Category: 8. Health

Gait analysis and pain measures show that subtly adjusting the angle of the foot during walking may reduce knee pain caused by osteoarthritis. This approach may also slow progression of the condition, an uncurable disease in which the cartilage cushion inside a joint breaks down.

Led by a team of researchers at NYU Langone Health, the University of Utah, and Stanford University, a new study explored whether changing the way patients position their feet when walking could lessen extra loading – stress on the joint during motion – and help treat the disease.

For the investigation, the scientists tested this intervention in 68 men and women with mild to moderate knee osteoarthritis and then used advanced MRI scans to track how well it worked.

The results suggest that those trained to angle their feet slightly inward or outward from their natural alignment experienced slower cartilage degeneration in the inner part of their knee compared with those who were encouraged to walk more frequently without changing their foot position. A report on the study is being published online on August 12th, 2025 in the journal The Lancet Rheumatology.

Although our results will have to be confirmed in future studies, they raise the possibility that the new, noninvasive treatment could help delay surgery.”

Valentina Mazzoli, PhD, Study Co-Lead Author and Assistant Professor, NYU Langone Health

Mazzoli, an assistant professor in the Department of Radiology at NYU Grossman School of Medicine, notes that the earlier patients receive a knee replacement, the more likely they are to require additional procedures in the future.

The findings also revealed that those who adjusted their foot angle reduced their pain score by 2.5 points on a 10-point scale, an effect equivalent to that of over-the-counter pain medications. By contrast, those who did not change their gait reduced their pain scores by little more than a point.

“Altogether, our findings suggest that helping patients find their best foot angle to reduce stress on their knees may offer an easy and fairly inexpensive way to address early-stage osteoarthritis,” added Mazzoli.

About one in seven Americans have some form of osteoarthritis, commonly in the inner side of the knee, according to the U.S. Centers for Disease Control and Prevention. A leading cause of disability, the disease is often managed with pharmaceutical pain relievers, physical therapy, and, in the most severe cases, knee-replacement surgery. Experts believe that excess loading can over time contribute to the condition.

Past research has offered little evidence that changes in gait can effectively reduce knee pain caused by osteoarthritis, says Mazzoli. Some previous trials trained all participants to adopt the same foot angle and found no relief, while others did not compare the intervention to a control group or only followed the participants for a month.

The new study is the first to show that tailoring each patient’s foot angle to their unique walking pattern can alleviate the disease’s symptoms in the long term and may slow cartilage breakdown, the authors say.

Mazzoli adds that this technique may have a significant advantage over pharmaceutical painkillers. These drugs, she says, do not address the underlying disease and can cause liver and kidney damage, stomach ulcers, and other unwanted side effects when taken for long periods.

For the study, the research team recorded the participants walking on a treadmill at a specialized gait-assessment laboratory. A computer program simulated their walking patterns and calculated the maximum loading that occurred in the inner side of their knees. Next, the team generated computer models of four new foot positions – angled inward or outward by either 5 degrees or 10 degrees – and estimated which option reduced loading the most.

The patients were then randomly divided into two groups. Half were trained in six sessions to walk with their ideal angle while the other half were instructed to continue walking naturally. Pain scores and MRI scans were taken at the beginning of the study period and one year after the intervention.

Study findings showed those who adjusted their gait reduced the maximum loading in the knees by 4%, while those who kept their normal walking pattern increased their loading by more than 3%.

“These results highlight the importance of personalizing treatment instead of taking a one-size-fits-all approach to osteoarthritis,” said Mazzoli. “While this strategy may sound challenging, recent advances in detecting the motion of different body parts using artificial intelligence may make it easier and faster than ever before.”

While the authors relied on a specialized laboratory for the new study, artificial intelligence software that estimates joint loading using smartphone videos is now available and can allow clinicians to perform a gait analysis in the clinic.

The researchers next plan to test whether these tools can indeed identify the most effective walking method for osteoarthritis patients, says Mazzoli. They also plan to expand their study to people with obesity.

