Abolishing NHS England is radical – why do it?

There are three main reasons body is going – money, bureaucracy and control, says Nick Triggle

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Warning over the dangers of Botox parties

Healthcare Improvement Scotland is concerned about treatment at parties organised with unregulated providers.

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Routine asthma test more reliable in the morning and has seasonal effects, say doctors

A lung function test used to help diagnose asthma works better in the morning, becoming less reliable throughout the day, Cambridge researchers have found.

Using real world data from 1,600 patients, available through a database created for speeding up research and innovation, the team also found that its reliability differs significantly in winter compared to autumn.

Asthma is a common lung condition that can cause wheezing and shortness of breath, occasionally severe. Around 6.5% of people over six years old in the UK are affected by the condition. Treatments include the use of inhalers or nebulisers to carry medication into the lungs.

The majority of asthma attacks occur at nighttime or early in the morning. Although this may in part be due to cooler nighttime air and exposure to dust mites and allergens, it also suggests that circadian rhythms — our ‘body clocks’ — likely play a role.

Researchers at the Victor Phillip Dahdaleh Heart and Lung Research Institute, a collaboration between the University of Cambridge and Royal Papworth Hospital NHS Foundation Trust (RPH), wanted to explore whether these circadian rhythms may also have an impact on our ability to diagnose asthma, using routinely performed clinical testing.

Typically, people with suspected asthma will be offered a spirometry test, which involves taking a deep breath in, then breathing out hard and fast for as long as possible into a tube to assess lung function. They will then be administered the drug salbutamol via an inhaler or nebuliser, and shortly afterwards retake the spirometry test.

Salbutamol works by opening up the airways, so a positive test result — that is, a difference in readings between the initial and follow-up spirometry tests — means that the airways must have been narrower or obstructed to begin with, suggesting that the patient could have asthma.

Cambridge University Hospitals NHS Foundation Trust (CUH) has recently set up the Electronic Patient Record Research and Innovation (ERIN) database so that researchers can access patient data in a secure environment to help in their research and speed up improvements in patient care.

Using this resource, the Cambridge team analysed data from 1,600 patients referred to CUH between 2016 and 2023, adjusted for factors such as age, sex, body mass index (BMI), smoking history, and the severity of the initial impairment in lung function.

In findings published today in Thorax, the researchers found that starting at 8.30am, with every hour that passed during the working day, the chances of a positive response to the test — in other words, the patient’s lungs responding to treatment, suggesting that they could have asthma — decreased by 8%.

Dr Ben Knox-Brown, Lead Research Respiratory Physiologist at RPH, said: “Given what we know about how the risk of an asthma attack changes between night and day, we expected to find a difference in how people responded to the lung function test, but even so, we were surprised by the size of the effect.

“This has potentially important implications. Doing the test in the morning would give a more reliable representation of a patient’s response to the medication than doing it in the afternoon, which is important when confirming a diagnosis such as asthma.”

The researchers also discovered that individuals were 33% less likely to have a positive result if tested during autumn when compared to those tested during winter.

Dr Akhilesh Jha, a Medical Research Council Clinician Scientist at the University of Cambridge and Honorary Consultant in Respiratory Medicine at CUH, said that there may be a combination of factors behind this difference.

“Our bodies have natural rhythms — our body clocks,” Jha said. “Throughout the day, the levels of different hormones in our bodies go up and down and our immune systems perform differently, for example. Any of these factors might affect how people respond to the lung function test.

“The idea that the time of day, or the season of the year, affects our health and how we respond to treatments is something we’re seeing increasing evidence of. We know, for example, that people respond differently to vaccinations depending on whether they’re administered in the morning or afternoon. The findings of our study further support this idea and may need to be taken into account when interpreting the results of these commonly performed tests.”

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Targeted alpha therapy: Breakthrough in treating refractory skin cancer

Metastatic melanoma, also known as stage IV melanoma, is a type of skin cancer that spreads to other parts of the body. It is one of the most aggressive forms of skin cancer, with current therapies — including immunotherapy and targeted drugs — showing limited effectiveness. Radiotherapy is an emerging treatment for melanoma, but conventional beta-emitting radionuclide therapies have limitations due to their low energy transfer and long-range radiation, which can cause unintended damage to healthy tissues.

