Publisher Health

21 minutes agoShareSaveFergus WalshMedical editorShareSaveA group of blind patients can now read again after being fitted with a life-changing implant at the back of the eye.A surgeon who inserted the microchips in five patients at Moorfields Eye Hospital in London says the results of the international trial are “astounding”.Sheila Irvine, 70, who is registered blind, told the BBC it was “out of this world” to be able to read and do crosswords again. “It’s beautiful, wonderful. It gives me such pleasure.”The technology offers hope to people with an advanced form of dry age-related macular degeneration (AMD), called geographic atrophy (GA), which affects more than 250,000 people in the UK and five million worldwide.In those with the condition, cells in a tiny area of the retina at the back of the eye gradually become damaged and die, resulting in blurred or distorted central vision. Colour and fine detail are often lost.The new procedure involves inserting a tiny 2mm-square photovoltaic microchip, with the thickness of a human hair, under the retina.Patients then put on glasses with a built-in video camera. The camera sends an infrared beam of video images to the implant at the back of the eye, which sends them on to a small pocket processor to be enhanced and made clearer. The images are then sent back to the patient’s brain, via the implant and optic nerve, giving them some vision again.The patients spent months learning how to interpret the images. Mahi Muqit, consultant ophthalmic surgeon at Moorfields Eye Hospital in London, who led the UK arm of the trial, told the BBC it was “pioneering and life-changing technology”.”This is the first implant that’s been demonstrated to give patients meaningful vision that they can use in their daily life, such as reading, writing. “I think this is a major advance,” he said.How the implant technology worksFor the research, published in the New England Journal of Medicine, 38 patients with geographic atrophy in five European countries took part in the trial of the Prima implant, which is made by California biotech Science Corporation.Of 32 patients given the implant, 27 were able to read again using their central vision. After a year, this equated to an improvement of 25 letters, or five lines, on an eye chart.For Sheila, from Wiltshire, the improvement is even more dramatic. Without the implant, she is completely unable to read. But when we filmed Sheila reading an eye chart at Moorfields Hospital, she did not make a single error. After completing it, she punched the air and cheered.’I am one happy bunny’The task took huge concentration. Sheila had to put a pillow under her chin in order to steady the feed from the camera, which can focus on just one or two letters at a time. At some points she needed the device switched to magnification mode, especially to distinguish between the letters C and O.Sheila began losing her central vision more than 30 years ago, due to loss of cells in the retina. She describes her vision as like having two black discs in each eye.Sheila gets around using a white cane because her very limited peripheral vision is completely blurred. She is unable to read even the largest street signs when outdoors. When she had to give up her driving licence, she says she cried.But after having an implant fitted around three years ago, she is delighted by her progress, as is the medical team at Moorfields.”I am able to read my post, books, and do crosswords and Sudoku,” she says.When asked if she ever thought she’d read again, Sheila replied: “Not on your nelly!””It is amazing. I am one happy bunny,” she adds.”Technology is moving so fast, it’s amazing that I am part of it.”Sheila doesn’t wear the device when outdoors. In part, this is because it requires great concentration – her head has to be held very still in order to read. She also does not want to become over-reliant on the device.Instead, she says she “rushes her chores” at home each day before sitting down and putting on the special glasses.The Prima implant is not yet licensed so is not available outside of clinical trials, and it’s unclear how much it may eventually cost.Nonetheless, Mahi Muqit said he hoped it would be available to some NHS patients “within a few years.”Dry age-related macular degeneration (AMD) is the most common cause of sight loss in older age. It’s hoped the technology could be used to help people with other eye conditions in the future.However the implant would not help restore sight in people born blind, because they don’t have a functioning optic nerve to pass signals to the brain.