“I call them spaghetti noodles,” because they lack structure and are highly flexible, Katie Dunleavy said of intrinsically disorder proteins, or IDPs, her chosen field of study. She studied IDPs in more depth during her Ph.D. at the University of Florida, focusing on their conformational dynamics and hydration properties using a yeast protein as a model system.

Now a postdoctoral fellow at the University of Minnesota and former American Society for Biochemistry and Molecular Biology Maximizing Opportunities for Scientific and Academic Independent Careers, or MOSAIC, scholar, Dunleavy is studying how the IDP transcription factor c-MYC interacts with Aurora kinase A, or AURKA. c-MYC is expressed in over 70% of human cancers, making its interactions a vital focus for potential cancer therapies. Meanwhile, AURKA is a binding partner that may stabilize c-MYC.

Although AURKA’s role in stabilizing c-MYC is known, the precise structure and mechanism behind this stabilization remain unclear. This lack of understanding makes it difficult to design inhibitors that could disrupt the interaction and restore the normal protein turnover. Through a process called ubiquitination, the small protein ubiquitin tags other proteins, such as c-MYC, for degradation. To investigate how AURKA alters c-MYC’s ubiquitination process, Dunleavy is employing advanced biophysical techniques.

To investigate how AURKA affects the degradation of c-MYC, Dunleavy uses several biophysical techniques. For example, she uses continuous-wave electron paramagnetic resonance, or CW–EPR, to track protein movement in real time. She also applies X-ray crystallography and cryo-electron microscopy (cryo-EM) to map the structure of the c-MYC–AURKA complex and examine how their interaction may prevent c-MYC from being broken down. Ubiquitination assays further allow her to study how c-MYC is modified in the presence of AURKA. Together, these methods help her explore the mechanisms by which AURKA stabilizes c-MYC and interferes with its degradation.

“The hypothesis is that (when AURKA binds to c-MYC), the bound complex can’t be properly ubiquitinated nor sent for proper degradation of the protein,” Dunleavy said.

While researchers have known that AURKA binds to and stabilizes c-MYC, the full implications of that interaction are still coming into focus. “In a broader sense, this means the mechanism of stabilization of c-MYC by AURKA in cancerous conditions in general is not known,” she said.

Dunleavy is especially intrigued by what sets this project apart from more conventional studies of kinases. “What I find so cool about this story is that it is not a traditional kinase story,” she said. AURKA doesn’t modify c-MYC — it binds to c-Myc and protects it from degradation.

Because c-MYC is an intrinsically disordered protein, or IDP, it lacks well-defined binding pockets, making it a challenging drug target. Dunleavy plans to launch her independent research focused on defining the structure of the MYC–AURKA complexes and how ubiquitination alters their interaction. Her work could help build a structural and mechanistic roadmap — and inform strategies for disrupting this interaction. Once considered “undruggable,” IDPs like c-MYC may now be viable targets for cancer therapies. Receiving the MOSAIC award inspired Dunleavy, a first-generation college graduate, to give back.

“I was drawn to the MOSAIC program since I have a passion for mentorship and helping the underrepresented, including students who come from similar situations (as me) that don’t have a background (in science) or

don’t know that research exists,” Dunleavy said. “It has empowered me to grow my ambitions. I want to help inspire others through mentorship to be an available outlet for those pursuing this career.”

BBC

Amy Symington

Antibiotic resistance ‘a catastrophic threat’

What are ‘superbugs’?

A personalized protocol involving self-managed cognitive functional therapy (CFT) was associated with sustained symptom improvement at 3 years in patients with chronic low back pain in a phase 3 follow-up study.

The three-armed RESTORE trial assessed adult patients in Australia with chronic disabling low back pain, showing effectiveness for CFT with or without motion sensor biofeedback compared with usual care for up to 1 year.

In this new extension analysis of RESTORE, both CFT treatments were still more effective than usual care at 3 years, with greater reductions in both pain intensity and activity limitation.

Interestingly, no differences in outcomes were found between the CFT-only group and the CFT plus biofeedback group.

