Category: 8. Health

Artificial intelligence programs can help doctors and nurses predict hours earlier which ER patients will likely require hospital admission, a new study says.

An AI program trained on nearly 2 million patient visits became slightly more accurate than ER nurses in predicting which patients would need to be admitted, according to findings published Aug. 11 in the journal Mayo Clinic Proceedings: Digital Health.

If this approach proves successful, it could help reduce overcrowding in hospital emergency departments, researchers say.

“Emergency department overcrowding and boarding have become a national crisis, affecting everything from patient outcomes to financial performance,” said lead researcher Jonathan Nover, vice president of nursing and emergency services at Mount Sinai Health System in New York City.

“Industries like airlines and hotels use bookings to forecast demand and plan. In the ED, we don’t have reservations,” he continued in a news release. “Could you imagine airlines and hotels without reservations, solely forecasting and planning from historical trends? Welcome to health care.”

Up to 35% of ER patients who require admission wind up spending four or more hours biding their time in spare rooms or busy hallways awaiting a bed, a practice known as “boarding,” according to a recent study in the journal Health Affairs.

Worse, nearly 5% of patients wait a full day for a bed during the busy winter months, the earlier study found.

“Our goal was to see if AI combined with input from our nurses could help hasten admission planning, a reservation of sorts,” Nover said. “We developed a tool to forecast admissions needs before an order is placed, offering insights that could fundamentally improve how hospitals manage patient flow, leading to better outcomes.”

For the project, researchers trained the AI on more than 1.8 million ER visits that had occurred between 2019 and 2023.

“By training the algorithm on more than a million patient visits, we aimed to capture meaningful patterns that could help anticipate admissions earlier than traditional methods,” co-senior researcher Dr. Eyal Klang, chief of generative AI at the Icahn School of Medicine at Mount Sinai, said in a news release.

The team then put the AI up against a cadre of more than 500 ER nurses in evaluating nearly 47,000 patient visits that occurred in September and October 2024 at six emergency departments in the Mount Sinai Health System.

The nurses were asked to judge whether a patient would need hospital admission, after performing a quick triage. Researchers also fed the triage results to the AI, to see what it would predict.

The nurses proved about 81% accurate in predicting which patients would need hospital admission, compared to 85% accuracy from the AI.

“We were encouraged to see that AI could stand on its own in making complex predictions,” co-senior researcher Robert Freeman, chief digital transformation officer at Mount Sinai Health System, said in a news release. “But just as important, this study highlights the vital role of our nurses — more than 500 participated directly — demonstrating how human expertise and machine learning can work hand in hand to reimagine care delivery.”

Researchers next plan to implement their AI into real-time workflows and monitor how the program affects boarding times and patient flow through the ER.

“This tool isn’t about replacing clinicians; it’s about supporting them. By predicting admissions earlier, we can give care teams the time they need to plan, coordinate, and ultimately provide better, more compassionate care,” Freeman said. “It’s inspiring to see AI emerge not as a futuristic idea, but as a practical, real-world solution shaped by the people delivering care every day.”

More information

The American College of Emergency Physicians has more on ER boarding and crowding.

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New research is shedding light on increases in the global burden of chronic kidney disease (CKD). From 1990 to 2021, while the overall CKD burden increased slowly, CKD-related deaths, disability-adjusted life-years (DALYs), and corresponding age-standardized rate (ASR)s attributable to high BMI exhibited a more pronounced and sustained growth.¹

In addition to this historical upward trend, study findings project further increases in the burden of CKD attributable to high BMI by 2050, underscoring the need for comprehensive strategies for the prevention, assessment, and management of CKD to effectively mitigate this growing burden.¹

According to the American Kidney Fund (AKF), an estimated 35.5 million people in the US have kidney disease, which is the fastest-growing noncommunicable disease in the country. The AKF recommends maintaining a healthy weight, following a kidney-friendly food and fluid plan, getting tested for kidney disease, and being physically active for preventing kidney disease.²

“Epidemiologically, quantifying the disease burden associated with modifiable risk factors such as obesity is essential for understanding its relationship with CKD,” Weihong Zhao, of the division of nephrology at Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital in China, and colleagues wrote.¹ “However, CKD burden attributable to obesity, especially in epidemiological patterns and dynamic changes, remains unclear.”

