NHS to lose out on new drugs, pharma firm warns

The claims from pharmaceutical giant Novartis comes amid a row over drug pricing deals.

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Patients struggle to get weight loss drug ahead of price rise

The drug’s US manufacturer has asked UK distributors to stop taking orders from pharmacies until next month’s price increase.

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More likely to be struck by lightning than get tetanus. So why the boosters?

The United States could safely drop tetanus and diphtheria booster shots for adults and save an estimated $1 billion a year, according to a new review led by researchers at Oregon Health & Science University.

The safety and savings depend on maintaining strong childhood vaccination rates, researchers emphasized.

“By maintaining high childhood vaccination coverage, we not only protect kids, but we may actually be able to reduce adult booster vaccinations,” said lead author Mark Slifka, Ph.D., professor of microbiology and immunology in the OHSU School of Medicine and the Oregon National Primate Research Center. “That would save $1 billion a year in the U.S. while maintaining the safety and protection of the general population.”

Slifka noted that dropping the 10-year schedule for adult boosters would more closely match guidelines recommended by the World Health Organization.

The review bolsters previous OHSU research in 2016 and in 2020 that concluded the combined vaccine produced at least 30 years of immunity, well beyond the current recommendation of every 10 years for adults from the U.S. Centers for Disease Control and Prevention. The vaccine is usually given as a combined tetanus, diphtheria and pertussis vaccine, known as DTaP.

In the U.S., childhood vaccinations are recommended six times, from infancy through age 12.

The new review suggests doing away with adult boosters altogether, as long as childhood vaccination rates remain high and the vaccine remains available on a case-by-case basis. For example, it may be necessary for someone injured in a workplace accident or car crash to receive a tetanus booster.

A natural experiment in the U.K. and France

Published recently in the journal Clinical Microbiology Reviews, the review highlights a comparison between two industrialized countries just 21 miles across the English Channel: France and the United Kingdom. Both countries have excellent childhood vaccination coverage, similar to the U.S.

“This represents sort of an experiment of nature,” Slifka said. “We have one country with over 60 million people that for decades has continued to vaccinate adults throughout their lifetime and another nearby country that also has over 60 million people, but over the past 50 years, they have never recommended adult booster vaccinations.

“The question we asked is, ‘What happens if we don’t vaccinate the adults? Are there more cases of disease or are these people protected after completing their childhood vaccination series?'”

Similar to the United States, France has a recommended booster vaccination schedule for adults. In contrast, except during pregnancy or for wound management, the United Kingdom hasn’t recommended boosters for tetanus and diphtheria beyond age 14 since the 1950s.

Yet, despite decades of adult booster vaccination, the review found that France had virtually no advantage over the U.K. in the rates of tetanus or diphtheria. In fact, the review found that the UK had a slightly lower rate overall.

In addition, “herd immunity” held strong even in 2022 when the U.K. reported an outbreak of 73 imported diphtheria cases among immigrants seeking asylum. This spike in cases was almost equal to the total number of diphtheria cases reported in the entire country over the previous 20 years combined.

“Remarkably, despite this proportionally large influx of imported diphtheria cases, there was no evidence of transmission reported among other asylum seekers who arrived by other routes or among staff or health care workers,” the authors write.

The U.K. Health Security Agency concluded that the country’s current childhood-focused vaccination program is sufficient for preventing the spread of diphtheria and that the risk to the general UK population remains low.

Strong rates of childhood vaccination are critical

The findings highlight the remarkable durability of protection following childhood vaccination against a pair of diseases that were once all but a death sentence.

In 1948, the U.S. mortality rate for tetanus was 91%. Before the introduction of antibiotics and vaccines, the mortality rate for diphtheria was roughly 50%. To this day, diphtheria kills roughly one out of 10 people who aren’t vaccinated against it.

Today, the public health threat is diminished thanks to childhood vaccinations as well as booster shots recommended in pregnancy.

“Thanks to childhood vaccinations, these diseases are incredibly rare,” Slifka said. “In fact, you’re 10 to 1,000 times more likely to be struck by lightning than to be diagnosed with tetanus and diphtheria in the United States.”

In addition to Slifka, co-authors include Archana Thomas and Lina Gao, Ph.D., of OHSU; Ian J. Amanna, Ph.D., of Najít Technologies, and Walter A. Orenstein, M.D., of the Emory Vaccine Center at Emory University.