“It shows that if we empower patients with knowledge and skills to manage back pain, including future flare-ups that are almost inevitable, then we can markedly reduce the massive personal and societal burden of back pain,” lead author Mark Hancock, PhD, Spinal Pain Research Center, Macquarie University, Sydney, Australia, told Medscape Medical News.

“We hoped to see these results, given the intervention design, but we were still somewhat surprised how well the effects lasted over time,” he added.

The findings were published online on August 5 in The Lancet Rheumatology.

Building on ‘Unusual’ Initial Findings

Hancock noted that most treatments for low back pain produce small, short-lasting benefits. 

“The CFT intervention is specifically designed to have long-term effects, as it gives people the skills, knowledge, and confidence to self-manage. The results we previously published showed the effects were sustained at 1 year, which is unusual, and we wanted to see if it remained effective at 3 years,” he said.

In the original RESTORE trial, the investigators recruited adult patients who had low back pain lasting more than 3 months and randomly assigned them to receive one of three treatments: CFT only (n = 164), CFT plus biofeedback (n = 163), or usual care (n = 165). 

The CFT groups received up to seven treatments over 12 weeks plus a booster session at 26 weeks, all of which were delivered by trained physiotherapists.

Investigators noted that CFT targets biopsychosocial barriers to recovery and has three components that are based on an individual patient’s goals. These components include “making sense of pain,” exposure with control, and lifestyle change.

Both CFT groups wore movement sensors during their sessions, but only the CFT plus biofeedback group and their physiotherapists had access to the data.

Usual care involved treatment that was chosen by the patient themselves and/or recommended by their healthcare provider.

The new 3-year follow-up included 312 of the original participants (mean age, 48 years; 60% women) and between 60% and 65% of each of the original treatment groups.

The extension’s primary outcome was self-reported pain-related physical activity limitation, as measured on the Roland-Morris Disability Questionnaire. The secondary outcome was pain intensity, as measured by the numeric pain rating scale.

Long-Term Pain Reduction

Results showed that CFT with biofeedback was more effective in reducing activity limitation at the 3-year mark vs usual care (mean difference, -4.1; P < .0001), as was CFT alone (mean difference, -3.5; P < .0001).

Additionally, CFT with or without biofeedback was more effective in reducing pain intensity vs usual care (mean differences, -1.5 and -1.0, respectively; P < .0001 for both).

For both measures, the differences between the two CFT groups were not significant.

Sensitivity analyses showed similar, although slightly smaller, effects.

In addition, 49% of the CFT plus biofeedback and 43% of the CFT-only groups maintained recovery level scores between the 1-year and 3-year follow-ups compared with 17% of the usual care group.

“These long-term effects are novel and provide the opportunity to markedly reduce the effect of chronic back pain if the intervention can be widely implemented,” the investigators wrote.

They noted that this would include an increase in clinician training and replication studies in other populations.

“This type of biopsychosocial intervention is widely recommended in guidelines, but the evidence [for it] is now becoming much stronger,” Hancock said.

“Many clinicians aim to deliver these interventions, but they often find it hard, especially if they were trained in a more pure biomedical way of thinking. There are now more resources to assist clinicians in upskilling in these approaches,” he added.

‘Cautious Optimism’

In an accompanying editorial, Dimitrios Lytras, PhD, Department of Physiotherapy, International Hellenic University, Thessaloniki, Greece, applauded how the study was conducted.

“Methodologically, RESTORE is exemplary: a pragmatic, multicenter trial embedded in routine care [and] supported by thorough therapist training,” Lytras wrote.

He added that the results “offer cautious optimism” and a shift from passive care models to ones that are more patient-centered.

The addition of biofeedback not leading to added benefit could be explained by the fact that CFT “already incorporates rich feedback mechanisms, making supplementary sensor input redundant,” he noted.

Lytras wrote that the intervention is also low risk and high value.

Durable Functional Gains

Commenting for Medscape Medical News, Sean Mackey, MD, PhD, Redlich professor and chief of the Division of Pain Medicine at Stanford Medicine, Palo Alto, California, said the study showed durable functional gains and modest pain changes.