To address this gap in research, investigators extracted annual data from 1990 to 2021 from the Global Burden of Disease (GBD) Study 2021 on CKD deaths, DALYs, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) attributable to high BMI, stratified by sex and age, for 204 countries and territories. In addition to the estimated annual percentage changes (EAPCs) from 1990 to 2021, investigators calculated projected attributable CKD burden through 2050.¹

Investigators defined CKD as renal dysfunction based on glomerular filtration rate (GFR) and proteinuria criteria in the GBD 2021 Study, including an estimated GFR < 60 mL/min/1.73m2, calculated using serum creatinine, and/or an albumin-to-creatinine ratio > 30 mg/g. High BMI was defined as a BMI ≥25 kg/m2.¹

The global number of CKD-related deaths was 1,527,639 (95% UI, 1,389,377-1,638,914) in 2021, with corresponding DALYs reaching 44,453,684 (95% UI, 40,840,762-48,508,462). The ASMR and ASDR were 18.50 (95% UI, 16.72-19.85) and 529.62 (95% UI, 486.25-577.42) per 100,000 population, respectively.¹

Globally, investigators noted high BMI was responsible an estimated 418,402 (95% UI, 224,309-621,353) CKD deaths, accounting for 27.4% of CKD-related deaths, with an ASMR of 5.06 (95% UI, 2.70-7.51). Corresponding DALYs were 10,422,561 (95% UI, 5,658,159-15,387,254), representing 23.4% of CKD-related DALYs, and the ASDR was 123.86 (95% UI, 67.23-182.96).¹

Further analysis revealed global CKD burden attributable to high BMI showed a sustained upward trend over the study period. Compared to 1990, deaths and DALYs cases increased approximately 3.5-fold and 2.9-fold in 2021, respectively. EAPC for ASMR was 2.25 (95% CI, 2.13-2.36), and EAPC for ASDR was 1.98 (95% CI, 1.89-2.07), indicating a faster growth rate compared to the overall CKD burden. Of note, trends were similar across the sexes, with slightly greater EAPCs for males.¹

Projections indicated that from 2022 to 2050, the number of deaths and DALYs, along with their ASRs, will continue to increase. Although ASRs for males and females were expected to remain comparable, females will account for more cases.¹

Further decomposition analysis assessed the relative contributions of aging, population growth, and epidemiological changes to the rising disease burden from 1990 to 2021, with results revealing that all 3 factors contributed to the increasing burden. Of note, aging played a prominent role in the middle, high-middle, and high SDI regions.¹

“Our findings provide valuable insights for policymakers in formulating evidence-based strategies to address this pressing public health challenge,” investigators concluded.¹

References

1. Ma Y, Chen S, Shen Y, et al. Independent and joint impacts of high body mass index and aging on global burden of chronic kidney disease: insights from the Global Burden of Disease Study 2021. Front. Nutr. doi:10.3389/fnut.2025.1582534

2. American Kidney Fund. Quick kidney disease facts and stats. February 11, 2025. Accessed August 12, 2025. https://www.kidneyfund.org/all-about-kidneys/quick-kidney-disease-facts-and-stats

Africa’s population over the age of 60 will triple by 2050, bringing “a sharp rise in neurodegenerative diseases, including Alzheimer’s, with profound health and economic costs”, according to a paper published in Nature last week.

The paper highlights a five-year strategy, headed by a pan-African task force, to address this demographic shift on the continent, focusing on “early detection, timely care, data-driven systems, and equitable innovation”.

Some three-quarters of people living with Alzheimer’s globally are undiagnosed, denying them access to appropriate treatment and care. 

Given widespread systemic weaknesses in the health systems of several African countries, this may well be the fate of many of the estimated 226 million Africans over 60 projected to be living on the continent by 2050 (up from 69 million in 2017). 

Currently, only 12 African countries submit data to the Global Dementia Observatory.

Tunisia, Algeria and Egypt already have some of the highest dementia-related disease burdens in the world, and by 2050, 14 million Africans are expected to develop Alzheimer’s and related disorders. 

Health system transformation

The “6×5” plan developed by the Davos Alzheimer’s Collaborative (DAC) aims to assist African countries to address this growing problem using low-cost innovations.

It comprises six interventions over the next five years: strengthening advocacy and health literacy; positioning brain health as a socioeconomic driver; breaking down silos of people and data; repurposing local resources; investing in artificial intelligence and digital health, and boosting research funding. 

