Publisher Health

Sir Julian Hartley, Chief Executive the Care Quality Commission which is the independent regulator of all health and adult social care services in England, has resigned. The announcement comes just days after an independent inquiry into maternity care at the Leeds Teaching Hospitals NHS Trust was announced.Mr Hartley had previously spent a decade leading the trust and said that in light of that inquiry, his role at the CQC, “has become incompatible with the important conversations happening about care at Leeds.”Some of the families who received poor maternity care had demanded his resignation.On Monday, the Health Secretary Wes Streeting announced an independent inquiry into “repeated failures” at the Leeds trust. Mr Streeting said the investigation would examine what had “gone so catastrophically wrong” at the trust’s maternity services at both Leeds General Infirmary and St James’ University Hospital. Earlier this year, a BBC investigation revealed the deaths of at least 56 babies and two mothers over the past five years may have been prevented. In a statement reacting to the inquiry’s announcement, the trust said it was “taking significant steps to address improvements.”Several of the families who had campaigned for the inquiry had questioned Mr Hartley’s role at the CQC given he had led the trust for 10 years, until 2023. He was appointed chief executive of the hospital regulator last December having spent 21 months leading NHS Providers, a health service trade body.Mandip Singh Matharoo and Amarjit Kaur’s daughter Asees was stillborn in January 2024 – a trust investigation found care issues which may have prevented her death. They welcomed Mr Hartley’s resignation and questioned his original appointment. “The fact that he was head of Leeds teaching hospitals over such a large period of time, where maternity care was substandard should have raised alarm bells within the system to prevent him becoming Chief Executive of such a large regulator in the first instance,” they said.A whistleblower at the trust, who has raised concerns about maternity, also said they were pleased he’d gone. “Its been dire for many years, including under his watch. Him being the head of CQC was a scandal when staff like us have been complaining to the regulator about unsafe care. Things need to change,” she said.In his statement, Sir Julian said he was “sorry for the fact that some families suffered harm and loss during this time” and vowed to cooperate with the inquiry “so families can get the transparency and answers that they need and deserve.”The chair of the CQC Professor Sir Mike Richards said that while Mr Hartley’s resignation was “a huge loss” he understood that his previous job at Leeds “may undermine trust and confidence in the CQC’s regulation.” On Monday, when the inquiry was announced, both Mr Richards and Wes Streeting said they had confidence in Sir Julian.A rapid review into maternity services in England is currently underway while the largest inquiry into maternity care in the history of the NHS, centred on services at the Nottingham University Hospitals NHS Trust, is due to report next summer. The inquiry into care at Leeds is the fifth investigation into maternity services at a single NHS since 2013.

A large study led by scientists at McMaster University has found that fat stored deep inside the abdomen and liver can quietly injure arteries, even in people who seem healthy on the outside.
The research, published on October 17, 2025, in Communications Medicine, questions the long-standing use of body-mass index (BMI) as a reliable indicator of obesity and heart risk. It offers new evidence that the fat people cannot see may be just as dangerous as the weight they can.
Going Beyond BMI to Understand True Health Risks
Visceral fat (which surrounds internal organs) and hepatic fat (fat stored in the liver) have long been associated with Type 2 diabetes, high blood pressure, and heart disease. However, their direct impact on artery health had not been well established until now.
Using advanced MRI scans and data from more than 33,000 adults in Canada and the United Kingdom, the researchers discovered that higher levels of visceral and liver fat were closely tied to thickening and clogging of the carotid arteries in the neck. These arteries carry blood to the brain, and when they narrow, they increase the risk of stroke and heart attack.
“This study shows that even after accounting for traditional cardiovascular risk factors like cholesterol and blood pressure, visceral and liver fat still contribute to artery damage,” says Russell de Souza, co-lead author of the study and associate professor in the Department of Health Research Methods, Evidence, and Impact at McMaster.
Hidden Fat Adds Risk Even in the Absence of Other Factors
“The findings are a wake-up call for clinicians and the public alike,” says de Souza, a faculty member in the Mary Heersink School of Global Health and Social Medicine, and member of the Centre for Metabolism, Obesity and Diabetes Research (MODR) and at McMaster, the results should prompt both doctors and patients to pay attention to hidden fat, not just visible weight. He led the research with co-author Marie Pigeyre, associate professor in McMaster’s Department of Medicine.

