Category: 8. Health

An estimated 4 million children undergo surgical procedures in hospitals across the U.S. each year. Although postoperative complications, such as infections, can pose significant health risks to kids, timely detection following hospital discharge can prove challenging.

A new study published in Science Advances — and led by researchers at Northwestern University, Shirley Ryan AbilityLab and University of Alabama at Birmingham — is the first to use consumer wearables to quickly and precisely predict postoperative complications in children and shows potential for facilitating faster treatment and care.

“Today, consumer wearables are ubiquitous, with many of us relying on them to count our steps, measure our sleep and more,” said senior author Arun Jayaraman, professor of physical medicine and rehabilitation, medical social sciences and physical therapy and human movement sciences at Northwestern University Feinberg School of Medicine and a scientist at Shirley Ryan AbilityLab. “Our study is the first to take this widely available technology and train the algorithm using new metrics that are more sensitive in detecting complications. Our results suggest great promise for better patient outcomes and have broad implications for pediatric health monitoring across various care settings.”

How the study worked

As part of the study, commercially available Fitbit devices were given to 103 children for 21 days immediately after appendectomy — the most common surgery in children, which results in complications up to 38% of the time. Rather than just using the metrics automatically captured by the Fitbit to identify signs of complications (e.g., low activity, high heart rate, etc.), Shirley Ryan AbilityLab scientists trained the algorithm using new metrics related to the circadian rhythms of a child’s activity and heart rate patterns. 

We have an opportunity to change the paradigm of postoperative monitoring and care,”

In the process, they found such metrics were more sensitive to picking up complications than the traditional metrics. In fact, in analyzing the data, scientists were able to retrospectively predict postoperative complications up to three days before formal diagnosis with 91% sensitivity and 74% specificity. 

“Historically, we have been reliant upon subjective reporting from children — who often have greater difficulty articulating their symptoms — and their caregivers following hospital discharge. As a result, complications are not always caught right away,” said study author Dr. Fizan Abdullah, who at the time of the study was an attending physician of pediatric surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and a professor at Feinberg. “By using widely available wearables, coupled with this novel algorithm, we have an opportunity to change the paradigm of postoperative monitoring and care — and improve outcomes for kids in the process.”

What’s next?

This research is part of a four-year National Institutes of Health-funded project. As a next step, scientists plan to transition this approach into a real-time (vs. retrospective) system that analyzes data automatically and sends alerts to children’s clinical teams. 

“This study reinforces wearables’ potential to complement clinical care for better patient recoveries,” said Hassan M.K. Ghomrawi, vice chair of research and innovation in the department of orthopaedic surgery at University of Alabama at Birmingham. “Our team is eager to enter the next phase of research exploration.”

June 30, 2025 — A new ESC Clinical Consensus Statement published in the European Heart Journal discusses the key role of vaccination in preventing cardiovascular events following various viral and bacterial infections.¹

“We have known for many years that influenza can increase the risk of major adverse cardiovascular events such as heart attacks and can exacerbate heart failure,” said Professor Thomas F. Lüscher, ESC President and senior author of the ESC Clinical Consensus Statement. “More recently, evidence suggests that other respiratory infections are also associated with increased cardiovascular morbidity and mortality. The new publication describes how vaccinations not only prevent infections but also reduce the risk of cardiovascular events, particularly in susceptible individuals.” 

The ESC Clinical Consensus Statement describes data on the risk of cardiovascular complications following infections such as pneumococcal pneumonia, influenza, SARS-CoV-2 and respiratory syncytial virus, among others, and describes the inflammatory mechanisms that may be responsible. Evidence is then summarised for the beneficial effects of vaccines in reducing cardiovascular events following various viral and bacterial infections, particularly in at-risk patient groups. Clinical practice guidelines from the ESC and from the American College of Cardiology (ACC)/American Heart Association (AHA) are presented, which advocate for vaccination against influenza and other widespread infections in patients with chronic coronary syndromes (including coronary artery disease) and in those with heart failure. 

