Category: 8. Health

A Surrey health trust is investing £1.8m in the latest X-ray and imaging equipment.

Frimley Health NHS Foundation Trust is replacing equipment that has been in place at Frimley Park Hospital for 14 years.

The new equipment can carry out more procedures and poses less risk to patients, according to the trust.

It produces lower doses of radiation, provides better pictures on larger screens and can even produce 3-D images, the trust added.

It will also feature a flexible arm, one of only two in use in the country, which reduces the need to move the patient to capture images from different angles.

It is hoped the enhanced images will lead to better diagnoses.

Consultant radiologist Dr Jeremy Taylor said: “We are so pleased to be able to offer our patients the best possible care, with some of the latest available technology and minimally invasion treatments.

“It will ensure that interventional radiology remains at the forefront of medical advances at Frimley Heath.”

Photo: VCG

 
Chinese health experts reassured the public that there is no need to panic and that effective precautions can be taken to control mosquitoes and protect oneself during daily activities, as the chikungunya outbreak in southern China has drawn public attention in recent days, with total reported cases surpassing 4,000 in Guangdong’s Foshan.

Thepaper.cn on Saturday reported that as of Thursday, all five districts of Foshan in South China’s Guangdong Province had reported cases of chikungunya, with total cases exceeding 4,000. In Shunde district – the epicenter of the outbreak – 3,627 cases have been confirmed, cases have also been reported in other Guangdong cities, including Guangzhou, Yangjiang, and Zhanjiang. 

Macao’s Health Bureau reported that the city confirmed one imported case of chikungunya on July 18, the first such case this year. The patient had visited Foshan’s Shunde district from July 8 to 17.

In response to the outbreak, the Guangdong provincial health authorities issued an open letter on Thursday via their official WeChat account, calling on all residents to join a province-wide campaign to eliminate stagnant water and control mosquito breeding. The campaign aims to curb the spread of both dengue fever and chikungunya fever.

On Friday, the Standing Committee of the CPC Guangdong Provincial Committee convened a meeting to hear updates on chikungunya prevention and control. The meeting noted that epidemic control efforts are at a critical stage, and while initial containment measures have shown results, challenges still remain. In addition, the summer typhoon season and heavy rainfall are complicating prevention efforts. Authorities stressed that there must be no complacency in combating the outbreak, Nanfang Plus reported.

Several cities in other parts of China have issued public health reminders. On Saturday, the Beijing Center for Disease Prevention and Control (CDC) released a Q&A guide on chikungunya, stating that the virus is primarily transmitted through bites from Aedes mosquitoes. It is not spread through coughing, sneezing, talking, or other casual contact. Most infections are mild, with symptoms including sudden fever and joint pain, which typically resolve within a week. 

The Beijing CDC reassured residents that the risk of local transmission in the city remains extremely low and that there is no need for panic. 

In another advisory issued on Tuesday, the Beijing CDC noted that although only sporadic imported cases have been found in the city so far, the growing volume of international travel means the risk of imported cases remains. 

On Tuesday, the World Health Organization (WHO) warned that a major chikungunya virus epidemic could sweep across the globe, calling for urgent action to prevent it. The WHO said it was observing the same early warning signs as in a major outbreak two decades ago and wanted to prevent a repeat, AFP reported.

“Chikungunya is not a disease that is widely known, but it has been detected and transmitted in 119 countries globally, putting 5.6 billion people at risk,” said the WHO’s Diana Rojas Alvarez, per the AFP.

Zhuang Shilihe, a Guangzhou-based medical expert who closely follows public health issues, told the Global Times on Saturday that for residents in Guangdong, prevention remains the most crucial aspect. Zhuang noted that this disease is not transmitted directly from person to person but through mosquitoes as vectors, making mosquito control measures particularly important.

“At the community level, areas with high mosquito density or standing water should be promptly cleared. On an individual level, people are advised to use mosquito repellent, wear long sleeves and pants, and protect exposed areas such as the neck,” Zhuang said.

While the outbreak has shown signs of spreading beyond Foshan to other cities in Guangdong Province, the overall risk remains controllable, as the disease is spread by mosquitoes, northern regions – where mosquitoes are less prevalent – face relatively lower transmission risks, Zhuang noted.

The expert added that Guangdong Province has in recent days launched a province-wide mosquito eradication campaign. Given the disease’s incubation period of around 2 to 9 days, the impact of the control measures will take some time to become apparent.

The transmission of the chikungunya virus typically peaks during the summer season. However, due to increasingly hot weather in recent years, the transmission period may be extended to September, Zhuang said.

China recorded its first imported chikungunya case in 2008. Since then, small-scale outbreaks caused by imported cases occurred in 2010 and 2019, but none reached the scale seen this year.