Research reported in this publication was supported by the Office of the Director of the National Institutes of Health, award number P51OD011092. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Scientists finally pinpoint Jupiter’s birth using “molten rock raindrops”

Four and a half billion years ago Jupiter rapidly grew to its massive size. Its powerful gravitational pull disrupted the orbits of small rocky and icy bodies similar to modern asteroids and comets, called planetesimals. This caused them to smash into each other at such high speeds that the rocks and dust they contained melted on impact and created floating molten rock droplets, or chondrules, that we find preserved in meteorites today.

Now, researchers at Nagoya University in Japan and the Italian National Institute for Astrophysics (INAF) have for the first time determined how these droplets formed and accurately dated the formation of Jupiter based on their findings. Their study, published in Scientific Reports, shows how the characteristics of chondrules, particularly their sizes and the rate at which they cooled in space, are determined by the water contained in the impacting planetesimals. This explains what we observe in meteorite samples and proves that chondrule formation was a result of planet formation.

Time capsules from 4.6 billion years ago

Chondrules, small spheres approximately 0.1-2 millimeters wide, were incorporated into asteroids as the solar system formed. Billions of years later, pieces of these asteroids would break off and fall to Earth as meteorites. How chondrules came to have their round shape has puzzled scientists for decades.

“When planetesimals collided with each other, water instantly vaporized into expanding steam. This acted like tiny explosions and broke apart the molten silicate rock into the tiny droplets we see in meteorites today,” co-lead author Professor Sin-iti Sirono from Nagoya University’s Graduate School of Earth and Environmental Sciences explained.

“Previous formation theories couldn’t explain chondrule characteristics without requiring very specific conditions, while this model requires conditions that naturally occurred in the early solar system when Jupiter was born.”

The researchers developed computer simulations of Jupiter’s growth and tracked how its gravity caused high-speed collisions between rocky and water-rich planetesimals in the early solar system.

“We compared the characteristics and abundance of simulated chondrules to meteorite data and found that the model spontaneously generated realistic chondrules. The model also shows that chondrule production coincides with Jupiter’s intense accumulation of nebular gas to reach its massive size. As meteorite data tell us that peak chondrule formation took place 1.8 million years after the solar system began, this is also the time at which Jupiter was born,” Dr. Diego Turrini, co-lead author and senior researcher at the Italian National Institute for Astrophysics (INAF) said.

A new way to date when planets form

This study provides a clearer picture of how our solar system formed. However, the production of chondrules started by Jupiter’s formation is too brief to explain why we find chondrules of many different ages in meteorites. The most likely explanation is that other giant planets like Saturn also triggered chondrule formation when they were born.

By studying chondrules of different ages, scientists can trace the birth order of the planets and understand how our solar system developed over time. The research also suggests that these violent planet formation processes may occur around other stars and offers insights into how other planetary systems developed.

The study, “Chondrule formation by collisions of planetesimals containing volatiles triggered by Jupiter’s formation,” was published in the journal Scientific Reports, on August 25, 2025, at DOI: 10.1038/s41598-025-12643-x.

Funding information:

This work was supported by JSPS KAKENHI Grant Number 25K07383, by the Italian Space Agency through ASI-INAF contract 2016-23-H.0 and 2021-5-HH.0 and by the European Research Council via the Horizon 2020 Framework Programme ERC Synergy “ECOGAL” Project GA-855130.

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Brain image doctor banned for assault and racism

Dr Sayed Talibi is told his conduct was “fundamentally incompatible” with being a doctor.

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The surprising reason x-rays can push arthritis patients toward surgery

Routine x-rays aren’t recommended to diagnose the condition. Instead, GPs can make a diagnosis based on symptoms and medical history.

Yet nearly half of new patients with knee osteoarthritis who visit a GP in Australia are referred for imaging. Osteoarthritis imaging costs the health system A$104.7 million each year.

Our new study shows using x-rays to diagnose knee osteoarthritis can affect how a person thinks about their knee pain – and can prompt them to consider potentially unnecessary knee replacement surgery.

What happens when you get osteoarthritis?

Osteoarthritis arises from joint changes and the joint working extra hard to repair itself. It affects the entire joint, including the bones, cartilage, ligaments and muscles.

It is most common in older adults, people with a high body weight and those with a history of knee injury.

Many people with knee osteoarthritis experience persistent pain and have difficulties with everyday activities such as walking and climbing stairs.