The device could help a million people with a severe form of macular degeneration to be able to see enough to read.For the first time, researchers restored some vision to people with a common type of eye disease by using a prosthetic retinal implant. If approved for broader use in the future, the treatment could improve the lives of an estimated one million, mostly older, people in the United States who lose their vision to the condition.The patients’ blindness occurs when cells in the center of the retina start to die, what is known as geographic atrophy resulting from age-related macular degeneration. Without these cells, patients see a big black spot in the center of their vision, with a thin border of sight around it. Although their peripheral vision is preserved, people with this form of advanced macular degeneration cannot read, have difficulty recognizing faces or forms and may have trouble navigating their surroundings.In a study published Monday in The New England Journal of Medicine, vision in 27 out of 32 participants improved so much that they could read with their artificial retinas.The vision that is restored is not normal: It’s black and white, blurry, and the field of view is small. But after getting the retinal implant, patients who could barely see gained on average five lines on a standard eye chart. The implant gets signals from glasses and a camera that projects infrared images to the artificial retina. The camera has a zoom feature that can magnify images like letters, allowing people to read, albeit slowly because with the zoom they don’t see many letters at a time.Patients wore glasses with a camera attached that captures images and sends signals to the artificial retina in their eye, allowing them to see.Science Corporation“This is at the forefront of science,” said Dr. Demetrios Vavvas, director of the retina service at Massachusetts Eye and Ear, a specialty hospital in Boston. He was not involved in the study and emphasized that the implant was not a cure for macular degeneration. But he called it the dawn of a new technology that he predicted will significantly advance.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 research group led by the Peter Doherty Institute for Infection and Immunity (Doherty Institute) has uncovered new details about how lymph nodes help the body fight persistent infections and cancer by coordinating key immune cell activity.
Published in two Nature Immunology papers, the findings show that lymph nodes create the ideal setting for stem-like T cells — an essential type of immune cell — to survive, multiply, and generate the “killer” T cells that target viruses and tumors. In contrast, other immune organs like the spleen do not support these processes as effectively, highlighting the lymph nodes’ importance for strong immune defenses and successful immunotherapy.
According to Professor Axel Kallies, Laboratory Head at the Doherty Institute and senior author of both studies, these discoveries could reshape approaches to cancer treatment.
“Lymph nodes aren’t just passive waiting rooms for immune cells, they actively train and educate T cells, and send them off to do their job,” said Professor Kallies.
“Our research suggests that removing lymph nodes during cancer surgery, a common practice to prevent tumor spread, may inadvertently reduce the effectiveness of treatments, such as checkpoint blockade and CAR T cell therapies. Preserving lymph nodes could strengthen immune responses and increase the effectiveness of immunotherapy.”
The research also offers insight into why some patients respond better to immunotherapy than others. The condition and function of lymph nodes appear to influence how effectively the immune system produces cancer-fighting T cells, which can directly affect treatment outcomes.
Dr. Carlson Tsui, a Postdoctoral Researcher at the University of Melbourne and first author of one of the papers, said the team’s work could pave the way for more powerful and precise immune-based treatments.

“Our research identifies molecular signals that are involved in the regulation of stem-like cells and in their capacity to produce effective killer cells. These findings could guide the development and refinement of immune-based treatments for cancer and chronic infection,” said Dr. Tsui.
“Furthermore, our research shows that rather than only focusing on the tumor itself, therapies should also be designed to preserve and enhance lymph node function. By targeting these critical immune hubs, we could boost the body’s natural ability to fight cancer, increase the effectiveness of existing immunotherapies and help more patients respond to treatment.”
Together, the two peer-reviewed papers provide a deeper understanding of how lymph nodes shape immune responses. While they are based on work with animal models, they will guide future treatment strategies for chronic infection and cancer treatment.
Professor Shahneen Sandhu, Research Lead for the Melanoma Medical Oncology Service at the Peter MacCallum Cancer Centre, commented on the clinical implications of this work.
“While this research was done in the laboratory with pre-clinical models, we’re excited to study these findings in clinical samples from patients receiving immune checkpoint inhibitors, as part of an ongoing Melanoma Research Victoria collaboration with Professor Kallies,” Professor Sandhu said.
“Combining clinical and preclinical studies will help us translate these discoveries from bench to bedside and back, ultimately improving outcomes for cancer patients.”
Collaboration: This research was led by the Doherty Institute and conducted in collaboration with University Hospital Bonn, German Center for Neurodegenerative Diseases, WEHI, ETH Zürich, IRCCS Humanitas Research Hospital, Olivia Newton-John Cancer Research Institute and The University of Queensland.
Funding: This work was supported by the National Health and Medical Research Council of Australia (NHMRC), the Australian Research Council (ARC), Cancer Council Victoria, EMBO, the Fondazione Italiana per la Ricerca sul Cancro-Associazione Italiana per la Ricerca sul Cancro, the German Research Foundation, the Helmholtz Association, Humanitas Research Hospital, the National Collaborative Research Infrastructure Strategy (NCRIS), Phenomics Australia and the University of Melbourne.