Serious adverse reactions to vaccinations are very rare. The consensus statement also discusses the risks of cardiovascular adverse events after vaccination, such as myocarditis, and describes appropriate management strategies. Then follows advice on which vaccines should be given to patients with cardiovascular diseases and how often. Vaccination of pregnant women and other vulnerable patient groups, such as those with congenital heart disease and heart transplantation, is considered.  

Professor Lüscher concluded: “Prevention is crucial for reducing the considerable burden of cardiovascular disease. The totality of the evidence indicates that vaccinations should become a foundational pillar of preventive strategies alongside other established measures.”

 

References and notes: 
¹Heidecker B, Libby P, Vassiliou VS, et al. Vaccination as a new form of cardiovascular prevention: an ESC Clinical Consensus Statement. Eur Heart J. 2025. doi: 10.1093/eurheartj/ehaf384.  https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehaf384

The ESC Clinical Consensus Statement was created with the European Association of Preventive Cardiology (EAPC), the Association for Acute CardioVascular Care (ACVC) and the Heart Failure Association (HFA) of the ESC. 

Devices like Fitbits can more quickly and accurately predict postoperative complications like infection

An estimated 4 million children undergo surgical procedures in hospitals across the U.S. each year. Although postoperative complications, such as infections, can pose significant health risks to kids, timely detection following hospital discharge can prove challenging.

A new study published in Science Advances — and led by scientists at Northwestern University, Shirley Ryan AbilityLab and University of Alabama at Birmingham — is the first to use consumer wearables to quickly and precisely predict postoperative complications in children and shows potential for facilitating faster treatment and care.

“Today, consumer wearables are ubiquitous, with many of us relying on them to count our steps, measure our sleep and more,” said senior author Arun Jayaraman, PhD, PT, professor of Physical Medicine and Rehabilitation, of Physical Therapy and Human Movement Sciences, and of Medical Social Sciences, who is also a scientist at Shirley Ryan AbilityLab. “Our study is the first to take this widely available technology and train the algorithm using new metrics that are more sensitive in detecting complications. Our results suggest great promise for better patient outcomes and have broad implications for pediatric health monitoring across various care settings.”

How the study worked

As part of the study, commercially available Fitbit devices were given to 103 children for 21 days immediately after appendectomy — the most common surgery in children, which results in complications up to 38 percent of the time. Rather than just using the metrics automatically captured by the Fitbit to identify signs of complications (e.g., low activity, high heart rate, etc.), Shirley Ryan AbilityLab scientists trained the algorithm using new metrics related to the circadian rhythms of a child’s activity and heart rate patterns.

In the process, they found such metrics were more sensitive to picking up complications than the traditional metrics. In fact, in analyzing the data, scientists were able to retrospectively predict postoperative complications up to three days before formal diagnosis with 91 percent sensitivity and 74 percent specificity.

“Historically, we have been reliant upon subjective reporting from children — who often have greater difficulty articulating their symptoms — and their caregivers following hospital discharge. As a result, complications are not always caught right away,” said study author Dr. Fizan Abdullah, MD, PhD, a former attending physician of pediatric surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago and professor of Surgery. “By using widely available wearables, coupled with this novel algorithm, we have an opportunity to change the paradigm of postoperative monitoring and care — and improve outcomes for kids in the process.”

What’s next?

This research is part of a four-year National Institutes of Health (NIH)-funded project. As a next step, scientists plan to transition this approach into a real-time (vs. retrospective) system that analyzes data automatically and sends alerts to children’s clinical teams.

“This study reinforces wearables’ potential to complement clinical care for better patient recoveries,” said Hassan M.K. Ghomrawi, PhD, vice chair of research and innovation in the Department of Orthopaedic Surgery at University of Alabama at Birmingham. “Our team is eager to enter the next phase of research exploration.”

For the first time, a fluorescent-guided nerve imaging agent shows promise for use in humans, according to a paper published in Nature Communications. The study sought to evaluate the safety of bevonescein, a synthetic peptide-dye conjugate thought to be applicable for intraoperative nerve-specific fluorescence imaging.