The analysis drew from two major population studies: the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the UK Biobank. MRI scans were used to measure fat distribution and artery condition. The team found that visceral fat was consistently associated with plaque buildup and artery wall thickening, while liver fat had a smaller but still important effect. These relationships remained significant even after adjusting for lifestyle habits and metabolic risk factors such as diet, exercise, and cholesterol.
Rethinking How We Measure Obesity
The findings highlight the need for clinicians to look beyond BMI or waist measurements when assessing heart risk. Imaging tests that reveal fat stored around internal organs may offer a more accurate picture of cardiovascular health.
For people in midlife, the study is a reminder that even a normal weight does not guarantee a healthy heart. Hidden fat can quietly increase the risk of serious disease without obvious physical signs.
“You can’t always tell by looking at someone whether they have visceral or liver fat,” says Sonia Anand, corresponding author of the study, a vascular medicine specialist at Hamilton Health Sciences and professor in the Department of Medicine at McMaster. “This kind of fat is metabolically active and dangerous; it’s linked to inflammation and artery damage even in people who aren’t visibly overweight. That’s why it’s so important to rethink how we assess obesity and cardiovascular risk.”
This research was supported by the Canadian Partnership Against Cancer, Heart and Stroke Foundation of Canada, and the Canadian Institutes of Health Research, with additional contributions from the Population Health Research Institute, Montreal Heart Institute, Sunnybrook Health Sciences Centre, and others. MRI reading costs were supported in-kind by Sunnybrook Hospital, and Bayer AG provided IV contrast. The study also drew on data from the Canadian Partnership for Tomorrow’s Health and the PURE Study.

In cities, coworking spaces bring people together to collaborate and innovate. Inside cancer cells, a similar concept plays out — but with deadly consequences. Scientists at the Texas A&M University Health Science Center (Texas A&M Health) have discovered that within the cells of a rare and aggressive kidney cancer, tiny molecular “hubs” form that accelerate disease instead of progress.
Their study, published in Nature Communications, reveals that RNA, typically known for transmitting genetic messages, can be hijacked to build liquid-like “droplet hubs” inside the cell nucleus. These droplets act as command centers that activate growth-related genes. The team not only observed this phenomenon but also developed a molecular switch that can dissolve these hubs on demand, effectively cutting off the cancer’s growth mechanism at its core.
RNA Becomes Cancer’s Builder
The researchers focused on a rare kidney cancer called translocation renal cell carcinoma (tRCC), which primarily affects children and young adults and currently lacks effective treatments. This cancer results from TFE3 oncofusions — abnormal hybrid genes created when chromosomes break and fuse incorrectly.
Until now, scientists did not fully understand how these fusion proteins made tRCC so aggressive. The Texas A&M team found that the fusions enlist RNA to serve as a structural framework. Instead of merely carrying messages, RNA molecules assemble into droplet-like condensates that cluster vital molecules together. These droplets then act as transcriptional hubs, activating genes that promote tumor growth.
“RNA itself is not just a passive messenger, but an active player that helps build these condensates,” said Yun Huang, PhD, professor at the Texas A&M Health Institute of Biosciences and Technology and senior author.
The team also identified an RNA-binding protein called PSPC1, which stabilizes these droplets and makes them even more effective at driving tumor formation.

Mapping the Hidden Machinery of Cancer
To uncover how this process works, the researchers used a suite of cutting-edge molecular biology tools: CRISPR gene editing to “tag” fusion proteins in patient-derived cancer cells, letting them track exactly where these proteins go. SLAM-seq, a next-generation sequencing method that measures newly made RNA, showing which genes are switched on or off as the droplets form. CUT&Tag and RIP-seq to map where the fusion proteins bind DNA and RNA, revealing their precise targets. Proteomics to catalog the proteins pulled into the droplets — pinpointing PSPC1 as a key partner.By layering these techniques, the researchers built the clearest picture yet of how TFE3 oncofusions hijack RNA to build cancer’s growth hubs.
Dissolving the hubs that drive tumors
Discovery alone wasn’t enough. The team wanted to know: If the droplets are cancer’s engine, can we shut them down?
To test this, they engineered a nanobody-based chemogenetic tool — essentially a designer molecular switch. Here’s how it works: A nanobody (a miniature antibody fragment) is fused with a dissolver protein. The nanobody locks onto the cancer-driving fusion proteins. When activated by a chemical trigger, the dissolver melts the droplets, breaking the hubs apart.The result? Tumor growth ground to a halt in both lab-grown cancer cells and mouse models.