People living with knee osteoarthritis may find the greatest relief from aerobic activities such as walking, cycling, or swimming, according to a new study published in The BMJ. Researchers found that these forms of exercise were the most effective for easing pain, improving movement, and enhancing overall quality of life.
Although other exercise types can provide added benefits, the researchers emphasized that aerobic activity should remain the foundation of treatment. Osteoarthritis develops when the cartilage cushioning the ends of bones wears down, leading to swelling, stiffness, and discomfort. It can affect any joint, but the knees are most commonly impacted. About 30% of adults over age 45 show signs of knee osteoarthritis on x-rays, and roughly half of them experience significant pain and mobility problems.
Filling the Evidence Gap in Exercise Guidance
Exercise is a cornerstone of osteoarthritis care, yet many medical guidelines lack clear direction on which kinds are most beneficial for knee osteoarthritis specifically. To clarify this, researchers analyzed the effectiveness and safety of several exercise approaches.
Their comprehensive analysis drew on 217 randomized clinical trials conducted between 1990 and 2024. In total, the research included 15,684 participants and compared multiple exercise categories — including aerobic, flexibility, strengthening, mind-body, neuromotor, and mixed programs — against control groups.
Evaluating Pain Relief, Function, and Mobility
The trials varied in quality, but the team assessed the strength of the evidence using the internationally recognized GRADE system. They examined several key outcomes: pain reduction, physical function, gait performance, and quality of life. Each was measured at short term (four weeks), mid-term (12 weeks), and long term (24 weeks) follow-ups.

Across these studies, aerobic exercise consistently ranked highest in improving outcomes among all exercise types tested.
Aerobic Activity Delivers the Broadest Benefits
Moderate-certainty evidence showed that, compared with control groups, aerobic exercise effectively reduced short- and mid-term pain and improved function in both the short and long term. It also enhanced gait performance and quality of life over short and mid-term periods.
Other exercise forms showed value too. Mind-body workouts likely provided a notable improvement in short-term function, neuromotor exercises likely boosted short-term gait performance, and strengthening or mixed routines improved function in the mid-term.
Safe and Effective for Long-Term Use
Importantly, none of the exercise types resulted in more adverse events than the control groups, indicating that these therapies are generally safe.
The authors did acknowledge some study limitations. Many results came from indirect comparisons, certain outcomes lacked long-term data, and smaller studies may have influenced some early findings.
Clear Takeaway for Patients and CliniciansDespite these limitations, the researchers describe their work as one of the most complete and current evaluations of exercise for managing knee osteoarthritis. They believe the findings will help clinicians make more targeted recommendations.
Based on the evidence, the team advises aerobic exercise “as a first line intervention for knee osteoarthritis management, particularly when the aim is to improve functional capacity and reduce pain” and say if aerobic exercise is not possible owing to individual limitations, “alternative forms of structured physical activity may still be beneficial.”