Eben Rosenthal, MD, chair of the Department of Otolaryngology-Head and Neck Surgery, served as the paper’s senior and corresponding author, and Sarah Rohde, MD, MMHC, division chief of Head and Neck Surgery, is the project’s lead investigator for Phase 3 clinical trials. Their findings, published with and associates from other centers around the country, identified a safe and effective fluorescent imaging agent that can assist surgeons in visualizing – and therefore protecting – nerves during surgery.

Through intravenous infusion of a fluorescent imaging agent such as bevonescein, surgeons can use excitation light to illuminate a patient’s tissue during surgery to guide their incisions, thus making it easier to locate and avoid injuring nerves. While previous research into nerve-specific fluorescence imaging had only yet been successful in animals, the finding that bevonescein is the first such agent safe for use in humans is a significant breakthrough in intraoperative safety for head and neck surgery.

“Nerve injury is a major problem related to surgical intervention. The idea is that if you can see nerves better, you would avoid injuring them,” said Rohde, who helped Vanderbilt recruit the greatest number of patients in the study.

This latest research into nerve imaging, conducted with lead author Yu-Jin Lee, MD, of Stanford University and Alume Biosciences Inc., builds on years of Rosenthal’s success in using fluorescence imaging to target tumors in oncological head and neck surgery at VUMC. Fluorescence imaging for cancer is an integral part of guiding surgical operations and assessing results.

“Cancer is a surgical disease,” said Rosenthal, who holds the Barry and Amy Baker Chair in Laryngeal, Head and Neck Research. “Most cancers get surgery. Primarily early-stage disease … is a cancer that can be taken out and cured with surgery. “[With fluorescence imaging,] you can see the cancer light up, which makes it easier to treat.”

Rosenthal said the ability to apply this technology to both tumors and nerves highlights multidisciplinary success. And with the research on nerve-specific fluorescence imaging now in Phase 3 trials, he’s optimistic about the prospect of getting this method for nerve imaging in front of the Food and Drug Administration for approval in the near future.

The research was supported in part by the National Institutes of Health (grants R01CA266233 and R37CA245157) and by Alume Biosciences, with which the Vanderbilt authors have no financial conflict of interest.

The value of a recent biochemical discovery can be seen in the case of an 8-year-old boy. In August 2023 he was able to play typical sports, but by November he needed a wheelchair because of a rare disease that caused worsening paralysis. As part of a new study, neurologists at NYU Langone Health treated the boy with an experimental compound that partially reversed his rapid decline. Two months after beginning treatment, he was able to walk long distances again and even run.

Published online July 9 in the journal Nature, the work revolves around mitochondria, the powerhouses of human cells, where sugars and fats are “burned” to produce energy. This energy production requires coenzyme Q10 (CoQ10), which is made by human cells. The boy described in the paper was born with a potentially fatal condition called HPDL deficiency, which hinders the building of CoQ10, one of several mitochondrial diseases that affect thousands nationally and come with paralysis, limb stiffness, and fatigue.

The child’s experimental treatment was made possible in part by findings from a 2021 study led by Robert Banh, PhD, who was a postdoctoral fellow at the time in the lab of Michael E. Pacold, MD, PhD, assistant professor in the Department of Radiation Oncology at NYU Grossman School of Medicine and its Perlmutter Cancer Center. NYU Langone’s deeply integrated system enabled researchers to convert their lab work into an effective experimental treatment.

Dr. Banh’s original work revealed that CoQ10 building in mitochondria starts when HPDL (the enzyme hydroxyphenylpyruvate dioxygenase-like) turns a compound called 4-hydroxymandelate (4-HMA) into another called 4-hydroxybenzoate (4-HB). Cells then use 4-HB to build a part of CoQ10 necessary for energy production.

Based on this discovery, the Pacold Lab was able to show that either 4-HMA or 4-HB can be used to restore CoQ10 synthesis and counter related brain damage in mice engineered to lack HPDL. Led by Guangbin Shi, a senior research assistant at the lab, the researchers found that adding 4-HMA or 4-HB to these animals’ water enabled more than 90 percent of them to move near normally and live to adulthood, instead of becoming paralyzed and dying.