Why, then, is this year’s outbreak larger than previous ones? Liu Qiyong, chief vector-borne disease expert at the Chinese CDC, explained that the current outbreak is largely driven by the virus’s high global prevalence.

On July 22, WHO experts issued an alert stating that chikungunya transmission has been reported in 119 countries and regions. After the virus entered China, the presence of Aedes mosquitoes, the primary vector, enabled local transmission and small-scale outbreaks, Liu said. 

Favorable climate conditions and the specific virus strain have also contributed to the unusually large scale of this year’s outbreak, Liu noted, as warm, humid weather has increased mosquito density. The imported strain – an Indian Ocean lineage – is also particularly efficient at spreading via Aedes mosquitoes.

In a new interview conducted on-site at the Dermatology Education Foundation (DERM) 2025 NP/PA CME Conference, Adam Friedman, MD, spoke with the HCPLive editorial team about managing tinea, also known as dermatophytosis.

Friedman, who serves as Professor, Chair of Dermatology, Residency Program Director, Director of Translational Research, and Director of the Supportive Oncodermatology Program in the George Washington University School of Medicine & Health, emphasized the importance of recognizing and treating dermatophytosis, a common but often overlooked group of fungal skin infections, due to the risk of anti-fungal resistance.

“Dermatophytosis, which encompasses a wide array of clinical cutaneous infections associated with dermatophyte infections, is super common, but is not commonly discussed because it just isn’t ‘sexy,’” Friedman said. “And I get it, who wants to talk about fungal infections? But we can’t put our heads in the sand. We need to be able to make the right diagnosis, but also consider the potential for anti-fungal resistance if we don’t treat the right thing, or if we’re not thoughtful about how we use our anti-fungals, of which we unfortunately don’t have a huge amount.”

Friedman stressed that clinical inspection alone is insufficient for diagnosis, advocating for the use of potassium hydroxide preps, scrapings, cultures, and biopsies to accurately identify and treat fungal infections.

“I know we pride ourselves as master diagnosticians, but we have proven time and again in the published literature that clinical inspection is not enough,” Friedman explained. “Use my favorite tool of all time, your potassium hydroxide prep. I realize there are some limitations with CLIA certification, but this very simple tool can be the distinguisher between calling something a dermatophyte infection or something primary inflammatory. By defining the disease, you can purposely select the correct treatment regimen, which will then make your patient happy and will prevent fungi from developing resistance to the limited things we have.”

Friedman went on to warn about of the growing resistance to antifungals, particularly azole anti-fungals like econazole and fluconazole. He noted the necessity for careful anti-fungal stewardship, similar to antibacterial stewardship, given the limited number of new anti-fungal treatments available.

“When we think about our anti-fungal armamentarium, most of them are what are called static,” Friedman said. “They are inhibiting an enzyme or something that’s needed for cell survival. And when you are inhibiting one thing, the problem is, the fungus among us can become kind of clever and pivot. That, in essence, is where resistance occurs, where one surviving cell has managed to shift the narrative and utilize other machinery to survive. And then it passes that information through its friends…and then we have an anti-fungal that’s rendered useless.”

To find out additional information on the subjects covered by Friedman in his session on tinea, view his full video interview posted above. For more on related information, view our latest DERM 2025 coverage.

The quotes contained in this interview description were edited for clarity.

Friedman has previously reported serving as a consultant to Dermira, Eli Lilly and Company, Encore Dermatology Inc, Exeltis, Galderma, IntraDerm, Johnson and Johnson, Oculus Innovative Sciences, Pfizer Inc, and Sanovaworks.

As both brands invest in clinically backed solutions, they mark a new chapter in hormone health—moving from reactive to preventative, and from fertility-centric to full-cycle support.

DITTO: smart nutrition for the hormone cycle

Founded by female scientists and healthcare professionals, DITTO has launched the Cycle Supplement, a first-of-its-kind, daily formula designed to support people experiencing PMS, PMDD, PCOS, endometriosis and perimenopause.

Its unique formulation includes 10 bioavailable nutrients, each supported by randomised, placebo-controlled trials.

The supplement uses advanced beadlet technology for enhanced absorption and is designed to target core hormonal symptoms such as cramps, mood swings, fatigue, bloating and hormonal acne.

“Hormonal symptoms respond best to daily, consistent nutritional support,” says Dr Asha Malik, a biomedical scientist and adviser to DITTO.

“We created this formula not as a patch, but as a foundation—one that stabilises and supports across the entire cycle, not just the worst days.”

DITTO also distinguishes itself through sustainability: the supplement is delivered in plastic-free, bio-based packaging and is compatible with hormonal contraception — removing common barriers to use.