2 hours agoShareSaveDivya Talwar andNatalie TruswellBBC News InvestigationsShareSaveFamily handout/PA WireAn independent inquiry into “repeated failures” at an NHS trust’s maternity units has been announced by Health Secretary Wes Streeting, following potentially avoidable harm to babies and mothers.Earlier this year a BBC investigation revealed that the deaths of at least 56 babies and two mothers at Leeds Teaching Hospitals NHS Trust (LTH) over the past five years may have been prevented.Streeting said a thorough investigation was required to understand what had “gone so catastrophically wrong” at the trust’s maternity units at Leeds General Infirmary and St James’s University Hospital.In a statement, the trust told the BBC it was already “taking significant steps to address improvements”.MARTIN MCQUADE / BBCThe BBC has now spoken to more than 70 families who have described traumatic care, with some cases going back more than 15 years.They include Fiona Winser-Ramm and Dan Ramm whose daughter, Aliona, died in January 2020 at Leeds General Infirmary. An inquest found “a number of gross failures” that “directly contributed” to her death.Four years later, Amarjit Kaur and Mandip Singh Matharoo’s daughter Asees was stillborn at the same hospital.Both couples were among a group of bereaved Leeds families who wrote to Streeting requesting an independent inquiry following the BBC’s initial coverage.They later shared their experiences with him in person before the inquiry was announced.MARTIN MCQUADE / BBC”We know we are not alone, and that there’s other families that have experienced what we have,” said Amarjit.Fiona added that “we can’t quite believe it yet”.”I think the scale of this inquiry will be enormous. There are so many people who don’t even know they are victims yet and it is going to snowball at an alarming pace,” she added.Streeting said he was “shocked” by the bereaved families’ stories and the “repeated maternity failures” that were “made worse by the unacceptable response of the trust”.”I do think there is an exceptional case in Leeds to have a Nottingham-style independent inquiry into the failures,” he said.Nottingham University Hospitals Trust is at the centre of a public inquiry that will examine 2,500 cases of maternity failings on a national level.Streeting said he hoped the Leeds inquiry would help the families to learn the truth about what went wrong in their care.PAThe Department of Health has not yet revealed the inquiry’s terms of reference or details of who will lead it.Bereaved families want Donna Ockenden – the senior midwife who led the review into maternity failings at Shrewsbury and Telford and is currently leading the Nottingham review – to also chair the Leeds inquiry.They said Ms Ockenden had the trust of families and proven experience in uncovering systemic failings in maternity care.The BBC has previously spoken to whistleblowers who said the previous rating of “good” for LTH maternity services did not reflect the reality.The body responsible for inspecting NHS hospitals, the Care Quality Commission (CQC) downgraded both of the trust’s maternity units to “inadequate” in June, after unannounced inspections raised concerns that women and babies were “at risk of avoidable harm”.Inspectors also highlighted a “blame culture” at the trust, which resulted in staff being reluctant to raise concerns and incidents.PA MediaThe Leeds units are also currently part of a rapid national review into maternity and neonatal services across England, which was launched in June and is being led by Baroness Valerie Amos.Brendan Brown, chief executive of LTH NHS Trust, apologised to bereaved families and said he hoped the inquiry would provide them with “answers”.He said: “We are determined to do better. We want to work with the families who have used our services to understand their experiences so that we can make real and lasting improvements.”I would also like to reassure families in Leeds who will be using our services currently, that we are already taking significant steps to address improvements to our maternity and neonatal services, following reviews by the Care Quality Commission and NHS England.”Families say serious questions now need answering about what Sir Julian Hartley, the man in charge of the trust for ten years until 2023, knew about poor maternity care. He’s now in charge of the health care regulator in England, the Care Quality Commission.In a statement, Sir Julian told the BBC that while he was Chief Executive of Leeds Trust, he was “absolutely committed to ensuring good patient care across all services, including maternity, but clearly this commitment wasn’t enough to prevent some families suffering pain and loss”.He said he was “truly sorry” for this.Lauren Caufield whose daughter, Grace Kilburn, died in 2022, and also met Streeting said:”It is completely unacceptable that nothing has been done to date to look into the situation with Sir Julian Hartley. We hope the inquiry will do that.”Do you have more information about this story?You can reach Divya directly and securely through encrypted messaging app Signal on: +44 7961 390 325, by email at divya.talwar@bbc.co.uk or her Instagram account.More on this story

Researchers at the University of California San Diego School of Medicine, working with the genetic testing company 23andMe, have pinpointed regions of the human genome linked to cannabis use. Their discoveries reveal new genetic connections to psychiatric, cognitive, and physical health, offering insights that could eventually guide prevention and treatment strategies for cannabis use disorder. The findings were published on October 13, 2025, in Molecular Psychiatry.
“Cannabis is widely used, but its long-term effects on health remain poorly characterized,” said Sandra Sanchez-Roige, Ph.D., associate professor of psychiatry at UC San Diego School of Medicine and senior author of the study. The researchers were also interested in the relationship between genetics and traits that contribute to the development of cannabis use disorder, which can interfere with a person’s daily life.
“While most people who try cannabis do not go on to develop cannabis use disorder, some studies estimate that nearly 30% will,” said Sanchez-Roige. “Understanding the genetics of early-stage behaviors may help clarify who is at greater risk, opening the door to prevention and intervention strategies.”
To explore these connections, the researchers performed a genome-wide association study (GWAS) using genetic data from 131,895 23andMe research participants. Participants completed surveys about whether they had ever used cannabis, and those who had were asked about their frequency of use.
“We’ve known for decades that genetic factors influence whether or not people will try drugs, how frequently they use those drugs, and the risk that they will become addicted to them,” said Abraham A. Palmer, Ph.D., professor and vice chair for basic research in the department of psychiatry at UC San Diego School of Medicine and co-author of the study. “Genetic tools like GWAS help us identify the molecular systems that connect cannabis use to brain function and behavior.”
The study identified two genes significantly associated with lifetime cannabis use. The first, Cell Adhesion Molecule 2 (CADM2), plays a role in how nerve cells form connections and communicate in the brain. Earlier research has tied CADM2 to traits such as impulsivity, obesity, and cancer metastasis. This same gene was also linked to how often people use cannabis.
The second gene, Metabotropic Glutamate Receptor 3 (GRM3), influences how neurons communicate and how the brain adapts over time. GRM3 has previously been connected to psychiatric disorders including schizophrenia and bipolar disorder.