Advocacy and health literacy

“In many African cultural settings, dementia is often linked to madness, witchcraft and demonic possession, or it is dismissed as a natural part of ageing,” the report notes.

To address this stigmatising approach, it proposes health literacy campaigns aimed at establishing dementia as “a biological issue that requires immediate attention”. 

Brain health as a socio-economic driver

“Positioning brain health as a cornerstone of Africa’s societal well-being, economic growth and sustainable development is imperative,” according to the plan.

It calls for health policy makers to recognise brain health as a critical economic priority, and address individual and societal determinants of brain health across people’s entire lifespans.

This would start with the first 1,000 days of life, a critical phase for brain development, and include childhood education to build cognitive skills and lifelong learning opportunities.

It would also encompass women’s health initiatives to address gender disparities, initiatives to promote emotional resilience, and healthy ageing strategies that incorporate physical activity, nutrition and social engagement.

“The continent has a deeply rooted heritage of social connectedness, collective identity and intergenerational support – factors shown to promote cognitive well-being and mitigate cognitive decline,” the report notes.

Repurposing local resources

“The continent needs a comprehensive Pan-African Resource Repurposing Strategy for Brain Health – one that identifies underutilised resources and fosters sustainable, affordable and locally driven solutions,” the report notes.

Expertise in managing infectious diseases such as HIV can be harnessed to help with the early detection of dementia, for example.

Community health workers can be trained to identify early signs of the disease, primary healthcare facilities can serve as hubs for cognitive screening, education and management, and dementia care can be included in non-communicable disease (NCD) services.

Breaking down silos

“A well-integrated research and data ecosystem is essential for identifying high-risk populations and implementing targeted dementia prevention and early intervention strategies,” the report notes.

However, Africa’s research and information systems are fragmented, with “weak data-sharing platforms, limited connectivity between research hubs, and a lack of standardised mechanisms for harmonisation and reporting”. 

It proposes establishing “a Pan-African network of research centres” to drive a harmonised, transdisciplinary approach to data generation and utilisation. 

It also advocates for “strengthening cross-sector collaboration through partnerships between health systems, governments, researchers and nongovernmental organisations” and global partnerships.

Tech-enabled systems

“Digital health solutions offer accessible, scalable and cost-effective alternatives to traditional healthcare approaches,” and Africa’s mobile technology “revolution” means it is well placed to adopt these, the report notes.

New digital biomarkers enable early and accurate detection, monitoring and treatment of brain disorders – including data from speech patterns and typing.

This “allows for passive and remote monitoring of cognitive changes”, which facilitates the use of AI.

Digital technologies can also play a critical role in “identifying and mitigating modifiable risk factors associated with cognitive decline”, including “sleep patterns, physical activity, social engagement and mental health indicators (such as depression)”.

But AI-driven solutions are often developed on and for high-income populations, which means Africa needs “a pan-African strategy for AI and machine learning solutions in brain health”.

Strengthening research funding

“To attract investment from both public and private sectors, brain health leaders must present a compelling economic and social case,” the report notes. 

It proposes that brain health is integrated into existing healthcare priorities such as maternal and child health, NCDs and social determinants of health. 

Way forward

As Africa transitions to a society with smaller families, there is the prospect of greater economic wealth as the working-age population becomes proportionally larger than the non-working-age population – and this offers a chance to implement measures to prepare for an older population, the paper argues.

To effectively implement the priority areas outlined in the 6 × 5 Plan, DAC launched a pan-African task force on brain health in March 2025. 

The task force’s organising committee, which provides strategic oversight, is composed of DAC, the World Health Organization (WHO), the World Economic Forum (WEF), the World Bank, Alzheimer’s Disease International (ADI) and the African Union. 

DAC leads the secretariat, which coordinates operational support and communication. Six thematic chairs – covering research, nonprofit, industry, policy, economics and systems thinking – shape strategy and liaise with working group leads. 

Six working groups, led by operational leads from the five geopolitical zones, focus on executing the priorities of the 6 × 5 plan, ensuring regionally relevant and inclusive solutions across Africa.

“Unlike research efforts that focus on therapeutic interventions, DAC’s model emphasises health system transformation, from earlier detection and evidence-based care pathways to strengthening workforce training and improving global data sharing,” according to a media release from the Geneva-based collaboration.

Image Credits: Kizito Makoye Shigela/HPW, UCLA .