“This is exciting because tRCC has very few effective treatment options today,” said Yubin Zhou, MD, PhD, professor and director of the Center for Translational Cancer Research. “Targeting condensate formation gives us a brand-new angle to attack the cancer, one that traditional drugs have not addressed. It opens the door to therapies that are much more precise and potentially less toxic.”
Beyond Kidney Cancer: A New Therapeutic Model
For the research team, the most powerful part of the study wasn’t just watching RNA build these hubs but seeing that they could be dismantled.
“By mapping how these fusion proteins interact with RNA and other cellular partners, we are not only explaining why this cancer is so aggressive but also revealing weak spots that can be therapeutically exploited,” said Lei Guo, PhD, research assistant professor at the Institute of Biosciences and Technology.
Because many pediatric cancers are also driven by fusion proteins, the implications extend far beyond tRCC. A tool that can dissolve these condensates could represent a general strategy to cut off cancer’s engine rooms at the source.
Why this matters
tRCC represents nearly 30% of renal cancers in children and adolescents, yet treatment choices remain scarce and outcomes are often poor. This breakthrough provides both an explanation for how the cancer organizes its molecular machinery and a potential way to dismantle it.
“This research highlights the power of fundamental science to generate new hope for young patients facing devastating diseases,” Huang added.
Just as cutting power to a coworking hub halts all activity, dissolving cancer’s “droplet hubs” could stop its ability to grow. By revealing how RNA builds these structures — and by finding a way to take them apart — Texas A&M Health researchers have opened a promising new path toward treating one of the most challenging childhood cancers.

When cholesterol levels in the bloodstream become excessive, a condition known as hypercholesterolemia can occur, posing a serious threat to the arteries and overall cardiovascular health. Researchers from the University of Barcelona and the University of Oregon have now developed a new therapeutic tool that can help regulate cholesterol levels in the blood. Their findings open new possibilities for preventing atherosclerosis, a disease caused by the buildup of fatty deposits along the artery walls.
The research team created a strategy to block the activity of PCSK9, a protein that plays a crucial role in controlling the amount of low-density lipoprotein cholesterol (LDL-C), often called “bad” cholesterol, in the bloodstream. This innovative approach relies on molecules called polypurine hairpins (PPRHs), which help cells absorb more cholesterol and prevent its accumulation in arteries, without producing the side effects often linked to statin drugs.
The study, published in Biochemical Pharmacology, was led by professors Carles J. Ciudad and Verònica Noé of the University of Barcelona’s Faculty of Pharmacy and Food Sciences and the Institute of Nanoscience and Nanotechnology (IN2UB), in collaboration with Nathalie Pamir from the University of Oregon in Portland (United States). Funding came from Spain’s Ministry of Science, Innovation and Universities (MICINN) and the U.S. National Institutes of Health (NIH).
Targeting the PCSK9 Protein
PCSK9 (protein convertase subtilisin/kexin type 9) has become a major target for cholesterol treatment and cardiovascular protection over the past decade. This enzyme binds to receptors on cell surfaces that normally capture LDL cholesterol. When PCSK9 binds to these receptors, it reduces their number, leading to higher LDL cholesterol levels circulating in the blood and increasing the risk of hypercholesterolemia.
The new technique developed by the team uses PPRHs to halt the transcription of specific genes, effectively silencing their expression. In this study, PPRHs were used to inhibit the PCSK9 gene, resulting in an increase in LDL receptors (LDLR) and improved cholesterol uptake by cells. This mechanism helps reduce both circulating cholesterol and the risk of plaque buildup in arteries.
How Polypurine Hairpins Work
PPRHs are single-stranded DNA molecules, known as oligonucleotides, that can bind precisely to complementary DNA or RNA sequences. The research demonstrated for the first time that two specific PPRHs, HpE9 and HpE12, lower PCSK9 RNA and protein levels while raising LDLR levels.