“We showed that the genetics of cannabis use — both trying it and using it more often — are tied to the genetics of other psychiatric traits, cognitive measures, and even physical health problems,” said Sanchez-Roige.
A secondary analysis revealed an additional 40 genes associated with lifetime cannabis use and four genes associated with frequency of cannabis use. Twenty-nine of these genes had not previously been associated with cannabis-related traits.
The researchers then analyzed which health conditions were correlated with a genetic predisposition for cannabis use. They analyzed thousands of traits in two large independent datasets from the National Institutes of Health’s (NIH) All of Us Research Program and Vanderbilt University Medical Center’s biobank.
Across the genome, lifetime cannabis use and frequency of cannabis use were genetically correlated with more than 100 different traits including psychiatric conditions (e.g., schizophrenia, ADHD, anxiety and depression), cognitive traits (e.g., executive function and risk-taking) and physical health (e.g., diabetes, chronic pain and coronary artery disease). They were also associated with an increased risk for tobacco use, infectious diseases including HIV and viral hepatitis, and autoimmune diseases.
The study is one of the first genome-wide association studies to examine behaviors that precede cannabis use disorder.
“Cannabis use exists on a continuum,” said first author Hayley Thorpe, Ph.D., a visiting scholar in Sanchez-Roige’s lab and postdoctoral researcher at Western University. “By studying these intermediate traits, we can begin to map how genetic risk unfolds before cannabis use disorder develops.”
There are currently no FDA-approved drug therapies to treat cannabis use disorder. The authors hope that the biological discoveries generated by GWAS will support future efforts to identify therapeutic targets and preventative interventions against the disorder.

Additional co-authors on the study include: John J. Meredith, Mariela V. Jennings, Renata B. Cupertino, Shreya Pakala, UC San Diego; Pierre Fontanillas, Sarah L. Elson and the 23andMe Research Team at 23andMe, Inc.; Jibran Y. Khokhar, Western University; Emma C. Johnson, Washington University in St. Louis; and Lea K. Davis, Vanderbilt University Medical Center.
The study was funded, in part, by the National Institutes of Institute on Drug Abuse (grants R01 DA050721, P50DA037844 and P30DA060810) at the NIH, and the Tobacco-Related Disease Research Program (grant T32IR5226).
The 23andMe Research participants provided informed consent and volunteered to participate in the research online, under a protocol approved by the Association for Accreditation of Human Research Protection Programs, Inc. (AAHRPP)-accredited Salus IRB.