UC Davis Health researchers have discovered that a natural molecule made by gut bacteria can reverse liver damage and repair the gut lining after aflatoxin exposure. The treatment may offer a new, non-toxic way to prevent and treat non-alcoholic fatty liver disease (NAFLD), a growing health problem affecting more than 1 in 4 adults in the U.S.

The study revealed that 10-hydroxy-cis-12-octadecenoic acid (10-HSA), a compound produced by Lactobacillus bacteria, successfully restored gut-liver health in mice exposed to aflatoxin. Aflatoxin is a toxic substance made by mold commonly found in peanuts, corn and other crops. It is known to cause liver injury.

This is the first time a single microbial molecule has been shown to repair both the liver and gut together.”

Satya Dandekar, lead author

Dandekar is a distinguished professor and the chair of the Department of Medical Microbiology and Immunology at UC Davis Health.

The paper was published today in mBio.

Gut-liver axis: A new treatment target

The gut and the liver are intricately linked. They communicate through bile acids, immunity responses and lipid metabolism – a relationship known as the gut-liver axis. When one organ is damaged, the other suffers too. In diseases like NAFLD (now also called MASLD), this connection becomes a key therapeutic target.

“NAFLD prevalence is on the rise in the United States. It has increased globally over 50% in the last 30 years. Chronic liver diseases like NAFLD disrupt lipid metabolism and generate high levels of inflammation, also impacting the gut health. It limits the gut digestive functions and breaks down the epithelial barrier,” Dandekar said.

Despite the crucial role the gut-liver axis plays in maintaining homeostasis, treatments that target both the liver and the gut remain under investigated.

Dandekar’s team used a mouse model mimicking NAFLD. Exposing mice to aflatoxin B1 (AFB1), a toxic compound made by Aspergillus fungi, triggered liver injury, inflammation and damage to the gut lining.

But when these mice were treated with 10-HSA, the researchers saw a dramatic reversal of the liver and gut damage:

• Gut epithelial barrier was restored.
• Key bile acid metabolites like cholesterol and deoxycholate returned to healthy levels.
• Energy metabolism and detoxification functions in the liver improved.
• Gut immune responses normalized.

Microbial weaponry

“We think of these microbial products like precision weapons,” Dandekar said. “They are released by bacteria at the site of inflammation and act exactly where they’re needed to help repair and heal tissue.”

Chronic liver diseases like NAFLD and cirrhosis are driven in part by the suppression of PPARα signaling. 10-HSA activates PPARα, a protein that regulates lipid metabolism. By activating PPARα, the molecule repaired liver tissue and supported gut health – all without the side effects of synthetic drugs.

“What makes this molecule special is that it is produced naturally in the gut and has no cytotoxic effects,” said co-author Abhaya Dandekar, a professor of plant sciences at UC Davis. “It works only when the body and the microbiome are in sync.”

A preventive tool for aflatoxin exposure

Aflatoxin exposure affects many people, especially in developing countries. In agricultural areas with poor food safety, this exposure is a serious public health concern. This study lays the foundation for developing a simple, safe supplement that could be life changing.

“It would truly be a unique and exciting opportunity if we can provide a microbially-derived supplement that can alleviate or prevent the detrimental impact on human health,” said Dylan Kramer, the first author of the study and a graduate student in Dandekar’s lab.

According to the authors, microbiologists have traditionally focused on short-chain fatty acids (SCFAs) produced by the gut microbiome. This study shifted the focus to other metabolites.

“While SCFAs are very important, our study serves as one of the first to broaden the focus to larger, more complex metabolites produced in direct response to pro-inflammatory conditions in the gut,” Kramer said.

What is next?

The study highlighted the powerful role of the microbiome in healing and prevention – and how tapping into this natural pharmacy could transform medicine. With strong preclinical evidence and no toxicity concerns, the researchers are preparing for human clinical trials, especially in people with fatty liver disease or metabolic issues.

Biomarkers that could help predict and manage chronic kidney disease (CKD) have been identified in a new study led by the University of Surrey.

The research, funded by Kidney Research UK, and as part of the National Unified Renal Translational Research Enterprise (NURTuRE) CKD study, leveraged data on 2,884 adult CKD patients from across 16 nephrology centres – in which specialists study, prevent, diagnose and treat kidney disease.

The study, which has been published by the Journal of the American Society of Nephrology, examined 21 biomarkers linked to kidney damage, fibrosis, inflammation and cardiovascular disease.