Fairhaven Health: a legacy brand expands its vision

Meanwhile, Fairhaven Health — a trusted name in reproductive nutrition — is expanding its focus from fertility to a broader women’s health mission.

Best known for its FH PRO for Women, which has been shown to increase clinical pregnancy rates by 23%, the company is now rolling out a suite of supplements supporting menstrual regularity, vaginal microbiome balance, lactation and menopause symptoms.

The shift is driven by consumer demand and emerging clinical evidence, reflecting a lifecycle view of hormone health.

 “Women’s health doesn’t begin with a fertility journey or end with menopause,” said Suzanne Munson, VP of Product Development at Fairhaven Health.

“We’re meeting women where they are—whether they’re managing cycle irregularities, transitioning through menopause, or just trying to feel good every day.”

This evolution includes reformulations of core products with newer clinical ingredients, and a refreshed focus on quality, transparency and practitioner collaboration.

Shared vision: clinically proven lifecycle-oriented care

Both DITTO and Fairhaven Health represent a broader industry pivot: moving beyond trend-driven products to science-backed, personalised solutions for hormone health.

Each brand has committed to randomised clinical validation, clear ingredient transparency and a holistic approach to care — meeting the needs of women at all stages of life.

“This isn’t just about supplements; it’s about restoring confidence in women’s health science,” says Malik.

“With DITTO and companies such as Fairhaven leading the way, we’re finally seeing research and real-life needs align.”

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By analyzing CT images with 3D software, small liver tumors can be successfully treated using ablation. This has been demonstrated by research conducted by Radboudumc.

Liver tumors up to three centimeters in size can be treated in various ways. In consultation with the patient, the treating physician decides whether to perform surgery or ablation, a method in which the tumor is punctured with a thin needle and heated so that it breaks down. The latter method is less invasive; it takes less time, there is less chance of complications, and the patient recovers more quickly.

Higher chance of cancer recurrence

However, the chance of cancer recurrence was found to be relatively high with ablation compared to surgery. “By looking at the procedure and technical possibilities together, we have arrived at a new process,” says oncological surgeon Martijn Stommel.

3D analysis during treatment

Part of this new process is a 3D analysis. The ablation does not take place in an operating room, but in a room with a CT scanner. Immediately after treatment, while the patient is still under anesthesia, a CT scan is made.

Previously, doctors assessed the CT scan visually, but this is now done using advanced 3D software. This provides a much more accurate image of the tumor. By superimposing images from before and after the operation, it is immediately clear whether the entire tumor has been treated.

More effective treatment

The results are promising. Thanks to the analysis with the 3D software, the number of recurrent liver tumors within two years after ablation has fallen sharply, from 33% to less than 10%.

The 3D analysis is a great example of the smart use of technology that directly benefits patients. Less invasive procedures are better for patients, but they also mean lower costs and less strain on the healthcare system.

PHILADELPHIA (July 25, 2025) – A group of scientists from the Monell Chemical Senses Center will present their research at the 32nd Annual Meeting of the Society for the Study of Ingestive Behavior from July 28th – August 1st at the Mathematical Institute, Oxford, UK.

The annual conference broadly covers research on behaviors associated with all aspects of eating and drinking. Monell researchers from three labs will share their investigations on how taste and smell influences what foods we consume, how that changes across the lifespan, and internal cues called interoception, along with the role of the brain reward system and vagal nerve system. These are highlights of Monell sensory science being delivered in oral sessions at this meeting:

Tuesday, July 29

ORAL SESSION 2: COMING TO YOUR SENSES; OLFACTION AND GUSTATION IN INGESTION

1:15pm

AgRP neurons distinguish oral sugars from sweeteners

MISGANA Y GHIDEWON^{1, 2}, LARYSSA O COUTINHO², MILENA S ALMEIDA², SEVINCH RAKHMONOVA², ALISHA A ACOSTA², AMBER L ALHADEFF^{1, 2}.
¹University of Pennsylvania, Philadelphia, PA, USA. ²Monell Chemical Senses Center, Philadelphia, PA, USA

Food intake requires intricate coordination between orosensory signaling and central feeding circuits that initiate and maintain feeding. Yet, the impact of oral sugar sensing on homeostatic feeding circuits is not fully understood. They found that sugars and sweeteners affect hypothalamic agouti-related protein (AgRP) neuron activity but do so through different mechanisms. Overall, these findings show that differences in caloric sugar and non-caloric sweeteners are distinguished in the mouth and transmitted to AgRP neurons, which has typically been ascribed only to post-ingestive signaling.

More on the Alhadeff lab here and here.