The dose of seven visits over 12 weeks plus a 26-week booster was “lean,” but the effects held, which was “pleasantly surprising,” said Mackey, who was not involved with the research.

However, he did note a few caveats, including that only 63% of the randomized cohort contributed to the 3-year data. In addition, “those followed were less severe at baseline and did better at 1 year, though loss to follow-up was nondifferential by arm,” he said.

In reflecting on the study design, Mackey noted that an “attention-matched active comparator to blunt performance and expectancy bias” would have been helpful. He pointed out that the researchers themselves acknowledged that usual care was not contact-matched.

He added that it would also have been valuable to include data on 3-year adverse events, healthcare utilization, and costs.

If future research confirms its generalizability to other countries, Mackey said he would recommend clinicians “adopt the CFT package” of graded exposure with a control and lifestyle coaching, schedule 6-8 visits plus a 6-month booster, measure function as the primary outcome, and set expectations for about a one-point reduction in pain. He recommended against adding sensor biofeedback because “it didn’t help.”

Hancock reported being a member of the Australian Physiotherapy Association and holding research grants from the Australian National Health and Medical Research Council and Medical Research Future Fund, the Physiotherapy Research Foundation, the Australian Chiropractors Education and Research Foundation, and the Canadian Institutes of Health Research. The other investigators reported having a wide list of financial relationships, which are fully provided in the original article. Lytras and Mackey reported having no relevant financial relationships.

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Hong Kong’s hygiene officers will adopt an “act first” approach by clearing stagnant water in unattended private places to tackle the threat of chikungunya fever, the city’s environment minister has said.

Secretary for Environment and Ecology Tse Chin-wan on Wednesday pledged to eliminate mosquito breeding grounds, even in places where responsibility for maintenance was unclear.

“This is a critical time for disease prevention. I believe the public is most concerned about private alleyways where no government department is clearly responsible,” Tse told a radio programme, a day after the city recorded its sixth imported case of chikungunya fever.

“If the Food and Environmental Hygiene Department sees stagnant water or a potential mosquito problem, but cannot find the person in charge as the management of private streets and buildings can sometimes be unclear, it will act first to clean it.”

Tse referred to “three-nil” buildings that have neither an owners’ corporation nor a residents’ organisation and do not employ a property management company.

He added that other government departments were expected to adopt the same mindset, tackling issues as they arose and avoiding delays caused by jurisdictional disputes.

“We need everyone to work together on mosquito extermination. It would be inefficient if we were to divide the tasks among different departments,” Tse said.

Description of confirmed malaria cases and precipitation data

A total of 5,522,650 confirmed malaria cases were reported during the study period in Togo (Table 1). Between 2013 and 2017, confirmed malaria cases increased from 915,117 to 1,204,192 cases. This increase was observed in all three target groups. Children < 5 years old, children ≥ 5 years old and adults, and pregnant women represented 36.6%, 58.5% and 4.9% of the total number of confirmed malaria cases, respectively.

The intensity of monthly precipitation and duration of the rainy season varied between northern and southern health districts (Figure S1). In the north, precipitation was more intense than in the south, especially between July and September. The maximum monthly rainfall was observed in the Binah district in August 2017, with 411 mm. In the south, maximum precipitation occurred mainly in May, June, September or October depending on the year.

Epidemic periods in children < 5 years old

The monthly observed and predicted cases in children < 5 years old from 2013 to 2017 are shown in Figure S2 for each health district. In children < 5 years old, 29 health districts recorded one epidemic period per year, five health districts recorded two epidemic periods per year, one health district recorded three epidemic periods per year, and five health districts recorded no epidemic period (Fig. 2, Table S1). A time lag of at least one month was observed between the onset of precipitation and the start of the epidemic periods, except for the Wawa district. The duration of the epidemic periods varied from one to nine months. The maximum duration of an epidemic period was observed in the Kpele district from April to December.

In the health districts of the Savanes region, the epidemic periods were observed from July to November. The maximum relative increase in cases ranged from 168 to 347% and occurred in July, August or October.