When the researchers were approached by the parents of the fast-declining child with HPDL deficiency, they shared their evidence with NYU Langone pediatric neurologists Claire Miller, MD, PhD, and Giulietta M. Riboldi, MD, PhD. The two clinicians then worked with a team of experts to secure government authorization to treat the boy with 4-HB. The treatment brought stunning results in less than two months: it partially countered the child’s worsening spasticity, a combination of stiffness and paralysis.

“To our knowledge, this is the first demonstration that neurological symptoms of a primary CoQ10 deficiency can be stabilized or improved by supplying not CoQ10 itself, but instead its smaller, more easily processed precursors, which cells then use to build more of the coenzyme,” said Dr. Pacold, senior author of the new study in Nature.

Beyond rare diseases, cellular supplies of CoQ10 are known to drop as people develop heart disease, diabetes, and Alzheimer’s disease, and in all of us as we age. For these reasons, the industry supplying CoQ10 as a dietary supplement is expected to represent a billion-dollar market within a decade. The problem, say the current study authors, is that even at high doses, less than 5 percent of ingested CoQ10 makes it into the body because of its structure and size. This may explain why CoQ10 has failed to reverse the neurological symptoms of HPDL/CoQ10 deficiencies, the researchers say.

Recovery window

For the current study, the Pacold Lab acquired mice engineered to lack HPDL function, which were known to quickly become paralyzed. The team also found that these mice had smaller-than-normal mitochondria, as well as smaller cerebellums and malfunctioning Purkinje cells, both of which control movement. Replacement therapy with 4-HMA partially reversed the abnormalities by encouraging the building of the mouse version of CoQ10.

Then, in 2023, with the mouse results in hand, Dr. Pacold met the parents, both of whom had genetic mutations that sabotaged HPDL function and caused two of their children to die in infancy. Their other child had thrived for eight years but had recently declined.

A team quickly assembled to include Dr. Miller and Dr. Riboldi, members of NYU Langone’s Office of Science and Research, Regulatory Affairs, Technology Opportunities and Ventures, the Office of General Counsel, and the Conflicts of Interest Management Unit (CIMU), and gained NYU Langone approval under its policies to clinically test 4-HB. The team next gained approval from the U.S. Federal Drug Administration for the boy’s experimental treatment, under a process called expanded access. It enables physicians caring for a patient with a life-threatening disease to use an experimental treatment when no other options are available. With subsequent approval from NYU Langone’s Institutional Review Board, the patient’s treatment started in December 2023.

Treated daily with the experimental compound dissolved in water, the patient saw improved balance and endurance over the following weeks. Two months after the trial began, just before the patient departed from NYU Langone to continue it at home, the boy went for a one-and-a-half-mile walk with his family in Central Park. The recovery, however, was partial, with some spasticity and gait issues remaining.

The discovery of the experimental treatment was serendipitous, occurring while the Pacold Lab was investigating the anticancer potential of targeting CoQ10 production. During that test, the team happened to discover that the CoQ10 precursors caused recovery from neurodegenerative processes in one of its animal models. This ultimately led to an effort across NYU Langone to design the child’s treatment.

Further, children with HPDL deficiencies are known to have a range of disease severity depending on their specific versions of key variant genes, from no function (fatal) to levels of partial function. The clinical and research teams theorize that the treated child still had some HPDL function and so was able to develop normally until a certain stage. The team’s mouse data suggest that there is a time window in neural development during which the effects of HPDL deficiency will be most reversible with CoQ10 precursor treatment, and after which treatment will have little effect. Identifying this window, along with the most effective dose, in larger studies will be the focus of the next round of research. 

NYU Langone owns the intellectual property developed in the Pacold Lab and covering the treatment outlined above, which NYU Langone and Dr. Pacold are seeking to license to a partner to develop CoQ10 intermediates. In April this year Dr. Pacold received the Pershing Square Foundation’s “MIND” Prize, which came with $750,000 to support this work.

Along with Dr. Banh, Dr. Pacold, Shi, Dr. Miller, and Dr. Riboldi, NYU Langone study authors included Sota Kuno, Quentin Spillier, Zixuan Wang, and Drew Jones from the Department of Radiation Oncology; Megan Korn and Wyatt Tran from the Department of Biochemistry and Molecular Pharmacology; Lia Ficaro in the Metabolomics Laboratory; Begoña Gamallo-Lana and Adam Mar of the Rodent Behavioral Laboratory; Matija Snuderl in the Department of Pathology, and Soomin C. Song, PhD, in the Ion Laboratory.