To enhance the efficacy of radiotherapy, a research team from Japan, led by Assistant Professor Hiroyuki Suzuki from Chiba University, including Dr. Tomoya Uehara from Chiba University, Dr. Noriko S. Ishioka from National Institutes for Quantum Science and Technology, Dr. Hiroshi Tanaka from Juntendo University, Dr. Tadashi Watabe from Osaka University, adopted targeted alpha therapy (TAT) as a promising alternative to conventional beta therapy. They developed an astatine-211 (211At)-labeled peptide drug that could offer a potential breakthrough for treating metastatic melanoma. The research was conducted in collaboration with the National Institutes for Quantum Science and Technology and was published in the European Journal of Nuclear Medicine and Molecular Imaging on January 20, 2025.

TAT is a form of radiotherapy that involves drugs labeled with alpha particle-emitting radioisotopes. Compared to other forms of radioactive emissions (beta and gamma emissions), alpha particles are heavier and therefore have a short range. Owing to their greater mass, alpha particles also carry relatively higher energy, which is beneficial for the disruption of cancer cells.

To develop the treatment, the researchers first identified an optimal hydrophilic linker to enhance tumor targeting and reduce off-target accumulation. The team then designed an astatine-211(211At)-labeled α-melanocyte-stimulating hormone (α-MSH) peptide analog called [211At]NpG-GGN4c to specifically target melanocortin-1 receptors (MC1R), which are overexpressed in melanoma cells. “Since the tagged peptide was also receptor-targeted, it allowed for a high tumor selectivity while minimizing radiation exposure to the surrounding tissues,” comments Dr. Suzuki.

The synthesized peptides were then tested on B16F10 melanoma-bearing mice models, following which they conducted a biodistribution analysis where the team compared tumor uptake, clearance from organs, and the overall stability of the compound. Dr. Uehara elaborates on the methodology, saying, “We treated the mice with different doses of the compound while monitoring the tumor response, body weight, and survival rates over time. We found a dose-dependent inhibitory effect in a melanoma-bearing mouse model, confirming the effectiveness of our approach.”

The findings were remarkable. The [211At]NpG-GGN4c showed high accumulation in tumors and rapid clearance from non-target organs, confirming its specificity for MC1R on melanoma cells. Monitoring tumor growth revealed significant tumor suppression in a dose-dependent manner. Furthermore, [211At]NpG-GGN4c also demonstrated high stability in blood plasma, minimizing the risk of radioactive leakage in the body.

Hailing the exciting results, Dr. Suzuki affirms that the molecular design of their synthesized drug could be useful for developing other 211At-labeled radiopharmaceuticals. He says, “We believe our approach could open up new possibilities for treating refractory cancers beyond melanoma.”

The team is also hopeful about promoting a clinical application of 211At-based TAT. “If successfully translated into human trials, this therapy may emerge as a viable treatment option for patients with advanced melanoma in the coming years,” speculates Dr. Suzuki. “This could provide new therapeutic opportunities for patients with refractory cancer.”

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Blind to the burn: Misconceptions about skin cancer risk in the US

Skin cancer is the most common cancer in the United States and a significant health issue, with millions of non-melanoma cases and tens of thousands of melanomas diagnosed annually. Furthermore, treating skin cancer costs the U.S. approximately $8.9 billion annually.

Those with fair skin, a history of sun exposure or tanning bed use, and a genetic predisposition, are at higher risk. Key barriers to prevention include a lack of awareness, cultural preferences for tanned skin, and limited access to sun protection.

A study by researchers at Florida Atlantic University’s Charles E. Schmidt College of Medicine is one of a few to explore associations between reported number of sunburns and sociodemographic characteristics, in addition to examining prevalence of protective skin behaviors adopted by the U.S. adult population in a nationally representative sample. According to the American Academy of Dermatology, experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80% and nonmelanoma skin cancer risk by 68%.

Using data from the U.S. National Cancer Institute’s 2022 Health Information National Trends Survey 6 (HINTS 6), researchers selected questions focused on respondents’ confidence in their health, perceived cancer risk, and worry about getting diagnosed with cancer, as well as their sunburn experiences over the past year. Sociodemographic factors that were studied included age, gender, occupational status, marital status, educational level, Hispanic origin, race and income due to their potential link to skin cancer risk.

Among 6,252 participants surveyed, when asked how confident they felt about their ability to take good care of their own health, most respondents felt either very confident (44%) or completely confident (27.3%). Findings, published in the American Journal of Lifestyle Medicine, also showed most respondents had moderate concerns about skin cancer risk. Only 9.1% reported being extremely worried, while the majority were either somewhat (26.6%) or slightly (25.6%) concerned.

For sunburn and skin protection, 67.6% reported no sunburns in the past year, while 30.3% had 1-5 sunburns. Additionally, 6.4% reported consuming alcohol while sunburned, a known risk factor for increased sunburn incidence. Activities like drinking alcohol, working outside or swimming were common among those who reported sunburns.