How is it treated?

In 2021–22, more than 53,000 Australians had knee replacement surgery for osteoarthritis.

Hospital services for osteoarthritis, primarily driven by joint replacement surgery, cost $3.7 billion in 2020–21.

While joint replacement surgery is often viewed as inevitable for osteoarthritis, it should only be considered for those with severe symptoms who have already tried appropriate non-surgical treatments. Surgery carries the risk of serious adverse events, such as blood clot or infection, and not everyone makes a full recovery.

Most people with knee osteoarthritis can manage it effectively with:

  • education and self-management
  • exercise and physical activity
  • weight management (if necessary)
  • medicines for pain relief (such as paracetamol and non-steroidal anti-inflammatory drugs).

Debunking a common misconception

A common misconception is that osteoarthritis is caused by “wear and tear”.

However, research shows the extent of structural changes seen in a joint on an x-ray does not reflect the level of pain or disability a person experiences, nor does it predict how symptoms will change.

Some people with minimal joint changes have very bad symptoms, while others with more joint changes have only mild symptoms. This is why routine x-rays aren’t recommended for diagnosing knee osteoarthritis or guiding treatment decisions.

Instead, guidelines recommend a “clinical diagnosis” based on a person’s age (being 45 years or over) and symptoms: experiencing joint pain with activity and, in the morning, having no joint-stiffness or stiffness that lasts less than 30 minutes.

Despite this, many health professionals in Australia continue to use x-rays to diagnose knee osteoarthritis. And many people with osteoarthritis still expect or want them.

What did our study investigate?

Our study aimed to find out if using x-rays to diagnose knee osteoarthritis affects a person’s beliefs about osteoarthritis management, compared to a getting a clinical diagnosis without x-rays.

We recruited 617 people from across Australia and randomly assigned them to watch one of three videos. Each video showed a hypothetical consultation with a general practitioner about knee pain.

One group received a clinical diagnosis of knee osteoarthritis based on age and symptoms, without being sent for an x-ray.

The other two groups had x-rays to determine their diagnosis (the doctor showed one group their x-ray images and not the other).

After watching their assigned video, participants completed a survey about their beliefs about osteoarthritis management.

What did we find?

People who received an x-ray-based diagnosis and were shown their x-ray images had a 36% higher perceived need for knee replacement surgery than those who received a clinical diagnosis (without x-ray).

They also believed exercise and physical activity could be more harmful to their joint, were more worried about their condition worsening, and were more fearful of movement.

Interestingly, people were slightly more satisfied with an x-ray-based diagnosis than a clinical diagnosis.

This may reflect the common misconception that osteoarthritis is caused by “wear and tear” and an assumption that the “damage” inside the joint needs to be seen to guide treatment.

What does this mean for people with osteoarthritis?

Our findings show why it’s important to avoid unnecessary x-rays when diagnosing knee osteoarthritis.

While changing clinical practice can be challenging, reducing unnecessary x-rays could help ease patient anxiety, prevent unnecessary concern about joint damage, and reduce demand for costly and potentially unnecessary joint replacement surgery.

It could also help reduce exposure to medical radiation and lower health-care costs.

Previous research in osteoarthritis, as well as back and shoulder pain, similarly shows that when health professionals focus on joint “wear and tear” it can make patients more anxious about their condition and concerned about damaging their joints.

If you have knee osteoarthritis, know that routine x-rays aren’t needed for diagnosis or to determine the best treatment for you. Getting an x-ray can make you more concerned and more open to surgery. But there are a range of non-surgical options that could reduce pain, improve mobility and are less invasive.

Written by:

  • Belinda Lawford
    Senior Research Fellow in Physiotherapy, The University of Melbourne
  • Kim Bennell
    Professor of Physiotherapy, The University of Melbourne
  • Rana Hinman
    Professor in Physiotherapy, The University of Melbourne
  • Travis Haber
    Postdoctoral Research Fellow in Physiotherapy, The University of Melbourne 

The Conversation

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How did a planet this big form around a star this small?

The host star, TOI-6894, is a red dwarf with only 20% the mass of the Sun, typical of the most common stars in our galaxy. Until now, such low-mass stars were not thought capable of forming or retaining giant planets. But as published recently in Nature Astronomy, the unmistakable signature of a giant planet — TOI-6894b — has been detected in orbit around this tiny star.