ORAL SESSION 3: OH TO BE YOUNG; EARLY LIFE FOOD PERCEPTION AND EATING

3:30pm

Working memory moderates the relationship between attentional bias and eating behavior

JESSICA H. LIU^{1, 2}, AFRODITI PAPANTONI², KYLE S. BURGER².
¹The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ²Monell Chemical Senses Center, Philadelphia, PA, USA

Previous research has shown that impaired working memory (perception that is affected by a current train of thought) and attentional bias towards food have independently been associated with atypical eating behavior patterns and weight gain. The researchers hypothesized lower working memory and higher attentional bias would be related to faster energy eating rates, increased caloric intake, and higher body mass. They found that working memory and attentional bias interact to influence eating behavior. Specifically, individuals with poorer working memory may be more susceptible to food cues, and that combination increases how fast and how much people consume.

More on the Burger lab here.

3:45pm

Using machine learning to identify task fMRI predictors of appetite ratings and weight status in adolescents

TRINITY CHENG¹, LIUYI CHEN¹, AFRODITI PAPANTONI², SUSAN CARNELL¹.
¹Johns Hopkins University School of Medicine, Baltimore, MD, USA. ²Monell Chemical Senses Center, Philadelphia, PA, USA

Food cue responsiveness is thought to influence body weight. Task fMRI studies have identified brain regions activated by exposure to food cues. However, the degree to which responses within these regions can predict appetite and body weight is unclear. The team applied machine-learning models to an fMRI food cue reactivity task with 77 adolescents to classify participants into groups based on subjective appetite ratings.

More on Postdoctoral Fellow Afroditi Papantoni here.

Wednesday, July 30

ORAL SESSION 4: KNOW THYSELF; INTEROCEPTION AND INGESTION

 

10:15am

Vagal sensory neurons selectively encode intestinal protein

ALAN DE ARAUJO^{1, 2}, MINGXIN YANG^{1, 2}, AVNIKA BALI^{1, 2}, JAMES MCCUTCHEON4, CHRISTOPHER MORRISON³, GUILLAUME DE LARTIGUE^{1, 2}.
¹Monell Chemical Senses Center, Philadelphia, PA, USA. ²University of Pennsylvania, Philadelphia, PA, USA. ³Pennington Biomedical Research Center, Baton Rouge, LA, USA. 4UiT the Arctic University of Norway, Tromso, Norway

Dietary protein is essential for survival and generally palatable. When protein intake is restricted, animals rapidly increase consumption of protein-rich foods, suggesting that animals can detect protein deficiency and adapt accordingly. However, the neural circuits that sense ingested protein and guide this adaptive behavior are poorly defined. The team identified a vagal gut-brain pathway that detects dietary protein and influences protein appetite through post-ingestive feedback.

More on the de Lartigue lab here and here.

10:30am

A dedicated gut-brain pathway for hypothalamic fructose sensing

AARON D MCKNIGHT^{1, 2}, FANG Y HSU², ALEXANDRA G VARGAS², ALAN ARAUJO², GUILLAUME LARTIGUE^{1, 2}, AMBER L ALHADEFF^{1, 2}.
¹Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA. ²Monell Chemical Senses Center, Philadelphia, PA, USA

Activity in agouti-related protein (AgRP)-expressing neurons in the hypothalamus drives food intake and is inhibited by the post-ingestive detection of calories. Given that modern diets contain increasing levels of added sugars, the team examined how glucose and fructose impact activity in AgRP neurons. They found that fructose engages a distinct gut-to-hypothalamic pathway and is less effective than glucose at inhibiting AgRP neurons, a finding that may impact feeding behavior and weight gain.

More on the Alhadeff lab here and here.

Friday Aug 1

ORAL SESSION 7: BEYOND HOMEOSTASIS; HOW REWARD AND LEARNING INFLUENCE EATING

10:00am

Hypothalamic circuits shape accumbal dopamine release to drive feeding

(Elsevier Physiology & Behavior New Investigator Travel Awardee)

SAM Z. BACHARACH¹, LARYSSA O. COUTINHO¹, KATIE A. ZAPPETTI^{1, 2}, AMBER L. ALHADEFF^1,2.
¹Monell Chemical Senses Center, Philadelphia, PA, USA. ²University of Pennsylvania, Philadelphia, PA, USA

Agouti-related protein (AgRP)-expressing neurons in the arcuate nucleus of the hypothalamus are tuned to feelings of hunger and critical for feeding behavior. Stimulation of AgRP neurons robustly drives food intake and increases dopamine release. However, the neural mechanisms linking energy-sensing circuits to dopamine release remain poorly understood. The team demonstrated that AgRP neurons bidirectionally modulate dopamine release. Ongoing studies are investigating the downstream neuron populations linking hypothalamic AgRP neurons to dopamine release.

More on the Alhadeff lab here and here.

