.

    Without these variables, he says it “becomes harder to connect and be specific about where the viruses are moving and whether outbreaks are connected to each other.”

    The Importance of Avian Flu Metadata

    Even though H5N1 has circulated in the U.S. since 2022, scientists are still largely following its trail. There is not a national surveillance system that predicts where avian flu will emerge next. Instead, the tracking of the virus is largely performed retroactively: the public only knows about confirmed cases. This differs from the predictive surveillance system that has developed for Covid-19; the Center for Disease Control provides a weekly forecast of the number of Covid-19 hospital admissions, on a state and national level.

    The public data that exists on avian flu testing in animals is available on the websites of state agricultural departments and the U.S. Department of Agriculture (USDA), which maintains a public dashboard of H5N1 cases reported in the last 30 days. This includes the confirmed date of a positive test, the country and state of the outbreak and the type of farm business (such as live bird market, commercial turkey farm, etc.). But this testing data exists in a vacuum of other critical data points — it lacks contextual data, known as metadata, associated with each recorded avian flu outbreak.

    “The metadata generally that’s been associated with either reports of positives — or even worse when you have sequence data on the virus — has just been abysmal across the board,” Meghan Davis, an epidemiologist and microbiologist at Johns Hopkins Bloomberg School of Public Health, tells Sentient.

    One kind of metadata that would be helpful to have, Davis says, is more precise geographic tags for each H5N1 detection. She also would like information on the date of the outbreak (which may differ from the date of the confirmed positive test) and more detailed demographic data on the animals, known as signalment data, such as their breed, sex and age — information that could surface risk patterns. Like Pitesky, she envisions some of this metadata could feed into more predictive tracking surveillance models.

    “If you can actually tag these down a little bit better and then start to look at the potential for clustering and time and space, you might get a better sense of movement, and movement can then feed into more predictive models forecasting,” says Davis. “It would be lovely if you could in real time, or as near to real time as you could, actually send alerts out into areas where you predict it’s going to be next.”

    There is also a lack of comprehensive genetic sequencing data, which is submitted by scientists to repositories such as the National Institutes of Health’s GenBank U.S. This data is crucial for tracking how the virus is evolving and identifying new clusters, but the sequences tend to include very little metadata — to a point where “it may not be even detailed enough for you to really be able to study how the viruses are spreading,” says Pekosz.

    In particular, he’d like metadata on the “precise areas, precise dates of collection, the animals that they were collected from, the nature of the samples. Did you swab an animal? Did you harvest something from the animal? What’s the tissue that was the source?” — data that can help shed light on the genetic linkages between outbreaks.

    The federal data on testing for cattle is especially limited. According to the California Department of Food and Agriculture, “The USDA website reports new (first time detections) in dairies; it does not capture when a herd is cleared, ongoing cases, or reinfections on premises that had previous detections.” As a result, there can be significant discrepancies between California’s more detailed data and federal data on dairy outbreaks.

    For instance, on August 1st, California reported that 43 farms that had been previously infected reported new infections and were placed back under quarantine. But the federal data reflected a different story, revealing just one case reported on that day of avian flu in dairy herds in California. Depending on which dataset you’re looking at, you could have a very different understanding of avian flu infection levels.

    There is also a lack of public information around how live cattle are transported around the country, which drives infection risk. At a 2024 workshop, hosted by the National Academies, Martha Nelson, a staff scientist at the National Institute of Health, discussed the need for a “national database for dairy cattle movement.” Nelson, who discovered the zoonotic origins of the virus that caused H1N1 in 2009, said that this data could help scientists forecast H5N1’s movements across the U.S.

    Drawbacks & Challenges of Obtaining Avian Flu Data

    Scientists seeking to request more data face a web of legal exemptions. Information that is collected through the state or federal government can potentially become a public record, but over the years, agricultural data has become increasingly exempt.

    “It is incredibly difficult to get any kind of specific information about industrial farm operations, especially geospatial data because of an overlapping system of exemptions from the public records laws,” says Kelsey Eberly, an attorney at the legal nonprofit FarmSTAND.

    One of the main legal barriers is a sweeping 2008 exemption to the Freedom of Information Act, which prevents the release of nearly all data that farmers provide to the federal government, including geospatial data and information “concerning the agricultural operation, farming or conservation practices, or the land itself.” Then there are also state-level exemptions to records laws, which often cite the need to protect business privacy and sensitive commercial information.

    Yet some researchers agree that the exemption of some farm data is necessary, even from a public health standpoint. The sweeping public disclosure of farm data could potentially disincentivize producers from complying with reporting requirements, fearing that this could trigger economic loss, for instance — an argument raised in the workshop hosted by the National Academies.