Chronic kidney disease affects millions worldwide and is a major global health issue which is characterized by the gradual loss of kidney function over time, leading to serious health complications.

While established risk factors like age, sex, ethnicity, estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) remain strong predictors, the research found that a combination of biomarkers, namely sTNFR1, sCD40, UCOL1A1, could be key for predicting kidney failure. A different combination of biomarkers including hs-cTnT, NT-proBNP, suPAR were instead comparably good at predicting all-cause mortality (death from any cause).

Our research shows that these novel biomarker models offer predictive results comparable to established methods, but the key finding here is that we can use these biomarkers to understand the underlying mechanisms of disease progression, potentially paving the way to more personalized treatments and medicines for CKD patients.”

Dr. Tony Onoja, lead author of the study and Research Fellow, University of Surrey

The biomarker signatures identified provide insights into the underlying disease mechanism and associated processes linked to CKD’s progression, including extracellular matrix accumulation, chronic inflammation, and cardiovascular stress. These insights could inform the development of new targeted therapies and more personalized treatments.

Professor Nophar Geifman, senior author of the study and Professor of Health and Biomedical Informatics at the University of Surrey said:

“Our study demonstrates that specific biomarkers can offer a more nuanced understanding of a patient’s disease progression and mortality risk and the disease’s ongoing activity. Further research is needed to evaluate how these biomarkers change in response to current treatments, and their clinical utility in patient care and in personalized medicine.”

Researchers have found why common cuff-based blood pressure readings are inaccurate and how they might be improved, which could improve health outcomes for patients.

High blood pressure, or hypertension, is the top risk factor for premature death, associated with heart disease, strokes and heart attacks. However, inaccuracies in the most common form of blood pressure measurement mean that as many as 30% of cases of high blood pressure could be missed.

The researchers, from the University of Cambridge, built an experimental model that explained the physics behind these inaccuracies and provided a better understanding of the mechanics of cuff-based blood pressure readings.

The researchers say that some straightforward changes, which don’t necessarily involve replacing standard cuff-based measurement, could lead to more accurate blood pressure readings and better results for patients. Their results are reported in the journal PNAS Nexus.

Anyone who has ever had their blood pressure taken will be familiar with the cuff-based method. This type of measurement, also known as the auscultatory method, relies on inflating a cuff around the upper arm to the point where it cuts off blood flow to the lower arm, and then a clinician listens for tapping sounds in the arm through a stethoscope while the cuff is slowly deflated.

Blood pressure is inferred from readings taken from a pressure gauge attached to the deflating cuff. Blood pressure is given as two separate numbers: a maximum (systolic) and a minimum (diastolic) pressure. A blood pressure reading of 120/80 is considered ‘ideal’.

The auscultatory method is the gold standard, but it overestimates diastolic pressure, while systolic pressure is underestimated. We have a good understanding of why diastolic pressure is overestimated, but why systolic pressure is underestimated has been a bit of a mystery.”

Kate Bassil, co-author from Cambridge’s Department of Engineering

“Pretty much every clinician knows blood pressure readings are sometimes wrong, but no one could explain why they are being underestimated – there’s a real gap in understanding,” said co-author Professor Anurag Agarwal, also from Cambridge’s Department of Engineering.

Previous non-clinical studies into measurement inaccuracy used rubber tubes that did not fully replicate how arteries collapse under cuff pressure, which masked the underestimation effect.

The researchers built a simplified physical model to isolate and study the effects of downstream blood pressure – the blood pressure in the part of the arm below the cuff. When the cuff is inflated and blood flow to the lower arm is cut off, it creates a very low downstream pressure. By reproducing this condition in their experimental rig, they determined this pressure difference causes the artery to stay closed for longer while the cuff deflates, delaying the reopening and leading to an underestimation of blood pressure.

This physical mechanism – the delayed reopening due to low downstream pressure – is the likely cause of underestimation, a previously unidentified factor. “We are currently not adjusting for this error when diagnosing or prescribing treatments, which has been estimated to lead to as many as 30% of cases of systolic hypertension being missed,” said Bassil.

Instead of the rubber tubes used in earlier physical models of arteries, the Cambridge researchers used tubes that lay flat when deflated and fully close when the cuff pressure is inflated, the key condition for reproducing the low downstream pressure observed in the body.

The researchers say that there is a range of potential solutions to this underestimation, which include raising the arm in advance of measurement, potentially producing a predictable downstream pressure and therefore predictable underestimation. This change doesn’t require new devices, just a modified protocol.