In the health districts of the Kara region, the epidemic periods began between May and July, and ended in October or November. The maximum relative increase in cases occurred in July or August (increase ranging from 127 to 264%).

In the health districts of the Centrale region, the epidemic periods began in April or May, and ended between August and November. The months with the highest relative increase in cases were May and July (increase of between 140 and 230%).

In the Plateaux region, some districts had one long epidemic period (from six to nine months), and other had several short epidemic periods (from one to five months) or a single month with an excess of cases compared to January. The maximum relative increase in cases ranged from 46 to 164%.

In the health districts of the Maritime region, the epidemic periods began in May or June and varied from one to seven months. The maximum relative increase in cases ranged from 52 to 130%.

In the Lome-commune region, only the District 2 recorded a one-month epidemic period in July with a relative increase in cases of 123%.

Epidemic periods in children ≥ 5 years old and adults

The monthly observed and predicted cases in children ≥ 5 years old and adults from 2013 to 2017 are shown in Figure S3 for each health district. In children ≥ 5 years old and adults, 29 health districts recorded one epidemic period per year, nine health districts recorded two epidemic periods per year, and two health districts recorded no epidemic period (Fig. 3, Table S2). A time lag of at least one month was observed between the onset of precipitation and the start of the epidemic periods, except for the Wawa and Danyi districts. The duration of the epidemic periods varied from one to nine months. The maximum duration of an epidemic period was observed in the Tchaoudjo district from April to December.

In the health districts of the Savanes region, the epidemic periods were observed from July to November or December. The maximum relative increase in cases ranged from 126 to 381% and occurred between August and October.

In the health districts of the Kara region, the epidemic periods began between May and August, and ended in November (except for the Keran district). The maximum relative increase in cases occurred in May, June or between August and November (increase ranging from 82 to 192%).

In the health districts of the Centrale region, the epidemic periods began in April or May, and ended between September and December. The months with the highest relative increase were May, July and August (increase of between 112 and 166%).

In the Plateaux region, some districts had one epidemic period from one to seven months, and other had several epidemic periods from one to five months. The maximum relative increase in cases ranged from 75 to 122% and occurred mainly in May or October.

In the health districts of the Maritime region, the epidemic periods began in May or June and varied from one to four months. The maximum relative increase in cases ranged from 57 to 172%.

In the health districts of the Lome-commune region, the epidemic periods began in June or July and varied from one to three months.

Epidemic periods in pregnant women

The monthly observed and predicted cases in pregnant women from 2013 to 2017 are shown in Figure S4 for each health district. In pregnant women, 22 health districts recorded one epidemic period per year, seven health districts recorded two epidemic periods per year, three health districts recorded three epidemic periods per year, and eight health districts recorded no epidemic period (Fig. 4, Table S3). A time lag of at least one month was observed between the onset of precipitation and the start of the epidemic periods, except for the Tchaoudjo district and the District 3. The duration of the epidemic periods varied from one to seven months. The maximum duration of an epidemic period was observed in the Tchamba district from May to November.

In the health districts of the Savanes region, the epidemic periods began in July or August, and ended between September and December. The maximum relative increase in cases ranged from 55 to 260% and occurred in August or September.

In the health districts of the other five regions, the epidemic periods did not follow a specific pattern as observed in the other target groups. A single long epidemic period was observed in the health districts of Binah, Tchamba, Est mono and Anie (4 to 7 months), while multiple short epidemic periods were observed in some health districts such as Assoli, Blitta or Agou. Of the 12 health districts in the Maritime and Lome-commune regions, seven districts recorded no epidemic period and three districts recorded a one-month epidemic period. In the health districts of these five regions, the maximum relative increase in cases ranged from 41 to 167%.

What is Ozempic?

Ozempic is the brand name for semaglutide, a medication created by Danish drugmaker Novo Nordisk. It belongs to a class of drugs called GLP-1 receptor agonists, meaning it imitates the effects of a hormone your body naturally produces, GLP-1. First approved by the US Food and Drug Administration in 2017 for managing type 2 diabetes, Ozempic comes as a once-weekly injection, usually given in the abdomen, thigh, or upper arm using a prefilled pen.