“Specifically, one of the arms of each chain of the HpE9 and HpE12 polypurines binds specifically to polypyrimidine sequences of exons 9 and 12 of PCSK9, respectively, via Watson-Crick bonds,” notes Professor Carles J. Ciudad, from the Department of Biochemistry and Physiology. This binding inhibits gene transcription and the action of RNA polymerase or the binding of transcription factors.
The new therapeutic technique has been validated in vivo in transgenic mice expressing the human PCSK9 gene. “The results show that both HpE9 and HpE12 are highly effective in HepG2 cells. HpE12 decreases PCSK9 RNA levels by 74% and protein levels by 87%. In the case of transgenic mice, a single injection of HpE12 reduces plasma PCSK9 levels by 50% and cholesterol levels by 47% on the third day,” says Professor Verònica Noé.
Toward Statin-Free Cholesterol Control
Since PCSK9 was defined as a significant target in plasma cholesterol-lowering therapy, several therapeutic approaches have been designed to lower or block its action. For example, gene silencing with siRNAs, antisense oligonucleotides or the CRISPR technique. In particular, Inclisiran, an siRNA agent against PCSK9, and the monoclonal antibodies such as evolocumab and alirocumab stand out.
“PPRHs, especially HpE12, are therapeutic oligonucleotides with many advantages, including low cost of synthesis, stability and lack of immunogenicity. In addition, such a PPRH-based approach against PCSK9 would not lead to side effects such as the myopathies associated with statin therapy,” the experts conclude.

8 hours agoShareSaveNick TriggleHealth correspondentShareSaveGetty ImagesMenopause screening is to be officially incorporated into NHS health checks in England for the first time.Women getting the checks – offered to adults aged 40 to 74 every five years – will be asked about the menopause and possible symptoms from next year.The aim is to identify women who may benefit from advice and support, including treatment, such as hormone replacement therapy (HRT), drugs to combat hot-flushes, and counselling.The government said the measure will bring menopause into the mainstream, but campaigners warned uptake of health checks was worryingly low in some communities so not enough women may benefit.Health checks are primarily aimed at identifying people at risk of conditions such as cardiovascular disease, stroke, kidney disease, diabetes and dementia.They include blood pressure and cholesterol checks as well as measuring a person’s BMI (body mass index) and are normally carried out in pharmacies and GP surgeries.But under these changes, from 2026 women will also be asked about the menopause. The exact questions have yet to be decided, but Health Secretary Wes Streeting said he hoped the move would improve the support offered.”Women have been suffering in silence for far too long and haven’t been encouraged to open up about the symptoms they’re experiencing,” he said.”This often means they’re left to navigate menopause alone with very little support. No-one should have to grit their teeth and just get on with what can be debilitating symptoms or be told that it’s simply part of life.”Reduce stigmaMenopause affects all women differently with most experiencing the transition between ages 45 and 55, though symptoms can begin earlier during perimenopause.Three-quarters of women experience symptoms – from physical changes like joint pain, weight gain and hot flushes to cognitive effects such as memory issues and brain fog.These symptoms can last an average of seven years and significantly affect daily life, yet research shows fewer than one in 10 feel they have enough information to deal with it.Women’s Health Ambassador Dame Lesley Regan welcomed the move to ask women about the menopause.She said: “Some 400,000 women in the UK will become menopausal this year, but the vast majority of them will have very little knowledge of what underlies the many and varied symptoms.”Prof Ranee Thakar, of the Royal College of Obstetricians and Gynaecologists, said it would help “break down barriers and reduce stigma”. But she said staff carrying out the health checks would need training for the change to have the maximum positive impact.And she added more needed to be done to help women from ethnic communities and the poorest areas access NHS health checks.Janet Lindsay, from Wellbeing of Women, said she hoped the move would help more women understand their symptoms and seek help.But she too is concerned about uptake of health checks.”Women and people from marginalised communities are less likely to know about or attend these appointments and progress on menopause support cannot leave them behind,” she said.Latests figures show fewer than half of people invited for a health check actually attend.