“You might not even need new devices, just changing how the measurement is done could make it more accurate,” said Agarwal.

However, if new devices for monitoring blood pressure are developed, they might ask for additional inputs which correlate with downstream pressure, to adjust what the ‘ideal’ readings might be for each individual. These may include age, BMI, or tissue characteristics.

The researchers are hoping to secure funding for clinical trials to test their findings in patients, and are looking for industrial or research partners to help refine their calibration models and validate the effect in diverse populations. Collaboration with clinicians will also be essential to implement changes to clinical practice.

The research was supported by the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation (UKRI).

Immunizations are the best way to prevent diseases and can often work with the body’s natural defenses to build better protection, according to the World Health Organization (WHO). There are approximately 30 different vaccines, which target diseases such as cervical cancer, COVID-19, diphtheria, hepatitis B, influenza, measles, mpox, mumps, pneumonia, polio, rabies, and yellow fever. According to WHO, immunizations can prevent 3.5 million to 5 million deaths every year.¹

Although vaccines have proven successful, vaccine information is still shared on social media, which can shape behaviors. Evidence-based interventions are important to reduce the effects of misinformation, and efforts can be led by pharmacists.

“When it comes to community pharmacy, it is the most accessible location to get vaccination,” Hashim Zaibak, PharmD, CEO of Hayat Pharmacy, said.² “You can walk into a community pharmacy and get vaccinated 7 days a week. You don’t have to make an appointment; community pharmacies are open on weekends, late in the evening. It’s a lot more convenient for people who are busy to come and get the vaccine in a community pharmacy versus getting it in a clinic or by appointment.”

During the COVID-19 pandemic, there was a rise of vaccine hesitancy due to the use of social media, which became the epicenter of misinformation, according to authors of a study published in the BMJ. Although standard approaches to encourage vaccination included mandatory vaccination and regulation for health care professionals, more contemporary strategies included debunking misinformation via social media.³

“With the COVID-19 pandemic, we saw a lot of misinformation and myths around the COVID-19 vaccines,” Lauren Angelo, PharmD, associate dean for academic affairs at Rosalind Franklin University, said.⁴ “There are some who think getting natural immunity from the disease is better than getting the vaccine. Parents are still concerned that the vaccines will overwhelm their [children’s] immune systems. We know that’s not true.”

Pharmacists can play an important role in vaccination as well as dispelling vaccine misinformation. In a study published in the Journal of the American Pharmacists Association, the authors stated that pharmacists, because of their accessibility and location, are one of the most trusted sources for patients who need health information and care. Further, pharmacists are in a prime position to listen to patients without judgement and offer honest information to address patient concerns.^5,6

“I’m encouraging patients to talk to trusted health care professionals and to not get their advice from social media or the internet or other strangers, focusing on the fact that vaccines have been studied before, during, and after FDA approval,” Laura Knockel, PharmD, BCACP, clinical associate professor at Iowa College of Pharmacy, said.⁷ “They’re more rigorously tested than any other medications because we give them to healthy people, so we have a very, very low tolerance for risk for adverse events. So just really focusing on the fact that our vaccine safety program in the US is very robust even after FDA approval, and so hopefully that will help override some of the conflicting messages that they may be hearing.”

READ MORE: Immunization Resource Center

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.

REFERENCES

1. World Health Organization. Vaccines and immunization. Accessed August 4, 2025. https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1

2. Nowosielski B, Zaibak H. Q&A: community pharmacies help increase immunization convenience, uptake. Drug Topics. August 3, 2025. Accessed August 4, 2025. https://www.drugtopics.com/view/community-pharmacies-help-increase-immunization-convenience-uptake

3. Ruggeri K, Vanderslott S, Yamada Y, et al. Behavioural interventions to reduce vaccine hesitancy driven by misinformation on social media. BMJ. 2024;384:e076542. Published 2024 Jan 16. doi:10.1136/bmj-2023-076542

4. Gallagher A, Angelo L. Q&A: Pharmacists Can Overcome Vaccine Hesitancy Through Trust and Communication | APhA 2025. Drug Topics. April 1, 2025. Accessed August 5, 2025. https://www.drugtopics.com/view/q-a-pharmacists-can-overcome-vaccine-hesitancy-through-trust-and-communication-apha-2025