###

About Monell Chemical Senses Center

The Monell Chemical Senses Center is an independent nonprofit research institute in Philadelphia, Pennsylvania. It was founded in 1968 to advance and share discoveries in the science of the chemical senses of smell, taste, chemesthesis, and interoception to solve the world’s health, societal, and environmental challenges.
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When William Dwyer Joyce was a teenager, skinny jeans and Indie bands were what was cool. To be slim was fashionable. As a someone who didn’t fit into that stereotype, and who was always “plus-sized”, Dwyer Joyce turned to food as a coping mechanism.

The now 32-year-old was diagnosed with binge-eating disorder when he was 21, though he says he struggled with mental health difficulties long before that diagnosis.

“For me, my binge eating was very secretive. It was going to the shop, getting large amounts of things like chocolate, crisps, cookies, whatever. And going home and secretly eating it to the point where I could not eat it any more,” he says.

“It created a coping mechanism that was quite harmful because my body image was very poor. It was about numbing. In a sense it was self-harm. If you eat to the point of pain, it’s not a nice thing to go through.”

Compounding this difficulty, Dwyer Joyce also struggled with alcohol addiction and drug misuse issues. These challenges, he says, all came from the same place: a desire to be able to exert control. He is now five years sober.

“When I got sober, it was like I was in a house that was on fire. Sobriety put the fire out, but now I’m standing in rubble and I have to build the house again,” he says.That was when he seriously sought help for his eating disorder.

“In April 2020 I got sober for the last time. A year after that, in 2021, I had a year of sobriety under my belt. My 30s were knocking on my door and I thought, I cannot live like this forever and the only person who can change this was me.”

One difficulty he found when seeking help, he says, was the questioning attitude and scepticism he faced by some healthcare professionals because he doesn’t fit the common eating-disorder stereotype: a young woman or teenager with anorexia.

“I am the opposite of the stereotype in that I’m a man, I’m plus-sized, I wasn’t restricting food,” he adds.

“There is all this messaging around fatness or plus-sized people that if you’re fat it’s a moral failing or you’re lazy or you don’t care about how you look. But that’s just not true.”

This stereotype is beginning to change, according to Laura Casey, director of services at Lois Bridges, an eating disorder treatment centre in Sutton, north Co Dublin. The number of young men seeking help at the centre has increased in recent years, she notes.

Casey attributes this rise to the increasing gym culture seen online – in which men are constantly fed images of bodybuilders with very little body fat – combined with the masculine tendency of men to keep their feelings to themselves.

“But when they do go and reach out, they’re not heard the same. Their voices can be dismissed a bit easier,” she says.

Another changing trend is the prevalence of a condition known as avoidant/restrictive food intake disorder, or Arfid, which is often diagnosed among people who are neurodivergent.

“It’s sometimes called the beige diet; they eat a lot of chicken nuggets and chips. But we’re moving away now from language that describes these people as being a picky eater, and acknowledging in many cases they have a sensory aversion to something.”

According to Casey, Arfid can have a significant impact on an individual, particularly in a social setting.

“Sometimes a person’s diet is so restrictive they won’t eat. There is a lot of shame and stigma if all they are able to eat is a chicken fillet roll. So, nutritionally, they can be at the same risk as anorexia. It affects their vitamin intake and electrolytes,” she says.

When it comes to certain foods, some people with this diagnosiscan have a panic attack or feel like they’re choking. “They can only eat yoghurts and drinks,” she adds.

Awareness of eating disorders has increased since the Covid-19 pandemic, when there was a rise in the number of referrals for treatment to HSE eating-disorder teams, who provide specialist treatment.

HSE data shows there were 894 referrals to such teams last year, a 33 per cent increase on 2023. There was also a 24 per cent rise in accepted referrals, where patients proceed to treatment after an initial consultation.

A total of 562 patients were assessed last year, of which 90 per cent were female and 59 per cent were children under the age of 18. One-third were teenagers aged between 15 and 17. Still, the service also saw the number of adults accessing treatment increase by 51 per cent.

Of those assessed, 503 had an eating disorder, 118 more diagnoses than in 2023.

Some 63 per cent (318) presented with anorexia nervosa; 18 per cent (97) with an “other specified feeding or eating disorder” (OSFED); 8 per cent (42) with bulimia nervosa; 3 per cent (16) with Arfid; and 2 per cent (10) with binge-eating disorder.

Many eating disorders begin the teenage years. But disorders often don’t end there.

Rebecca, not her real name, was first brought to Child and Adolescent Mental Health Services (Camhs) at age 15. However, she believes this “did a lot more harm than good”.

Although she acknowledges there are many good people working in the service, she was unhappy with the attitudes she faced in relation to her anorexia. Then the coronavirus lockdown happened, shutting down vast swathes of regular life. “Everything was gone, and I deteriorated very rapidly.”