Using multinomial regression analysis, statistically significant associations were reported between the number of sunburns and sociodemographic factors. Adults (over 40) had lower sunburn risks, as did women. Disabled, unemployed, and multi-occupation participants reported fewer sunburns. Married or partnered individuals had higher risks of sunburn, while divorced or single participants had lower risks. Higher education levels, being Hispanic, Black, Asian or of mixed race were linked to lower sunburn risks. Higher income groups had significantly higher risks of sunburns, with the highest income group being more than four times more likely to report a sunburn.

“Social determinants such as race/ethnicity, sex, income and employment status are closely linked to sunburn and skin cancer risk,” said Lea Sacca, Ph.D., senior author and an assistant professor in the Department of Population Health and Social Medicine, within the Schmidt College of Medicine. “While Hispanics and Black Americans generally report lower rates of sunburn, Hispanics often perceive greater benefits of UV exposure, which increases their risk. Factors such as sex, education, and income also influence sunscreen use, with lower use observed among Black Americans and Hispanic Americans. However, within these groups, women with higher education and income are more likely to use sunscreen. Interestingly, higher income is associated with more frequent sunburns.”

Skin cancer includes three main types: basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell carcinoma is the most common and least aggressive, typically appearing as a shiny, pearly bump or pinkish patch, often on sun-exposed areas. Squamous cell carcinoma usually appears as red, scaly patches or open sores and can spread to other parts of the body if not treated early. Melanoma, the most dangerous form, develops in pigment-producing cells (melanocytes) and can appear as a new mole or changes to an existing one. It is highly aggressive and can spread quickly to other organs if not caught early.

“Understanding perceptions of skin cancer risk and the prevalence of protective behaviors is vital to reducing the likelihood of developing skin cancer, particularly among vulnerable groups,” said Madison Etzel, first author and a second-year medical student in the Schmidt College of Medicine. “Our study underscores the importance of raising awareness about skin cancer susceptibility as we found that all sociodemographic factors were significantly linked to the number of reported sunburns in the past year. Future research should explore how additional social determinants of health influence sunburn incidence and prevention behaviors. A deeper understanding of these factors is critical to addressing the widespread harms of skin cancer in U.S. adults.”

According to the American Cancer Society and other health organizations, practicing sun safety and skin awareness is vital to preventing skin cancer. Regularly applying a broad-spectrum sunscreen with an SPF of 30 or higher, especially when spending time outdoors, and reapplying every two hours is essential as a first step for skin cancer prevention. Avoiding direct sunlight, particularly between 10 a.m. and 4 p.m., when UV rays are strongest, and seeking shade whenever possible are also additional preventive strategies to consider to reduce the risk of this disease. Moreover, protecting skin further by wearing long-sleeve clothing, wide-brimmed hats and sunglasses with 100% UVA/UVB protection has also been recommended. It’s also crucial to avoid tanning beds, as they increase the risk of skin cancer.

Regular self-exams of the skin for any unusual moles or changes, along with professional skin screenings by a dermatologist, can help with early detection. Surfaces like water, sand and snow also can reflect UV rays, so reapply sunscreen more frequently in these environments. Finally, staying hydrated supports skin health and resilience against UV damage.

Study co-authors are Nada Eldawy; Sahar Kaleem; Austin Lent; Adrienne Dean; Ayden Dunn; Paige Brinzo; and Samantha Jimenez, all medical students in the Schmidt College of Medicine.

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Sons worst affected by smoking in pregnancy – study

Data from half-a-million people was assessed by the University of Aberdeen research team.

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Children under eight should avoid drinking slushies, doctors warn

Paediatricians studied 21 children in the UK and Ireland who became very ill after the icy drinks.

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Doctors try to stop under-eights drinking slushies

Paediatricians studied 21 children in the UK and Ireland who became very ill after the icy drinks.

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NHS to offer take-at-home tablet for MS

Broadening access to cladribine should help more patients avoid hospital and free up clinic time.

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Nature-inspired 3D-printing method shoots up faster than bamboo

Charging forward at top speed, a garden snail slimes up 1 millimeter of pavement per second. By this logic, Beckman Institute for Advanced Science and Technology researchers’ new 3D printing process speeds past existing methods — at a snail’s pace.

Researchers in Beckman’s Autonomous Materials Systems Group created “growth printing,” which mimics tree trunks’ outward expansion to print polymer parts quickly and efficiently without the molds and expensive equipment typically associated with 3D printing. Their work appears in the journal Advanced Materials.