8 hours agoShareSaveYasmin RufoBBC NewsShareSaveHelen LedwickWhen Helen Ledwick typed “why do my insides feel like they’re falling out” into Google a decade ago, she had no idea that search would mark the beginning of a life-changing journey.The former BBC 5 Live journalist and podcaster was experiencing pelvic organ prolapse – a condition that affects around one in twelve women, but which many have never even heard of.Prolapse happens when one or more of the organs in the pelvis, such as the bladder, bowel or uterus, slip from their usual position and bulge into the vagina. It’s not life-threatening, but it can have a profound impact on daily life, relationships and mental health.For Helen, the shock came just two weeks after a difficult birth with her second child.”I stood up from the sofa and suddenly felt things shift,” she recalls. “It felt like when a tampon isn’t sitting properly, you can feel something’s not right.”Confused and frightened, she grabbed a mirror and her phone to see what was happening.”I’d never even heard the term prolapse before,” she says, and since talking openly about it she’s realised it’s often a “taboo” subject despite being very common.Helen believes the shame and stigma surrounding it has led to a lack of awareness among women and health professionals – something she’s now fighting to change.Helen LedwickHelen says her diagnosis, confirmed by a doctor, brought confusion and fear as she was “hoping for an explanation, fix or some sense of urgency, instead I got a shrug of the shoulders.”The initial advice she was given was to not do anything that could make it worse such as running, jumping or lifting.”It kind of felt like the advice was don’t live your life,” she says.Perhaps more debilitating than the physical symptoms was the isolation Helen felt.”You live with it in embarrassment, silence, shame and isolation,” she explains. “Because you don’t talk about it, you think you’re the only person in the world it’s happened to.”Helen initially ventured onto Instagram to seek support. Finding other people on the social platform who were similarly anxious and confused and in some cases too embarrassed to seek help prompted her to eventually launch a podcast and write a book, Why mums don’t jump.Her goal was to create a platform for women to share stories and break the silence around pelvic health.”I was angry because no-one ever talked about it. So I decided I would.”I wanted to give women the knowledge that I’d found so hard to come by, and comfort in knowing they were not on their own.”Dr Nighat Arif, a women’s health specialist, says Helen’s experience is far from unique and issues can arise as symptoms aren’t always obvious.”Sometimes physically there isn’t a lump to see, there’s just a feeling of pressure and it might be in the lower back, at the front or slightly higher up near your belly button,” she explains. “The symptoms can also be more pronounced during sex which is again massively taboo.”Prolapse can happen for a variety of reasons including childbirth, heavy lifting, being overweight or even after a hysterectomy. And in rare cases, it can affect men too.Pelvic floor exercises and lifestyle changes can help to improve symptoms, but sometimes medical treatment is needed such as vaginal pessaries or surgery.Gynaecologist Dr Christine Ekechi says women with prolapse may notice a swelling or a lump within their vagina “as essentially what has happened is that we have weakening of the ligaments within the pelvic floor that can move for example the bladder”.Helen LedwickHelen says what began as a lonely Google search 15 years ago, has now become something far more powerful, helping women to recognise when there is a problem and seek help.In her case, recovery has been slow, but transformative.”For me it’s been a long process of building up slowly, doing postpartum [immediately after pregnancy] exercises, building up some strength work.”Eventually she saw a physio who helped her to start running again. Helen says this was “a massive moment because I really thought that was something I would never do again.”Now, Helen is doing more than she ever thought possible and has signed up for a 10k run.”I feel good and I’ve learned how to manage my symptoms. I’ve still got prolapse, but it doesn’t rule my life in the way that it once was.”I feel like I’m kind of winning the battle.”