Following this, she underwent a “string of hospital admissions and A&E presentations” to help with her diagnosis, but she says it was like a “revolving door”.

“You’re either too sick for the psychiatric hospitals or you go into a general hospital and there’s no help there for these things. You’re stuck between nothing that will help,” she says.

“When you go into a general hospital, it’s really only for one thing: to be fed against your will. But it’s so important to get to the root cause of it. It was very difficult to find help that suited me. And then when people do offer you that help, it’s hard to accept it if you’ve had bad experiences. I’m still struggling a lot.”

The almost 21-year-old makes a comparison to alcoholism: relapse can be a common challenge for people, and oftentimes the difficulties of the illness are persistent.

“But there’s no AA meetings [for eating disorders] around the country that you can pop into. You’re kind of just left alone,” she adds.

Dr Art Malone, a consultant psychiatrist and chair of the eating disorder specialist interest group at the College of Psychiatrists, says one of the biggest challenges is that some areas of the State have inadequate access to the necessary specialist services.

“Not all areas that have a specialist service are fully resourced to deliver the sort of service they would need to do. The biggest one is probably the lack of higher-level care needed for severe cases, so the lack of inpatient treatment is something all teams have to contend with,” he says.

Dr Malone says that for the “very small minority of patients” who have very severe, acute illnesses there is “no higher-level care available in the way that it should be”.

“What ends up happening is there can be funding sought in other places such as private places or abroad but there can often be fairly lengthy delays in arranging that and then even when it is arranged – because it’s taking people out of their home environment – it can be quite tricky then to transfer their treatment back to their own home set-up,” he says.

Dr Malone says there’s a big push to try to make early intervention a priority, as this can prevent people from needing inpatient care.

He cites international research that found the relapse rate for people with severe illness who receive inpatient treatment is around 50 per cent in their first year.

“But it’s important to note that services where they do exist are extremely hardworking. Things have come on such a huge distance in a very short time, but it’s coming from such a low base in terms of service accessibility that there is still a way to go.”

[ Eating disorders: ‘I wouldn’t speak to my worst enemy the way I talked to myself’Opens in new window ]

In recent years, the Government has taken steps to improve eating-disorder services. Currently, 14 of the 16 specialist eating disorder teams recommended in its internal plans are funded.

Minister of State for Mental Health Mary Butler says no patients have been treated abroad this year so far for specialist eating-disorder care.

“I’m very proud of the progress we are making in establishing a full suite of services to support people with eating disorders, from early intervention in the community to the development of specialist inpatient beds for acute care,” she says.

However, things are far from perfect, those working in the sector say. Figures from the HSE show that one-third of funded posts at eating disorder regional specialists teams are currently unfilled.

In the adult eating disorder team in the Sligo, Leitrim, South Donegal health area, there are more vacancies than people in post: 3.2 whole-time equivalent staff are in place, with seven unfilled posts in the area.

Furthermore, there are only three adult specialist eating disorder beds in the country, all of which are in St Vincent’s hospital, Dublin. The rules for these beds, which are for those who are acutely unwell, require patients to be within that hospital’s catchment area to be treated there.

As a result, people with eating disorders outside that area who go into public hospitals for treatment are typically referred to a general psychiatric unit. Often they are unable to access specialised care in such settings.

However, The Irish Times understands a plan has been devised by the HSE to increase the number of public eating-disorder beds nationally.

At least 20 new specialist beds will be established in the coming years, under proposals submitted by the HSE for Ms Butler’s approval. The beds will be spread between Dublin and the rest of the country, but all of them will have a national catchment area.

For some people, recovery feels impossible. Aoife, which is not her real name, developed eating disorder behaviours when she was 12, after she sought to lose weight for her Confirmation.

“My family weren’t very nice about my body. But also society. You’d be in drama class and I was the biggest so I would have to try on the costume and if it didn’t fit me then nobody would get it. Then there were things like the Special K diet, or Kate Moss’s saying about skinny being better,” she says.

The 32-year-old Cork woman says she was diagnosed with anorexia at the age of 15, and went into hospital when she was 16, which she describes as “the worst point in my life ever”.

“I couldn’t control anything. I had a tube in my nose, I wasn’t allowed to walk anywhere. I basically just lay in bed. I soiled myself because it would expend too much energy to go to the bathroom. It was only about weight restoration, not about treating the eating disorder,” she says.

She struggled through college but was determined to continue her studies.

After graduating as a teacher, she realised she needed to get better before she could work full-time. In 2016, she returned to inpatient care. She improved somewhat, she says, but was not in recovery.

She was admitted again two years ago, but had to leave early due to panic attacks. For her, she says, a history of trauma is playing a role in her current condition: her sister died when she was very young.

“I overate when she died; that was soothing myself. My life felt out of control, I didn’t know who would die next. Food was something I could control,” she says.