Dr. Banh had been a postdoc in the labs of Dr. Pacold and Alec Kimmelman, MD, PhD, director of the Perlmutter Cancer Center, before joining the faculty as an assistant professor in the Department of Biochemistry and Molecular Pharmacology. Dr. Kimmelman was recently named dean of the NYU Grossman School of Medicine and chief executive officer of NYU Langone Health.

“Research breakthroughs show their true impact when they change a family’s life,” Dr. Kimmelman said. “Thanks to an extraordinary team working across our integrated system, we were able to safely and effectively get this treatment from a bench in the lab to a patient in need.”

Authors at other institutions were Alejandro Rey Hipolito, Tao Lin, and Roy Sillitoe in the Departments of Pathology and Immunology at Baylor College of Medicine and the Jan and Dan Duncan Neurological Research Institute of Texas Children’s Hospital; as well as Salsabiel El Nagar and Alexandra Joyner in the Developmental Biology Program at Memorial Sloan Kettering Cancer Center. 

The research was supported by National Institutes of Health grants NIGMS R35 MIRA 1R35GM147119 and NCI R37CA289040, Perlmutter Cancer Center grant P30CA016087, a Damon Runyon-Rachleff Innovation Award, Dale Frey Breakthrough awards DRR 63-20 and DRG-50-22, Tara Miller Melanoma Foundation / MRA Young Investigator Award 668365, and American Cancer Society Research Scholar Award RSG-21-115-01-MM. Additional funding came from the Harry J. Lloyd Charitable Trust, an Irma T. Hirschl Career Scientist Award, a Concern Foundation Conquer Cancer Now Grant, and from NYU Langone Health Technology Opportunities and Ventures.

The clinical portion of the research was supported by an NYU CTSA grant (includes UL1 TR001445, KL2 TR001446, and TL1 TR001447) and by funding provided through a Pershing Square Sohn Cancer Prize from the Pershing Square Foundation.

Dr. Pacold, Dr. Banh, Shi, and Spillier are co-inventors on patents related to the use of 4-HMA, 4-HB, and analogues in the diagnosis and treatment of neurodevelopmental and other diseases assigned to New York University. The treatment was conducted and supervised by Miller and Riboldi under an institutional conflict-of-interest management plan implemented by NYU Langone Health in accordance with its policies. Pacold consulted on the clinical protocol, while Dr. Miller and Dr. Riboldi directed the course of treatment in accordance with the plan.

Nature The low testing rates of Mpox suspected cases remain a key factor in the continued spread of the disease in the Democratic Republic of Congo (DRC) and neighboring countries. Here, we highlight the causes, as well as the challenges and strategies needed to curb the spread of the current uncontrolled Mpox outbreak in the DRC.

DRC is the country of Mpox genesis and the current worldwide epicenter

Mpox is a highly contagious zoonotic disease transmitted to humans through the handling and/or consumption of meat from animals carrying the virus. Human-to-human contamination occurs through close contact, including sexual contact, exposure to bodily fluids, lesions on the skin or internal mucosal surfaces, such as in the mouth or throat, respiratory particles, and contaminated objects¹. Discovered in 1970 in Equator Province in DRC, the Mpox virus (MPOXV) has caused many outbreaks around the world² and the ongoing outbreak remains the worst in history³. On August 14, 2024, the World Health Organization (WHO) declared Mpox as a Public Health Emergency of International Concern (PHEIC). The DRC remains the epicenter⁴ with 59.3% of all confirmed cases in Africa and 46.5% of all deaths³. Despite numerous public health interventions initiated to break the chain of transmission, Mpox continues to spread, claiming thousands of victims in the country. This comment describes the current state of DRC’s vulnerable position at the heart of Africa, highlighting the epidemiological trends, related regional risks, and resource-related challenges in responding to the Mpox outbreak, and proposes some potential strategies to help curb further transmission of Mpox within the country and beyond.