A mother from Oxfordshire is warning of the dangers of drugs packaged to look like sweets after her son ate an entire bag of cannabis gummies.The 17 year-old took the illegal drugs, branded to look like Starburst sweets, in his bedroom and had to be rushed to hospital after developing chest pains.Researchers studying similar drugs have said some even contain the synthetic drug spice, rather than cannabis.Thames Valley Police said it recognised “the concern these gummies pose, particularly due to their appeal to younger individuals”.The woman, who has asked not be named, said her son had never tried cannabis edibles before.She said he took one and, when nothing happened, finished the whole pack of six – not realising they can take more than an hour to take effect.Professor Chris Pudney, from the University of Bath, who works with police forces to test cannabis edibles, said it was likely he had consumed a “massive dose”.The pack suggested each sweet contained 68mg of THC – the main psychoactive constituent of cannabis. Prof Pudney suggested that would be an “incredibly high” dosage “and for some people would probably be quite risky”.”Every time you use one of these products you really don’t have a great idea of the dosage of THC you’re getting,” he said.”And in some cases we even found it’s not THC at all – it’s actually a synthetic drug that we normally find in prisons called spice.”Professor of psychology at the University of Bath, Tom Freeman carried out the UK’s largest survey into cannabis.He said it was not know how prevalent illegal cannabis edibles were in the UK, but based on current seizure data it was expected to be “an increasing trend”.Prof Freeman said manufacturers were using sweet brands on their packaging because “the youth of today are a big, lucrative market for commodities such as cannabis, nicotine and alcohol”.”For cannabis the typical age of prevalence is around 15 to 16,” he said. “We then see an escalation into the late teens and early 20s.”A spokesperson for Thames Valley Police added: “We would ask people to be aware and report any concerns that they may have.”

4 hours agoShareSaveGill DummiganNorth WestShareSaveBBCA growing number of young people are choosing to study in Eastern Europe due to a strict cap on medical school places in the UK.Freya Mandapalli from Preston is one of them.The 19-year-old has healthcare in her blood. Her parents both work at the local hospital and her older sister studied medicine at Edinburgh and now works as a doctor.”I just got inspired by her really,” Freya said.But getting into a medical school in the UK generally requires a minimum of three As at A-level and high grades in other subjects and Freya struggled to get them.Although she got interviews, she didn’t receive any offers. She considered a gap year but then a family friend mentioned the possibility of studying in Plovdiv, in Southern Bulgaria.”I was really nervous to start with, but the city’s beautiful and I’ve found some great friends,” added Freya, who has just started her second year of a medical degree.In England around 8,126 medical students started this academic year, just over a thousand of them in the North West. This is sharply up from two years ago when it was just 7,010 but still far short of the 15,000 the government says it needs for England by 2031 to meet demand.But with the cap on medical school places, it means competition to get one is intense, and many students are voting with their feet.’Word of mouth’Mohammed Adnaan Patel from Bolton has just started his fifth year at the same university in Plovdiv. He too found the course through word of mouth.”One of my friends told me that his brother already studies within Bulgaria and he was planning on going himself,” he said.”My mother was very worried, my father wanted me to stay strong and be independent, but the rest of my family didn’t know what to expect. But those worries gradually subsided.”The Medical University of Plovdiv is one of Bulgaria’s most prestigious medical schools and attracts many more applicants than it admits. Although it does ask for academic qualifications, a large part of the admissions process hangs on an entrance exam.Veselina Goranova, vice rector for Education, says their students’ home countries include Greece, Turkey, Italy, Germany, Canada, the US – but added the biggest group by far, “about 40% come from the UK”.That may be in part because classes for international students are held in English but also because a well-established network of agencies now exist to help those hoping to make the leap.Dr Muhammad Hamza from Blackburn graduated from Plovdiv last year and is currently back there helping to settle new students. He works with MedConnect Europe Ltd, an agency headquartered in London but with offices around Eastern Europe.He says the agency helps new students navigate the complications of a new life abroad like finding a flat, dealing with paperwork, and sorting out life’s essentials.”We get them in touch with the estate agents, we book the flights for them. Our representatives will be there at the airport to collect them, take them to the hotels,” he said.Strict timetable”We help them with shopping – buying bedding, cutlery..wifi, mobile sims, setting them up. Because they don’t know the language and we have representatives in each country which do know the language it becomes so much easier,” he added.Dr Hamza spends most of his time working as a private dentist in Chorley, where he spends a year with a mentor. The firm, he says, came out to Plovdiv to recruit dentists there.”It’s probably because of the vast practical experience we get in Bulgaria,” he said, adding that the Bulgarian system requires students to complete large numbers of relatively complex procedures.”So going and starting as a dentist in the UK, I already had somewhat of a solid foundation.”New students need to get used to a strict timetable which often begins at 7.30am and may not finish until 6pm. They also need to study Bulgarian so they can talk to the patients they will be treating in the last three years of their course.Bulgarian, like Russian, uses the Cyrillic alphabet, and a complex grammar structure. Milena Muleshkova is one of those tasked with getting the students up to scratch. She says that first year is about everyday communication, while the second-year concentrates on medical terms.Medical courses in Bulgaria last six years, one year longer than in the UK but common in mainland Europe. At the end of it, successful students have a degree which is recognised by the General Medical Council in England, and which allows them to practice in the NHS without any further tests.Watch BBC World Service documentary : Why are medical students going to Bulgaria?This may change though in 2028 when Britain next looks at its agreements with the EU. And another potential change is particularly worrying some students.The NHS has become increasingly reliant on attracting healthcare staff from overseas to meet increasing patient demand. In 2023 68% of doctors joining the NHS were international medical graduates (IMGs) and the number has been rising year on year.Currently the NHS treats applicants from overseas and the UK in the same way for jobs and training opportunities. This has become an increasingly contentious issue for resident (formerly known as junior) doctors in England who say many at the beginning of their career are being denied the opportunity to progress.Earlier this month they voted to strike over the shortage of speciality training places.But the doctors’ union the British Medical Association wants UK graduates to be prioritised for those training posts. Health Secretary Wes Streeting says he agrees. But this could mean British students studying abroad would also be looked at less favourably because they would also be classed as IMGs.’It’s quite scary’Mohammed Adnaan Patel said he did have sympathy with much of the argument but not all.He said: “It’s quite a topic of frequent discussion as the years go on as we get closer to that stage,””It is quite scary. It does raise a lot of anxiety within the students and myself.”But the NHS also has difficulty keeping hold of medical staff. Last year in the North West of England one in ten left – although that was actually better than the year before. Some will have left the profession altogether but some will have been tempted away by similar jobs in Canada, Australia, and the gulf states, who also run international recruitment campaigns.As the global population ages and healthcare needs increase, the international fight to attract trained medical staff, wherever they come from, is likely to intensify.Dr Muhammad Hamza from MedConnect Europe says he doesn’t see the demand for European students slowing any time soon.He said: “I see it growing because the demand for doctors and dentists, not only in the UK is a lot but all over the world””I don’t see it slowing down. It’s going to expand further and further.”