    Davis suggests that there might be a compromise: more aggregated metadata while still preserving some degree of anonymity for the farms. This would enable researchers to analyze more detailed genomic and epidemiological patterns, but satisfy concerns over privacy. She points to how the location data could be limited to a specific radius to protect farm privacy, so “you don’t lose the importance of the regionality, but you no longer have it tied to a specific address.”

    Scott Wells, a veterinary epidemiologist at the University of Minnesota, has found a way to work with farmers to obtain more specific data on avian flu. It’s a strategy he says has enabled him to get around some of the data privacy issues that inevitably arise when tracking zoonotic disease outbreaks.

    “A lot of my career then has been ‘Okay, how can I help answer important research questions in which I do need access to data, but do it in a way that is acceptable to producers?’ Wells tells Sentient. “Sometimes the government doesn’t have the data, and so then it’s a matter of trying to work with producers and producer organizations.”

    With the support of an USDA grant, he currently leads a cross-disciplinary research team tracking the spread of H5N1 between cattle herds — a project that has prompted questions about how to best obtain access to the farms.

    “We have to always think about incentives. So why would a producer want to participate? What’s the value of participating? What’s the potential? What are potential disincentives?” says Wells. “Obviously, one important disincentive is if they’re going to agree to participate in the study with us, they don’t want that to lead to regulatory action.”

    To that end, his research team has decided to test milk for antibodies, which could be indicative of a previous avian flu infection rather than a current infection. “So there’s no regulatory action for a positive sample,” says Wells. It’s an approach that he says has led a couple producers to cooperate with his team in the process, allowing the researchers direct access to farms without fear that this could prompt regulatory action.

    There are limitations to this approach too, Wells acknowledged. “I mean, they’re going to do what’s best for their industry, right? And we have to recognize that. So there, I guess, could be some questions that don’t get addressed through a collaborative process.”

    A Barrier to Journalists and Public Health Advocates

    The lack of publicly available data on avian flu is not just a barrier to scientists. Sentient attempted to obtain testing data to confirm a potential avian flu outbreak at a Foster Farms facility in Turlock, California. In July, we filed a public records request for “the results of any PCR or serological testing performed by the California Animal Health and Food Safety Laboratory at UC Davis, between January 1st, 2024 and January 31st, 2024.” But we were similarly denied this request by UC Davis’s records officer, who deemed it “unwarranted invasion of personal privacy,” and therefore exempt from disclosure.

    This data would have helped clarify records that appeared to show Foster Farms refusing avian flu testing in early 2024. “Foster Farms upper management indicated that they do not want to allow APHIS to take a sample. Can they refuse APHIS to do that to send someone there?,” wrote Virginia Felix, a deputy district manager at the U.S. Department of Agriculture’s Food Safety and Inspection Service, on January 24th of 2024.

    The records describe 20 percent of three trucks of heavy hens showing “gross legions: swollen heads, especially around the beak; clear to mucoid ocular and nasal damage, higher mortality than usual” — symptoms that may indicate avian flu or, potentially, another common poultry illness such as avian metapneumovirus or coryza. Without more transparency around avian flu testing, it’s not possible to determine why these birds were sick.

    Foster Farms has denied resisting avian flu testing. “With the knowledge of USDA FSIS onsite personnel, bird samples were collected and sent to the California Animal Health and Food Safety Laboratory at UC Davis for analysis. Thus, tests were conducted, and the PCR results showed no evidence of Avian Influenza,” a representative of the farm wrote in an e-mail to Sentient. “These findings were officially documented, reported to USDA APHIS and the California Department of Food & Agriculture, and provided to onsite USDA FSIS inspectors.”

    When asked if Foster Farms could help us verify their claim by providing the testing results, a representative for the farm responded, “For reasons of protocol and confidentiality, we are unable to provide the specific laboratory report.” The USDA and Virginia Felix didn’t respond to requests for comment to clarify what happened on January 24th.

    Farmworker advocates faced similar challenges to obtaining data on farm locations, especially early in the avian flu outbreak.

    “It’s always been hard to get farm location data in any kind of state or national scale. It’s pretty private,” says Bethany Alcauter, an occupational epidemiologist with the National Center for Farmworker Health, which supports a national network of migrant health centers and farmworker advocacy groups. To get around this, they developed a map with dairy farm locations based on inspection reports and other public data.

    “It would have been nice if every state, the Department of Ag and the Department of Health, collaborated on it and kept those data private,” added Alcauter. “But just to make sure that at least public health folks could collaborate.”

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