“Humans are incredibly talented at making things. Completely new manufacturing processes are hard to find. Growth printing is entirely new, which is thrilling,” said Sameh Tawfick , a professor of mechanical science and engineering at the University of Illinois Urbana-Champaign and project lead.

Tawfick said the most common industrial manufacturing technology is injection molding, where molten polymers take shape in a metal mold. Though effective for mass production, maintaining the molds and curing ovens (where the plastic hardens) can be cost-prohibitive and unwieldy — especially for large objects like boat hulls or fan blades. Additive manufacturing, which prints 3D objects like a layer cake, is mold-less and ideal for custom parts like prosthetics.

“Polymer 3D printing equipment has matured, but there are still aspects that make it expensive and very slow,” Tawfick said. “Our goal was to increase the manufacturing speed, size and material quality while maintaining a low cost. This process that we came up with is truly fast and inexpensive.”

First, Sameh and his colleagues pour amber-colored liquid resin called dicyclopentadiene, or DCPD, into an open glass container submerged in ice water. They heat a center point in the resin to 70C. As the reaction takes over, heat radiates outward from the original point of contact at 1 mm/s, more than 100 times faster than the desktop 3D printers available for home use and 60 times faster than the world’s fastest-growing species of bamboo. Everything the heat touches hardens into a growing sphere, like if the mythical King Midas seized the Earth’s core. Self-sustained by heat’s steady release, the reaction — called frontal ring-opening metathesis polymerization and nicknamed FROMP — uses minimal energy to harden the resin into its solid form: poly- dicyclopentadiene, or p-DCPD.

As the hardened sphere grows, the researchers alter its shape by pulling it out of the resin like an apple out of gooey caramel. Since the liquid-to-solid reaction only happens below the surface, the researchers can lift, dip or spin the solid part like blown glass to manipulate its size and shape. For example: to create a corrugated, or wavy, edge, the researchers lift the resin slightly, hold it still, and repeat.

The researchers designed their process to mimic how a tree steadily expands outward, ring by ring. In nature, elements like gravity, wind and temperature complement and complicate a tree’s tendency to grow symmetrically, resulting in trees that bow in the wind or reach toward a patch of sunlight in the forest canopy.

Tawfick became enamored of living organisms’ growth patterns and resulting shapes — also known as morphogenesis — upon reading D’Arcy Wentworth Thompson’s book, “On Growth and Form.” Last August, when Tawfick was promoted from associate professor to full professor, he dedicated the book to the University Library.

Using their new method, Tawfick and his colleagues fabricated everyday items such as a pinecone, a raspberry and a squash. These are all axisymmetrical shapes, or symmetrical around a vertical axis. Non-symmetrical shapes are more difficult, but possible; for example, the researchers sculpted a kiwi bird by allowing the spherical body to expand below the surface before pulling it up just in time to create a diminutive head and minute beak.

“It is a beautiful and simple application of a reaction-diffusion process, which is found in many natural systems. The speed and energy efficiency of the growth-printing process make this process particularly attractive. On the modeling side of this collaborative project, we developed a computational tool that predicts the upward motion of the rod needed to achieve a target shape of the manufactured object,” said Philippe Geubelle, Illinois professor of aerospace engineering and co-author on the paper.

This method’s limitations are the same ones found in nature. Printing curved objects, like bananas, is theoretically possible but difficult to program mathematically, as are complex shapes “like a thorn in a rose,” Tawfick said.

“It’s hard to find a perfect cube in nature. I don’t know of any plant or organism that looks like a perfect cube. Similarly, our process cannot make a perfect cube. It’s an interesting mirror of nature,” he said.

Tawfick says the process is “simple and highly marketable” and hopes it can one day be used to create large polymer-based products like wind turbine blades. The project is funded through the U.S. Department of Energy Office of Science Basic Energy Sciences program.

“Basic energy science could lead to transformative manufacturing, meaning something with a transformative impact on our economy. This is a successful example and was made possible through collaboration here at the Beckman Institute with people from all areas of expertise,” Tawfick said.

First author and Illinois graduate student Yun Seong Kim said the project demonstrated true teamwork:

“It was really a work of true teamwork, because it required expertise in various backgrounds and we all came together to make it happen,” he said.

Coauthor Randy Ewoldt, the Alexander Rankin Professor of Mechanical Science and Engineering at Illinois, adds: “The many advances of this work resulted because of the outstanding teamwork. The Illinois culture of collaborative excellence shines bright.”

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