Iron-deficiency anemia is a widespread health problem that often leads to fatigue, headaches, or even cravings for ice. Traditional oral iron supplements can help, but they often leave behind unabsorbed iron that irritates the digestive tract and triggers inflammation. Researchers reporting in ACS Applied Materials & Interfaces have developed a new type of supplement that blends iron with prebiotics and probiotics. In animal studies, this innovative formula successfully restored healthy blood iron levels in anemic mice while preventing inflammation and keeping the gut microbiome balanced.
“By advancing biomaterial-based iron delivery, this research offers a transformative approach to address anemia, directly contributing to improved nutrition and long-term public health,” explains Poonam Sagar, an author of the study.
Anemia develops when the body lacks enough red blood cells to transport oxygen efficiently. It can result from infections, inherited conditions, or, most commonly, a shortage of dietary iron. Doctors typically prescribe oral iron tablets to treat the condition. However, the body absorbs only a small fraction of the iron they contain. The remaining iron can upset the balance of gut bacteria and cause inflammation, which is why probiotics are sometimes prescribed alongside iron to protect digestive health.
In earlier research, scientists had already tried combining iron with probiotics. Sagar, Nitin Kumar Singhal, and their team expanded on this concept by adding prebiotics (nutrients that feed beneficial bacteria) to create a three-part supplement designed to be more effective and gentler on the gut.
The new formulation combines dietary fiber extracted from millet (a grain), the probiotic Lactobacillus rhamnosus, and an iron-containing complex. The researchers first tested the supplement’s compatibility with human cells, then evaluated its effects in mice with iron-deficiency anemia. After two weeks, the treated mice showed: Restored hemoglobin levels (the main iron-rich molecule in red blood cells). Iron excretion levels similar to healthy control mice, showing improved absorption. Increased activity of genes involved in iron transport and metabolism. Very low signs of inflammation in the colon. A recovery of beneficial gut bacteria populations that had been depleted by anemia.While more research is needed, the team believes this approach could lead to a new generation of iron supplements that restore iron safely, improve gut health, and reduce unwanted side effects.
The study received support from the Ministry of Science and Technology of India and the National Agri-Food Biotechnology Institute.