But it is 20 years since the onset of those challenges. These days, she feels quite hopeless about her current trajectory.

“I’ve been told I’ll never recover. I have chronic anorexia. So you ask yourself, what’s the point in trying? Normal eating is no longer normal for me. This has become my normal and it’s very hard to see outside of it,” she says.

[ Eating disorders in later life: Some of my peers have had teenage weight levels for decadesOpens in new window ]

“It’s pointless to be here every day. I keep wondering, how did things come to this? I’d love for someone to tell me what to do because I just don’t know where to go or what to do. I look inward wondering what I could do differently. What did I do to deserve this?”

Trying to find somewhere to go is something many patients experience. Alicia Woods, clinical nurse specialist at Lois Bridges, says the centre is a private facility, but they receive “phone calls everyday of the week from people who don’t have private health insurance”.

“We treat a range of eating disorders. And in terms of age, we’ve treated from 18 up to people in their early 70s,” she says.

“The majority of older people with eating disorders have had it their whole life but they just haven’t had the information, education or support to seek help. Some people do develop it later in life.”

Though Woods says the reasons why individuals develop eating disorders are complex and nuanced, she believes social media is playing a role.

“Body positivity was such a thing, but now we’ve gone back almost 20 years. The videos on social media, encouraging people to obsessively run 5K a day, or the ‘what I eat in a day’ videos [and the food quantity] is not enough to feed a toddler,” she says.

She is also concerned about the potential impact the widespread availability of weight loss jabs like Ozempic might have on vulnerable individuals.

“We know that people can put in fake weights and get these prescriptions. If someone already has a low [body mass index] … the potential of that is frightening,” she adds.

But even when people can access treatment, often recovery is not linear, according to 38-year-old Edel Higgins.

She was diagnosed with an eating disorder when she was around 25. She didn’t know much about such disorders at the time, but says she had “always tried to change my physical appearance”.

[ Families: the untapped superpower in eating disorder recoveryOpens in new window ]

It took four inpatient stays before she reached a point where she sees herself as being in recovery. She says: “It doesn’t just take one go. People often feel guilty when they have to go back. But it’s such a complex illness.”

The Tallaght woman is four years in “proper recovery”, but she says for her that doesn’t mean the eating disorder is “completely gone”, but just now she has the “resilience” to acknowledge and challenge those urges when they arise.

She writes poetry to help her cope. She looks at inspirational quotes hung up on her wall.

“Sometimes I wish I could wake up, go about the day, not having all of these overwhelming feelings – the eating disorder and mental health [difficulties]. But it doesn’t work that way. It can be frustrating. But it’s about findings ways to deal with it.”

Bodywhys (The Eating Disorders Association of Ireland) – bodywhys.ie – (01) 210 7906 – alex@bodywhys.ie

Artificial intelligence (AI)-enhanced echocardiograms successfully detected structural heart disease (SHD) and outperformed cardiologist analysis in real time with accuracy and speed in a new study published in Nature.¹

Currently, the cost and accessibility of imaging tools like echocardiograms (ECG) pose a barrier to early detection of SHD and associated conditions like valvular heart disease and heart failure. SHD also constitutes $100 billion in annual direct and indirect costs in the US, which experts predict will continue to rise, thus increasing the disease burden.² However, the recent study aimed to develop a deep learning ECG model that can accurately detect a broad range of SHDs and, in that, assess the model’s performance across institutions, patient demographics, and clinical context.¹

“All forms of SHD can be definitively diagnosed with echocardiography, but cost, required expertise, and appropriate patient selection limit its total use,” the study authors wrote. “Thus, there remains a critical need to better risk-stratify patients and determine who should be referred for echocardiography to improve rates of SHD diagnosis and early treatment.”

The model, named EchoNext, was set to train on a database composed of 1,245,273 ECG-echocardiogram pairs from 230,318 unique patients aged 18 or older collected between December 2008 and 2022 at a New York Presbyterian–affiliated hospital. While the study did document patient covariates (age, sex, race/ethnicity), there was no clinically relevant difference in the model’s performance. Furthermore, in preparation to train the model, the data set was split at a patient level into categories for the model to train with (149,819 unique patients with 796,816 ECG–echocardiogram pairs), validate (35,780 unique patients with 35,780 ECG–echocardiogram pairs), and test (44,719 unique patients with 44,719 ECG–echocardiogram pairs).