How does GLP-1 support weight loss?

GLP-1 is an incretin hormone released in your gut after you eat. Health Shots also got in touch with dietitian Vidhi Chawla to learn more about it. She says, “It triggers more insulin, curbs glucagon (which raises blood sugar), and slows digestion, all of which help keep blood sugar stable and reduce appetite.” That is why Ozempic is effective for weight loss.

Foods to boost GLP-1

Here are 10 foods that may help make weight loss feel easier and quicker with an Ozempic prescription:

1. Avocados

Packed with healthy monounsaturated fats and fibre, avocados keep hunger hormones in check. Dr Adrian notes that their slow-digesting fat content supports steady blood sugar, while the fibre helps keep you feeling full for longer. A study published in Nutrients revealed that eating a whole avocado can boost GLP-1 levels, along with reducing cravings and appetite. This food is also rich in potassium, which supports metabolism and slows down digestion.

2. Chia seeds

These tiny seeds are a powerhouse of soluble fibre. When soaked, they form a gel in your stomach that slows digestion, much like Ozempic delays gastric emptying (the rate at which food moves from the stomach to the small intestine). Vidhi Chawla adds that chia seeds are also a good plant-based omega-3 source, supporting gut health and reducing inflammation linked to weight gain.

3. Potatoes

Often misunderstood, potatoes (especially boiled or baked) are among the most satiating foods that can support weight loss. They provide slow-digesting carbs that keep energy stable. Dr Adrian points out that their resistant starch content feeds beneficial gut bacteria, which may indirectly support weight control.

4. Oats

Oats, particularly rolled oats, are rich in beta-glucan, a soluble fibre that triggers fullness hormones. They are a steady energy source that reduces the risk of unwanted hunger. Vidhi recommends starting your day with oatmeal paired with protein, like Greek yogurt, for even better hunger control. According to her, fibre rich foods help reduce your calorie intake by promoting the feeling of fullness.

5. Eggs and egg whites

Eggs are loaded with protein that lowers ghrelin, the “I’m hungry” hormone. Their amino acids also support muscle maintenance during weight loss. Having them at breakfast can help curb appetite for hours, making them a simple yet effective tool in any weight-loss-friendly diet. So, make sure you start your day with a protein and fibre-rich breakfast to support weight loss.

6. Greek Yogurt

Thick, creamy, and protein-rich, Greek yogurt is digested slowly, keeping you satisfied for longer. Its probiotic content supports gut health, which is linked to better weight management. Dr Adrian advises choosing unsweetened versions to avoid unnecessary sugar spikes.

7. Lean meat

From skinless chicken to turkey, lean meats deliver high-quality protein that boosts metabolism due to the thermic effect of food. This means you burn more calories even when digesting food. Vidhi notes that protein also helps prevent the muscle loss often seen in rapid weight loss, keeping metabolism healthy.

8. Fish

Fatty fish like salmon, mackerel, and sardines offer both protein and omega-3 fats. Dr Adrian says this combo reduces inflammation, balances hormones, and suppresses appetite. Eating fish 2–3 times a week can be a game-changer for promoting both satiety and metabolic health.

9. Berries

Low in sugar but high in fibre, berries are ideal for controlling blood sugar spikes. Their antioxidants also help reduce inflammation, which can interfere with hunger and satiety signals. Vidhi suggests pairing berries with Greek yogurt for a balanced, filling snack.

10. Leafy greens

Spinach, kale, broccoli, and other fibre-rich vegetables are filling yet low in calories. They fill your stomach, stimulate fullness hormones, and deliver vitamins that support overall metabolic function, explains Dr Adrian. One 2022 study published in the International Journal of Preventive Medicine found that eating vegetables before carbohydrates significantly improves glucose and GLP-1 levels in people with type 2 diabetes. What’s more? Since they are also high in vitamins, minerals, and antioxidants, they can also help support healthy metabolism and the fat-burning process.