16 hours agoShareSaveEleanor MaslinEast Yorkshire and LincolnshireShareSaveFamily handoutA mother is urging the government to “act immediately” to roll out spare allergy pens in schools after her five-year-old son died from a reaction to cow’s milk.Benedict Blythe, from Stamford, Lincolnshire, died in hospital after collapsing at Barnack Primary School in December 2021. An inquest found delayed administration of his adrenaline pen was a factor in his death.His mother, Helen Blythe, said: “No parent should lose a child because medication wasn’t there when it was needed. The solutions exist. What’s missing is action.”The Department for Education said it was “working across government to consider how we might extend the availability of allergy pens in schools.”Benedict had asthma and a number of allergies to food including eggs, nuts, kiwi fruit and milk.His parents had worked with the school to put together a personal allergy action plan and a specific process for storing, preparing and supplying oat milk to the pupil.In July, an inquest jury looking into Benedict’s death found that the school did not follow all the measures in place to prevent his death from a fatal anaphylactic reaction to cow’s milk which he had been given accidentally.This included delays in administering his medication, Mrs Blythe said.At the time, Mrs Blythe called for a new “Benedict’s Law” to ensure schools have adequate allergy plans for children and said her son’s death was “preventable and caused by a cascade of failures”.Family handoutThe Benedict Blythe Foundation, set up by Mrs Blythe, has published new research with Professor Paul Turner, of Imperial College London, and the National Allergy Strategy Group (NASG) in the Archives of Disease In Childhood, a peer-reviewed journal.The study said putting spare allergy pens in every UK school could not only save lives but also reduce NHS medication waste, be simpler logistically, improve emergency access and be cost-neutral for most NHS Integrated Care Boards.It could save the government at least £4.6m a year in costs, the foundation said.”Despite clear evidence and cost savings that would fully fund “Benedict’s Law”, the Department for Education has yet to act – leaving pupils starting in school this year at risk,” it added..Family handoutMrs Blythe said: “The evidence is now published, peer-reviewed and beyond question – yet nothing has changed.”Another school year has started and children are still going to class without guaranteed access to adrenaline.”The Department for Education had this evidence ahead of Benedict’s inquest in July. They know what needs to be done – yet schools remain unequipped.”Peter Blythe, Benedict’s father, said: “The savings identified are more than sufficient to fund national allergy training, emergency planning and policy development across schools. “It’s financially sound, evidence-based, and morally urgent.”A Department For Education spokesperson said: “What happened to Benedict was a tragedy for his family and our thoughts remain with all of those who loved him.”To put a stop to allergies being a barrier to children feeling safe at school, we are planning to consult on strengthened guidance later this year and are working across government to consider how we might extend the availability of allergy pens in schools.”More on this storyRelated internet links

Kiwifruit, rye bread, and mineral-rich water may help reduce the discomfort of chronic constipation, according to new evidence-based dietary guidelines developed by researchers at King’s College London.
The team’s work represents the first comprehensive, evidence-supported dietary recommendations specifically for adults living with long-term constipation. The research also found that supplements such as psyllium fiber, certain probiotics, and magnesium oxide may provide additional relief.
In contrast, some popular methods often promoted for constipation management, including general “high-fiber diets” and senna supplements (a type of laxative), were found to lack convincing scientific support for effectiveness.
Backed by Strong Evidence and Expert Endorsement
The new guidelines were published in two major international journals, the Journal of Human Nutrition & Dietetics and Neurogastroenterology & Motility, and are endorsed by the British Dietetic Association (BDA). The aim is to transform how constipation is treated in clinical settings by providing healthcare professionals with clear, evidence-based tools. The guidelines also give individuals the ability to manage their condition more effectively through diet and hydration.
Constipation is a chronic condition that can seriously affect quality of life while adding to healthcare costs. Previous clinical recommendations have typically relied on increasing dietary fiber and fluid intake, an approach that researchers now say may be overly simplistic and outdated.
The Science Behind the New Guidelines
Unlike earlier guidance, the new recommendations draw on extensive systematic reviews and meta-analyses. Using the GRADE framework to evaluate evidence quality, an expert panel consisting of dietitians, a nutritionist, gastroenterologist, gut physiologist, and general practitioner examined data from more than 75 clinical trials. Their work resulted in 59 recommendations and the identification of 12 key areas for future research.

Dr. Eirini Dimidi, Reader in Nutritional Sciences at King’s College London and lead author, explained: “Chronic constipation can have a huge impact on someone’s day-to-day life. For the first time, we’ve provided direction on what dietary approaches could genuinely help, and which diet advice lacks evidence. Being able to improve this condition through dietary changes would allow people to self-manage their symptoms more and, hopefully, improve their quality of life.”
Personalized Nutrition and Global Application
The guidelines also emphasize measurable outcomes, such as stool frequency and consistency, straining, and quality of life. This practical focus allows healthcare professionals to tailor dietary advice to individual symptom patterns. To support implementation, the researchers have created a clinician-friendly tool that can be used worldwide.
The review also revealed that while several foods and supplements appear effective, the quality of most existing research remains low. Many trials examined single interventions instead of comprehensive diet patterns, highlighting the need for more robust nutrition studies in constipation management.
Rethinking Fiber and Future Directions
Dr. Dimidi noted that although high-fiber diets are often promoted as beneficial for overall health, the new findings indicate limited evidence for their specific effectiveness in relieving constipation. “Eating a high fiber diet offers many benefits to overall health and has been a go-to recommendation for constipation,” she said. “However, our guidelines found that there simply isn’t enough evidence to suggest it actually works in constipation specifically. Instead, our research reveals some new dietary strategies that could indeed help patients. At the same time, we urgently need more high-quality trials to strengthen the evidence on what works and what doesn’t.”
Professor Kevin Whelan, senior author and Professor of Dietetics at King’s College London, added: “This new guidance marks a promising step towards empowering health professionals and their patients to manage constipation through diet. This means that from now on that people suffering from constipation across the world can now receive up-to-date advice based upon the best available evidence in order to improve their symptoms and well-being. With continued research, it holds real potential to drive lasting improvements in quality of life.”