5. Shen AK, Tan ASL. Trust, influence, and community: Why pharmacists and pharmacies are central for addressing vaccine hesitancy. J Am Pharm Assoc (2003). 2022;62(1):305-308. doi:10.1016/j.japh.2021.10.001

6. Accetta RC. The Role of the Pharmacist in Addressing Vaccine Misinformation. Caring for the Ages. August 2025. Accessed August 4, 2025. https://www.caringfortheages.com/article/S1526-4114(25)00166-0/fulltext

7. Gallagher A, Knockel L. Q&A: Expert Highlights Importance of Trusted Sources for Vaccine Information. Drug Topics. July 6, 2025. Accessed August 5, 2025. https://www.drugtopics.com/view/q-a-expert-highlights-importance-of-trusted-sources-for-vaccine-information

Want to ease your sleep apnea and get a better night’s sleep?

Blow through a conch shell, a new pilot clinical trial says.

Regularly blowing through a conch shell for six months, like Disney princess Moana or Anchorman legend Ron Burgundy, significantly improved sleep among a small group of people with sleep apnea.

Patients blowing a conch slept better, felt more alert during the day and had fewer breathing interruptions at night, researchers reported.

Conch blowing might prove a reasonable alternative to using a continuous positive air pressure machine, in which a face mask blows air to keep a patient’s airways open while sleeping, said lead researcher Dr. Krishna Sharma, director and head of pulmonology at the Eternal Heart Care Center and Research Institute in Jaipur, India.

While CPAP is the gold standard treatment for sleep apnea, many patients find it uncomfortable and noisy.

“For people living with obstructive sleep apnea, especially those who find CPAP uncomfortable, unaffordable, or inaccessible, our findings offer a promising alternative,” Sharma said in a news release. “[Conch] blowing is a simple low-cost, breathing technique that could help improve sleep and reduce symptoms without the need for machines or medication.”

Blowing a conch shell, also called shankh blowing, has been part of Indian culture for thousands of years, he explained.

“In my clinical practice, several patients reported feeling more rested and experiencing fewer symptoms after regularly practicing shankh blowing – a traditional yogic breathing exercise involving exhaling through a conch shell,” Sharma said.

Based on these anecdotes, Sharma and colleagues designed a small clinical trial to see if the simple, ancient practice might help people with sleep apnea.

In sleep apnea, a person stops breathing repeatedly during the night because their airway collapses, causing them to wake. Sleep apnea patients often snore loudly, and have a higher risk of high blood pressure, heart disease and stroke.

Researchers think conch blowing might help by exercising the muscles of the airway.

“The way the shankh is blown is quite distinctive. It involves a deep inhalation followed by a forceful, sustained exhalation through tightly pursed lips,” Sharma said.

“This action creates strong vibrations and airflow resistance, which likely strengthens the muscles of the upper airway, including the throat and soft palate — areas that often collapse during sleep in people with obstructive sleep apnea,” he continued. “The shankh’s unique spiraling structure may also contribute to specific acoustic and mechanical effects that further stimulate and tone these muscles.”

Researchers recruited 30 people with moderate sleep apnea and randomly assigned 16 to practice blowing through a conch shell. The other 14 were taught a deep breathing exercise.

All participants were encouraged to practice either conch blowing or deep breathing for a minimum of 15 minutes a day, five days a week.

After six months, the people armed with conch shells were 34% less sleepy during the daytime than those practicing deep breathing, results show. They also reported better sleep.

Sleep lab tests showed that those blowing a conch shell experienced on average four to five fewer episodes during the night in which they breathing stopped during sleep, as well as higher oxygen levels during sleep.

“This is a small study, but we are now planning a larger trial involving several hospitals,” Sharma said. “This next phase will allow us to validate and expand on our findings in a broader, more diverse population and assess how shankh blowing performs over longer periods.”

Future studies also will test to see how conch blowing affects the muscle tone of the airways, and compare the practice directly against standard treatments like CPAP, Sharma said.

Sophia Schiza, head of the European Respiratory Society’s group on sleep-disordered breathing, reviewed the findings. She said conch blowing might fill a need for more treatments for sleep apnea.

“This is an intriguing study that shows the ancient practice of shankh blowing could potentially offer an obstructive sleep apnea treatment for selected patients by targeting muscles training,” Schiza said in a news release.