The presence of SHD was based on clinical ECG reports and guidelines, which included low LVEF less than or equal to 45%, maximum low left ventricular wall thickness greater than or equal to 1.3 cm, moderate or severe right ventricular dysfunction, and pulmonary hypertension (pulmonary artery systolic pressure greater than or equal to 45 mm Hg, or tricuspid regurgitation jet velocity greater than or equal to 3.2 m s⁻¹). The model was also trained to make multiple predictions at once to determine which specific diseases are present or not, whether the multiple disease presence is correlated, and to learn from its predictions. The model performed the best with right ventricular (AUROC 91%) and low left ventricular systolic dysfunction (90%). The lowest performance was seen for low left ventricular wall thickness (AUROC 77%), aortic regurgitation (78%), pulmonary regurgitation (79%), and pericardial effusion (80%).

Furthermore, when compared with cardiologist non-AI–assisted reviews of ECGs, the EchoNext significantly outperformed cardiologists in a review of clinically normal and abnormal ECGs, maintaining a 77% accuracy, while cardiologists’ accuracy was 69% versus 62%, respectively. However, with AI assistance, cardiologist review accuracy improved to 69.2% (CI, 95%, 66.9–71.4%) with sensitivity 64.7% (CI, 95%, 60.9–68.3%) and specificity 72.4% (CI, 95%, 69.4%–75.3%) was still less than the EchoNext model’s accuracy with 77.3%, sensitivity 72.6%, and specificity of 80.7%.

The study was limited by race in that 89.4% of the population was White, thus limiting generalizability; however, amongst the small diverse sub-populations, there was no clinically significant difference in the model’s performance. Furthermore, the disease labels were based on ECG reports based on clinician interpretation, which may implement unknown bias.

“Together, these data demonstrate the potential for AI to help further expand the clinical and diagnostic use for an already broadly used and broadly accessible test,” the study authors wrote. “The fact that EchoNext alone performed significantly better than cardiologists, even when given the AI results, warrants further exploration.”

References

Poterucha, T.J., Jing, L., Ricart, R.P. et al. Detecting structural heart disease from electrocardiograms using AI. Nature (2025). https://doi.org/10.1038/s41586-025-09227-0

Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, et.al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2023 update: a report from the American Heart Association. Circulation. 2023 Feb 21;147(8):e93-e621. doi:10.1161/CIR.0000000000001123

Amyotrophic lateral sclerosis (ALS) – which you may know as the disease that affected Stephen Hawking – is a fatal neurodegenerative disease that causes progressive muscle weakness. A research team at Tohoku University and Keio University has uncovered a unifying mechanism in ALS revolving around the expression of UNC13A (a gene crucial for neuronal communication) that represents a common target for developing effective treatment strategies that could improve the lives of patients with ALS.

“Scientists still don’t fully understand the process behind the loss of motor neurons in ALS. ALS is known for its genetic heterogeneity – meaning that there are numerous possible combinations of genes and factors that could lead to ALS. This makes it difficult to develop a singular treatment that works for everyone.”

Yasuaki Watanabe, Assistant Professor, Tohoku University

For example, a hallmark of many ALS cases is the loss of TDP-43 (a nuclear RNA-binding protein) which causes widespread RNA dysregulation. However, many other ALS-linked proteins such as FUS, MATR3, and hnRNPA1 have also been implicated, each with differing pathological mechanisms. This diversity has long hindered the search for common therapeutic targets.

Led by Assistant Professor Yasuaki Watanabe and Professor Keiko Nakayama, Tohoku University, the team sought to identify a molecular pathway shared among different forms of ALS. They generated neural cell lines in which one of four key ALS-related RNA-binding proteins was depleted. In all cases, the expression of UNC13A was significantly reduced.

The study revealed two distinct molecular mechanisms underlying this reduction. One mechanism involves the inclusion of a cryptic exon in the UNC13A transcript, which leads to mRNA destabilization. The second was a completely new finding, which shows that the loss of FUS, MATR3, or hnRNPA1 causes overexpression of the transcriptional repressor REST. As the name implies, REST suppresses UNC13A gene transcription, making it unable to perform its usually helpful functions. This suppression may be what leads to the symptoms found in ALS.

To clarify whether these results mirrored what was really occurring in patients with ALS, the researchers looked at motor neurons derived from ALS patient iPS cells and in spinal cord tissues from ALS autopsy cases. Importantly, the researchers confirmed elevated REST levels, strengthening the clinical relevance of their findings.

This newly discovered convergence of distinct ALS-causing mutations on a single downstream effect–UNC13A deficiency–offers critical insight into the disease’s complexity. The results highlight UNC13A as a central hub in ALS pathogenesis and suggest that preserving its expression, or modulating REST activity, could represent promising therapeutic strategies.

“This study provides a valuable framework for developing broad-spectrum treatments that target shared molecular vulnerabilities in ALS,” says Nakayama.

As ALS progresses, patients’ muscles waste away until they eventually lose the ability to swallow or breathe. A treatment that could potentially slow down or prevent this progression in as many patients as possible represents a large stride forward in ALS research.