When Dr. Marketta Blue bursts into an examination room, she greets her patients as long-lost friends, a whirl of energy in leopard-print Crocs: “Tell me what’s up!”Dr. Blue is a family physician at Delta Health Center, the oldest federally funded rural community health center in the United States. The center sits in the Mississippi Delta, at the entrance to Mound Bayou, which was founded in 1887 as an all-Black town. Today, more than half of the town’s children live below the federal poverty line. Last year, the health center saw just over 14,000 patients, 36 percent of whom had Medicaid.Dr. Blue, 38, grew up in the region and lived with her grandmother, who could not afford to take time off work for medical appointments. She saw a doctor only if she was “bleeding from the eyes, mouth and nose,” she recalled. That experience, she added, left her attuned to the many reasons that her own patients might struggle to come see her: Maybe they can’t afford the gas to drive there, can’t cover child care or have lost their health insurance.Insurance was on the mind of one patient, Johnie Williams, 64, who shifted uncomfortably in his wheelchair as Dr. Blue entered his exam room in early September. His wife, Carolyn Williams, sat nearby, cradling their granddaughter. He was having trouble sleeping at night, he told Dr. Blue. When he lay down in bed, his lungs felt like cement, like no air could pass through. He felt nauseated all the time, which made it hard to eat.Also, he said, “Medicaid cut me off.” He had received a letter about the change in his coverage in July, although he noted that he still had health care coverage through Medicare. (He’d previously had both.) “They said by me and my wife being in the same household, the same address, that our income was a few dollars over the limit,” he added.Dr. Blue’s face twisted in alarm. “Oh my gosh,” she said.Their conversation could well be a precursor to many similar ones to come. The health care provisions in the Trump administration’s tax and domestic policy bill, passed in July, mean that 10 million more Americans will become uninsured by 2034, according to estimates from the Congressional Budget Office. Federal spending on Medicaid will be reduced by more than $1 trillion, the largest reduction to Medicaid since the creation of the program in 1965.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

A tiny wireless chip placed at the back of the eye, combined with a pair of advanced smart glasses, has partially restored vision to people suffering from an advanced form of age-related macular degeneration. In a clinical study led by Stanford Medicine and international collaborators, 27 of the 32 participants regained the ability to read within a year of receiving the implant.
With the help of digital features such as adjustable zoom and enhanced contrast, some participants achieved visual sharpness comparable to 20/42 vision.
The study’s findings were published on Oct. 20 in the New England Journal of Medicine.
A Milestone in Restoring Functional Vision
The implant, named PRIMA and developed at Stanford Medicine, is the first prosthetic eye device to restore usable vision to individuals with otherwise untreatable vision loss. The technology enables patients to recognize shapes and patterns, a level of vision known as form vision.
“All previous attempts to provide vision with prosthetic devices resulted in basically light sensitivity, not really form vision,” said Daniel Palanker, PhD, a professor of ophthalmology and a co-senior author of the paper. “We are the first to provide form vision.”
The research was co-led by José-Alain Sahel, MD, professor of ophthalmology at the University of Pittsburgh School of Medicine, with Frank Holz, MD, of the University of Bonn in Germany, serving as lead author.

How the PRIMA System Works
The system includes two main parts: a small camera attached to a pair of glasses and a wireless chip implanted in the retina. The camera captures visual information and projects it through infrared light to the implant, which converts it into electrical signals. These signals substitute for the damaged photoreceptors that normally detect light and send visual data to the brain.
The PRIMA project represents decades of scientific effort, involving numerous prototypes, animal testing, and an initial human trial.
Palanker first conceived the idea two decades ago while working with ophthalmic lasers to treat eye disorders. “I realized we should use the fact that the eye is transparent and deliver information by light,” he said.
“The device we imagined in 2005 now works in patients remarkably well.”
Replacing Lost Photoreceptors
Participants in the latest trial had an advanced stage of age-related macular degeneration known as geographic atrophy, which progressively destroys central vision. This condition affects over 5 million people worldwide and is the leading cause of irreversible blindness among older adults.