This exceptional system was first identified in data from NASA’s Transiting Exoplanet Survey Satellite (TESS), as part of a large search for giant planets around small stars, led by Dr. Edward Bryant from UCL’s Mullard Space Science Laboratory.

The planetary nature of the signal was then confirmed by an extensive ground-based observation campaign, involving several telescopes — including those of the SPECULOOS and TRAPPIST projects, both led by the University of Liège.

Dr. Khalid Barkaoui, researcher on the SPECULOOS and TRAPPIST teams, oversaw these crucial follow-up observations. He explained: “The transit signal was unambiguous in our data. Our analysis ruled out all alternative explanations — the only viable scenario was that this tiny star hosts a Saturn-sized planet with an orbital period of just over three days. Additional observations confirmed that its mass is about half that of Saturn. This is clearly a giant planet.”

TOI-6894 is now the smallest star known to host a transiting giant planet, with a radius 40% smaller than that of any previous such host.

Prof. Jamila Chouquar, who was an astronomer at ULiege at the time of the discovery, added: “We previously believed that stars this small couldn’t form or hold on to giant planets. But stars like TOI-6894 are the most common type in the Milky Way — so our discovery suggests there may be far more giant planets out there than we thought.”

A Challenge to Planet Formation Models

According to current planet formation models, giant planets are rare around small stars. This is because their protoplanetary disks — the gas and dust reservoirs from which planets form — are thought to lack the material needed to build massive cores and accrete thick gas envelopes.

Dr. Mathilde Timmermans, member of the SPECULOOS team and ULiege astronomer at the time of the discovery, noted: “The existence of TOI-6894b is hard to reconcile with existing models. None can fully explain how it formed. This shows that our understanding is incomplete, and underscores the need to find more such planets. That’s exactly the goal of MANGO, a SPECULOOS sub-program led by myself and Dr. Georgina Dransfield at the University of Birmingham.”

Prof. Michaël Gillon,Fund for Scientific Research — FNRS Research Director at ULiege and head of the SPECULOOS and TRAPPIST programs, concluded: “This giant planet orbiting a tiny star reveals that planetary diversity in the galaxy is even greater than we imagined. Most of the targets observed by SPECULOOS and TRAPPIST are similar stars, or even smaller — so we’re well positioned to uncover more cosmic outliers in the years ahead.”

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Maui’s fires drove a 67% jump in deaths. Most went uncounted

New research unveils the true death toll of the deadly August 2023 wildfires which took place in Lāhainā, Maui, Hawaiʻi — and which temporarily made wildfire a leading cause of death in Maui. By comparing death rates over time, the scientists found that two-thirds more people died that August than would have been expected. To stop this happening again, the authors say, major policy changes are needed, ranging from removing flammable invasive vegetation to improving disaster preparedness.  

“Wildfires can cause a measurable, population-wide increase in mortality, beyond what is captured in official fatality counts,” said Michelle Nakatsuka of the Grossman School of Medicine, co-first author of the article in Frontiers in Climate. “This suggests the true toll of the Lāhainā wildfire was even broader than previously understood.”  

“It also points to the need for prevention strategies that go beyond reactive wildfire control,” added Nakatsuka. “As Native Hawaiians, the co-first authors are especially hopeful that wildfire mitigation strategies will center kānaka maoli perspectives, including the restoration of traditional agroecological systems.” 

Fire risk  

As the climate crisis makes wildfires more common and destructive, understanding the full extent of their impact is critical to mitigating it. To capture the wide range of possible deaths attributable to the fires, the authors calculated the all-cause excess death rate: this is how many more deaths took place over a given period than would have been expected. They trained a model on demographic data from Maui County from August 2018 to July 2023 and weighted the analysis to exclude deaths caused by Covid-19.  

“Wildfires can cause death in a variety of ways,” said Dr Kekoa Taparra of UCLA, co-first author. “In this case, recent reports suggest many deaths were due to direct exposure, smoke inhalation and burns. Others likely stemmed from disruptions in healthcare, like not being able to access critical medications or emergency treatment. Wildfires can also exacerbate pre-existing conditions.” 

The researchers found that in August 2023, 82 more deaths were reported than expected: an excess death rate of 67%. In the week of 19 August, the rate was 367% higher than expected compared to previous years. 80% of these deaths didn’t take place in a medical context, 12% higher than in other months, suggesting some people never reached medical care because of the fires. At the same time, the proportion of deaths with a non-medical cause rose from 68% to 80%.  