A maternal diet characterized by high intake of pro-inflammatory foods during pregnancy may increase the risk of type 1 diabetes in offspring, according to findings from a large prospective cohort study in Denmark published in the Journal of Epidemiology & Community Health.^1,2

Researchers evaluated data from 67,701 mother-child pairs enrolled in the Danish National Birth Cohort (DNBC) between 1996 and 2002. The study excluded mothers with pre-existing diabetes or implausible dietary reports. Maternal diet was assessed at approximately 25 weeks of gestation using a comprehensive 360-item food frequency questionnaire. An empirical dietary inflammatory index (EDII) score was calculated to quantify the inflammatory potential of each participant’s diet, with higher scores indicating a more pro-inflammatory dietary pattern.

Over an average follow-up period of 17.6 years, 281 children (0.42%) were diagnosed with type 1 diabetes. The investigators observed a statistically significant association between maternal EDII score and the risk of type 1 diabetes in offspring. Each 1 standard deviation increase in the EDII score was associated with a 16% increased hazard (adjusted HR, 1.16; 95% CI, 1.02–1.32) of type 1 diabetes diagnosis during childhood or adolescence.

“A low-grade inflammatory state secondary to an altered immune cell profile, which triggers pro-inflammatory pathways, is increasingly acknowledged as a critical early-life factor influencing offspring health,” the authors wrote.

The EDII score was derived using reduced rank regression and weighted based on associations between specific food group intake and circulating C-reactive protein (CRP) concentrations, using data from a similar Nordic cohort. Diets high in red or processed meats, low-fat dairy, pizza, French fries, margarine, and savory snacks were associated with higher EDII scores. Conversely, higher intake of alliums, tomatoes, whole grains, fruits, vegetables, tea, and dark meat fish contributed to lower (anti-inflammatory) EDII scores.

Higher EDII scores were also associated with other maternal characteristics such as younger age, higher body mass index (BMI), smoking beyond 12 weeks of pregnancy, lower alcohol consumption, shorter breastfeeding duration, and lower socioeconomic status. However, total energy intake did not significantly differ across EDII quintiles.

Importantly, the observed association between a pro-inflammatory diet and type 1 diabetes remained robust after adjusting for multiple potential confounders, including maternal age, BMI, smoking status, socioeconomic status, breastfeeding duration, and energy intake. Additional analyses indicated that gluten intake during pregnancy was also independently associated with elevated type 1 diabetes risk in offspring (HR per 10 g/day increase, 1.36; 95% CI, 1.09–1.71). In contrast, continued smoking during pregnancy was associated with a reduced risk (HR, 0.47; 95% CI, 0.31–0.72).

“Of particular note is the fact that three factors during mid-pregnancy, a pro-inflammatory dietary pattern, gluten, and smoking, seemed to independently predict the child’s risk of type 1 diabetes,” the authors stated. “This suggests that mid-pregnancy may be a critical period during which the fetus is particularly susceptible to maternal lifestyle influences in relation to the individual’s later risk for developing type 1 diabetes during childhood or adolescence.”

While the findings support the role of fetal programming in the development of autoimmune disease, the authors acknowledge limitations. As an observational study, causality cannot be established. Additionally, the child’s own diet postnatally was not assessed, and residual confounding from unmeasured factors remains possible.

Nevertheless, the study adds to a growing body of evidence linking maternal dietary exposures during pregnancy to long-term metabolic and immune outcomes in children. The authors concluded that further studies are warranted to replicate these findings and elucidate underlying biological mechanisms.

References:

1. BMJ Group. ‘Inflammatory’ diet during pregnancy may raise child’s diabetes type 1 risk. Eurekalert. July 1, 2025. Accesed July 9, 2025. https://www.eurekalert.org/news-releases/1089224?

2. Rohina Noorzae, Bjerregaard AA, Thorhallur Ingi Halldorsson, et al. Association between a pro-inflammatory dietary pattern during pregnancy and type 1 diabetes risk in offspring: prospective cohort study. Journal of Epidemiology & Community Health. Published online July 1, 2025:jech-223320. doi:https://doi.org/10.1136/jech-2024-223320