In macular degeneration, the light-sensitive photoreceptor cells in the central retina deteriorate, leaving only limited peripheral vision. However, many of the retinal neurons that process visual information remain intact, and PRIMA capitalizes on these surviving structures.
The implant, measuring just 2 by 2 millimeters, is placed in the area of the retina where photoreceptors have been lost. Unlike natural photoreceptors that respond to visible light, the chip detects infrared light emitted from the glasses.
“The projection is done by infrared because we want to make sure it’s invisible to the remaining photoreceptors outside the implant,” Palanker said.
Combining Natural and Artificial Vision
This design allows patients to use both their natural peripheral vision and the new prosthetic central vision simultaneously, improving their ability to orient themselves and move around.
“The fact that they see simultaneously prosthetic and peripheral vision is important because they can merge and use vision to its fullest,” Palanker said.
Since the implant is photovoltaic — relying solely on light to generate electrical current — it operates wirelessly and can be safely placed beneath the retina. Earlier versions of artificial eye devices required external power sources and cables that extended outside the eye.
Reading Again
The new trial included 38 patients older than 60 who had geographic atrophy due to age-related macular degeneration and worse than 20/320 vision in at least one eye.
Four to five weeks after implantation of the chip in one eye, patients began using the glasses. Though some patients could make out patterns immediately, all patients’ visual acuity improved over months of training.
“It may take several months of training to reach top performance — which is similar to what cochlear implants require to master prosthetic hearing,” Palanker said.
Of the 32 patients who completed the one-year trial, 27 could read and 26 demonstrated clinically meaningful improvement in visual acuity, which was defined as the ability to read at least two additional lines on a standard eye chart. On average, participants’ visual acuity improved by 5 lines; one improved by 12 lines.
The participants used the prosthesis in their daily lives to read books, food labels and subway signs. The glasses allowed them to adjust contrast and brightness and magnify up to 12 times. Two-thirds reported medium to high user satisfaction with the device.
Nineteen participants experienced side effects, including ocular hypertension (high pressure in the eye), tears in the peripheral retina and subretinal hemorrhage (blood collecting under the retina). None were life-threatening, and almost all resolved within two months.
Future Visions
For now, the PRIMA device provides only black-and-white vision, with no shades in between, but Palanker is developing software that will soon enable the full range of grayscale.
“Number one on the patients’ wish list is reading, but number two, very close behind, is face recognition,” he said. “And face recognition requires grayscale.”
He is also engineering chips that will offer higher resolution vision. Resolution is limited by the size of pixels on the chip. Currently, the pixels are 100 microns wide, with 378 pixels on each chip. The new version, already tested in rats, may have pixels as small as 20 microns wide, with 10,000 pixels on each chip.
Palanker also wants to test the device for other types of blindness caused by lost photoreceptors.
“This is the first version of the chip, and resolution is relatively low,” he said. “The next generation of the chip, with smaller pixels, will have better resolution and be paired with sleeker-looking glasses.”
A chip with 20-micron pixels could give a patient 20/80 vision, Palanker said. “But with electronic zoom, they could get close to 20/20.”
Researchers from the University of Bonn, Germany; Hôpital Fondation A. de Rothschild, France; Moorfields Eye Hospital and University College London; Ludwigshafen Academic Teaching Hospital; University of Rome Tor Vergata; Medical Center Schleswig-Holstein, University of Lübeck; L’Hôpital Universitaire de la Croix-Rousse and Université Claude Bernard Lyon 1; Azienda Ospedaliera San Giovanni Addolorata; Centre Monticelli Paradis and L’Université d’Aix-Marseille; Intercommunal Hospital of Créteil and Henri Mondor Hospital; Knappschaft Hospital Saar; Nantes University; University Eye Hospital Tübingen; University of Münster Medical Center; Bordeaux University Hospital; Hôpital National des 15-20; Erasmus University Medical Center; University of Ulm; Science Corp.; University of California, San Francisco; University of Washington; University of Pittsburgh School of Medicine; and Sorbonne Université contributed to the study.
The study was supported by funding from Science Corp., the National Institute for Health and Care Research, Moorfields Eye Hospital National Health Service Foundation Trust, and University College London Institute of Ophthalmology.