This differs slightly from the official fatality count of 102, although it’s very close to the 88 fire-related deaths reported in August 2023 by the CDC.  

“We think this might reflect a temporary drop in other causes of death, like car accidents, during the fire period, similar to what we saw during Covid-19, when deaths from some non-Covid causes dropped during lockdowns,” said Nakatsuka. “It’s also possible that some deaths occurred after the August time window we studied, for example from missed treatments or worsening of chronic conditions.” 

The scientists point out that there are some limitations to this analysis. For instance, the data is not geographically granular enough to identify whether the death toll was particularly high in Lāhainā itself.  

“Our study only covers a short time window, so we can’t speak to longer-term mortality impacts,” explained Nakatsuka. “Excess mortality models also can’t determine exact causes of death, and we didn’t have access to detailed death certificate data like toxicology reports or autopsy findings. Still, we believe this type of analysis offers important insights into the broader health impacts of disasters like the Lāhainā fire.” 

Planting the future 

To protect Hawaiʻi from similar tragedies in the future, the researchers call for improved disaster preparedness and investment in the restoration of Native Hawaiian plants and agroecological systems, which reduce the likelihood of destructive wildfires compared to modern monocultures and invasive plant species.  

“In the short term, it’s critical for people exposed to wildfires to get immediate medical treatment,” said Nakatsuka. “Fast, accessible emergency care can save lives.” 

“In the long term, we’d like to see more policy investment in wildfire prevention rooted in Native Hawaiian ecological knowledge,” said Taparra. “This includes restoring traditional agroecological systems, removing dry, non-native grasses, restoring traditional pre-colonial water systems, and improving fire risk modeling to better guide preparedness efforts.” 

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Ocean air may add years to your life, research shows

Living within miles of the ocean breeze may be linked to a longer life, but you shouldn’t count on the same benefits if you live in a riverside city, suggests a recent study.

Researchers from The Ohio State University analyzed population data — including life expectancy — in more than 66,000 census tracts throughout the U.S. and compared it based on proximity to waterways. Their study was published online in the journal Environmental Research.

A correlation between longer life expectancy and water was clear for those who live within about 30 miles of an ocean or gulf. But for those who live in urban settings and near an inland body of water larger than 4 square miles, the opposite was true. Rural residents who live near water may also reap some lifespan advantages, according to the research.

“Overall, the coastal residents were expected to live a year or more longer than the 79-year average, and those who lived in more urban areas near inland rivers and lakes were likely to die by about 78 or so. The coastal residents probably live longer due to a variety of intertwined factors,” said lead researcher Jianyong “Jamie” Wu.

The analysis suggested that milder temperatures, better air quality, more opportunities for recreation, better transportation, less susceptibility to drought, and higher incomes could all be contributors to a better outlook for coastal residents compared to those who live inland.

“On the other side, pollution, poverty, lack of safe opportunities to be physically active and an increased risk of flooding are likely drivers of these differences,” said Yanni Cao, a postdoctoral researcher who worked on the study.

The most critical difference the researchers found is that coastal areas experience fewer hot days and lower maximum temperatures compared to inland water areas.

Previous research has found a connection between living near water and better health measures, including higher physical activity levels, lower obesity rates and improved heart health. That prompted Wu to wonder if there could be a link between “blue space” living and longer lives, and how that relationship might differ depending on the type of neighborhood people call home, he said.

“We thought it was possible that any type of ‘blue space’ would offer some beneficial effects, and we were surprised to find such a significant and clear difference between those who live near coastal waters and those who live near inland waters,” said Wu, an assistant professor of environmental health sciences at The Ohio State University College of Public Health.

“We found a clear difference — in coastal areas, people are living longer,” said Wu, adding that the study is the first to comprehensively and systematically examine the relationship between various types of “blue space” and longevity in the U.S.

Cao said she was especially curious about how this data might provide insights into the trends in life expectancy in the U.S. compared to other wealthy nations. In the past several years, the U.S. experienced a sharper decline and a slower rebound in life expectancy than peer countries.

“It’s likely that various social determinants of health, including complex environmental factors, that contribute to health inequities are playing a key role in the differences we saw,” she said.

Ria Martins, a graduate student in public health, was also a co-author.

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Sitting up straight isn’t the only secret to good posture – here are three more tips

Here are Dr Xand’s three suggestions on how to look after your back without turning into a statue.

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