“A larger study will help provide more evidence for this intervention which could be of benefit as a treatment option or in combination with other treatments in selected obstructive sleep apnea patients,” added Schiza, a professor of pulmonology and sleep disorders at the University of Crete in Greece.

The new study appears in the journal ERJ Open Research.

More information

Johns Hopkins Medicine has more on sleep apnea.

Copyright © 2025 HealthDay. All rights reserved.

A new study from the Gray Faculty of Medical and Health Sciences at Tel Aviv University may mark a breakthrough in the treatment of Eosinophilic Esophagitis (EoE) — a chronic inflammatory disease of the esophagus caused by food allergies. 

EoE leads to difficulty swallowing, chest and abdominal pain, and even growth delays in children. Its prevalence has been steadily increasing over the past decade in Israel and the Western world. In this new study, researchers identified the protein TSLP as a catalyst in the disease’s development, and found that neutralizing it may lead to significant relief of symptoms.

The study, led by Prof. Ariel Munitz and doctoral student Anish Dsilva from the Gray Faculty of Medical and Health Sciences, was conducted in collaboration with Dr. Chen Varol of Ichilov Hospital, Prof. Marc Rothenberg of Cincinnati Children’s Hospital, and the pharmaceutical company AstraZeneca. The research was supported by grants from the Israel Science Foundation, the US-Israel Binational Science Foundation, and the Azrieli Foundation Canada–Israel. The article was published in Allergy, the leading journal in clinical immunology.

Prof. Munitz explains: “Eosinophilic Esophagitis, or EoE, is a type of food allergy. It is a chronic inflammation of the esophagus caused by an abnormal immune response to food — mainly milk, eggs, wheat, nuts, fish, and more. The disease is characterized by an accumulation of eosinophils, a type of white blood cell that is not typically present in a healthy esophagus. EoE is often associated with other allergic conditions such as asthma and atopic dermatitis. It causes difficulty swallowing, food getting stuck in the esophagus, chest and abdominal pain, and growth delays in children. Current treatments require restrictive diets, and in severe cases, patients rely on essential amino acid formulas. Over the past decade, there has been a concerning rise in the prevalence of EoE worldwide, including in Israel. We are studying the disease in depth to understand the involvement of various immune system components in its progression. These components may serve as targets for future treatment for this disease, and for other allergic disorders as well.”

A previous study from Prof. Munitz’s lab, also published in Allergy, presented an experimental model that closely mimics the course and symptoms of EoE in humans. As a direct continuation of that study, the researchers now focused on a specific aspect of the disease, aiming to understand the role of epithelial cells. Prof. Munitz elaborates: “Epithelial cells form a protective outer layer that prevents foreign bodies from entering organs, including the digestive and respiratory systems. In allergic conditions, epithelial cells release various substances in response to encountering an allergen, and these substances trigger the chain of events that initiate the inflammatory process we experience as an allergy attack.”

The researchers found that epithelial cells in the esophagus of the EoE experimental model secreted high levels of two proteins: IL-33 and TSLP. They also discovered that the esophageal tissue in the mouse models contained a variety of immune cells that express receptors for both proteins. The fact that these two proteins are released in EoE, and that there are tissue cells with receptors that can respond to them, indicates that these are active proteins capable of causing the onset of the disease.

The researchers then sought to understand the division of roles between these two proteins in the disease: does each contribute differently, or do they act together? They believed that answering these questions would clarify the mechanisms that trigger EoE, and reveal which could be blocked as a treatment strategy. To this end, they used genetic engineering tools to create experimental models of the disease in which one of the proteins was absent.

The findings were unequivocal: the absence of the IL-33 protein did not significantly change the course of the disease. However, in the absence of TSLP, there was a significant improvement in EoE symptoms — to the point where the disease did not develop at all. Furthermore, a series of experiments in which the researchers neutralized TSLP with an antibody led to a significant reduction in symptoms. Further investigation using sequencing technologies and bioinformatic analyses revealed that TSLP functions as a key regulator of the disease. Based on these findings, the researchers concluded that the TSLP protein could serve as a target for new treatments for chronic esophageal inflammation (EoE).

Munitz concludes: “In this study, we found that the TSLP protein is a central player in EoE — a disease that causes significant suffering and is becoming increasingly prevalent worldwide. We know that pharmaceutical companies are currently developing a variety of antibodies targeting disease-causing proteins, under the broad category of biological therapies, including antibodies against TSLP. We believe these antibodies could serve as an effective treatment for EoE.”

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