Genetic mutations that can cause disease become increasingly common in sperm as men grow older, and new evidence suggests this happens because certain DNA changes are actually favored during sperm production, according to new research.
In a major study published on October 8 in Nature, scientists from the Wellcome Sanger Institute and the TwinsUK study at King’s College London mapped how harmful DNA mutations accumulate across the entire sperm genome as men age.
The results open new avenues for studying how environmental and lifestyle factors might influence the genetic health of future generations.
In tissues that constantly renew, mutations (changes in DNA) can give some cells an advantage, allowing them to multiply faster than others. These groups of identical “clonal” cells then expand, eventually outnumbering their neighbors. While most mutations in the body’s ordinary cells (such as those in organs, connective tissue, and bone) are not passed to children, mutations in sperm and egg cells can be inherited. Until recently, however, scientists lacked the precise tools to measure how strongly certain mutations are favored in sperm.
To overcome this, the team used NanoSeq1, a highly accurate DNA sequencing technology, to analyze sperm from 81 healthy men aged 24 to 75.2,3 The samples came from the TwinsUK cohort, the UK’s largest adult twin registry, which provided a well-documented and diverse population for comparison.
The data revealed that about 2 percent of sperm from men in their early 30s carried disease-causing mutations. This proportion increased to 3-5 percent in men aged 43 to 74. Among 70-year-old participants, 4.5 percent of sperm contained harmful mutations, showing a clear link between age and genetic risk to offspring.
The increase is not caused solely by random DNA errors accumulating over time. Instead, a subtle form of natural selection within the testes appears to give certain mutations a reproductive advantage, allowing them to become more common during sperm formation.

Researchers pinpointed 40 genes that seem to benefit from this process, many of which are tied to serious neurodevelopmental disorders in children and inherited cancer risks. While 13 of these genes were previously known to be involved, the new study shows the phenomenon affects many more genes linked to cell growth and development than scientists once realized.
Although the number of sperm carrying harmful mutations rises with age, not every one of these mutations leads to conception or a healthy pregnancy. Some may prevent fertilization or normal embryo development, while others could cause miscarriage. More studies are needed to determine how the growing number of sperm mutations affects children’s health outcomes.
By revealing how mutations arise and are shaped by selection within sperm, the researchers hope to refine reproductive risk assessments and better understand how genetics, lifestyle, and environment interact across generations.
In a complementary study, also published in Nature,4 scientists from Harvard Medical School and the Sanger Institute investigated the same phenomenon from a different angle by looking at mutations already passed on to children, rather than those measured directly in sperm. By analyzing DNA from over 54,000 parent-child trios and 800,000 healthy individuals, the team identified more than 30 genes where mutations give sperm cells a competitive edge, again including many linked to rare developmental disorders and cancer, and many overlapping the set of genes observed directly in sperm. The study found that these mutations can increase sperm mutation rates roughly 500-fold which helps explain why some rare genetic disorders appear when parents do not carry the mutations in their own DNA. Interestingly, the study notes that as these mutations are common in the sperm, it may look like some genes cause false-positive disease association due to the elevated mutation rate rather than a true disease link. The work highlights how natural selection within sperm can be directly observed in the DNA of children, influencing their chances of inheriting certain genetic disorders.
Dr. Matthew Neville, first author from the Wellcome Sanger Institute, said: “We expected to find some evidence of selection shaping mutations in sperm. What surprised us was just how much it drives up the number of sperm carrying mutations linked to serious diseases.”
Professor Matt Hurles, Director of the Wellcome Sanger Institute and co-author, said: “Our findings reveal a hidden genetic risk that increases with paternal age. Some changes in DNA not only survive but thrive within the testes, meaning that fathers who conceive later in life may unknowingly have a higher risk of passing on a harmful mutation to their children.”
Professor Kerrin Small, co-author and Scientific Director of the TwinsUK study at King’s College London, said: “We are incredibly grateful to the twins who took part in this study. By working with the TwinsUK cohort, we could include valuable longitudinal samples linked to rich health and genetic information, allowing us to explore how mutations accumulate and evolve with age in healthy individuals. This collaboration highlights the power of large, population-based cohorts for advancing our understanding of human development and inheritance.”

Dr. Raheleh Rahbari, senior author and Group Leader at the Wellcome Sanger Institute, said: “There’s a common assumption that because the germline has a low mutation rate, it is well protected. But in reality, the male germline is a dynamic environment where natural selection can favour harmful mutations, sometimes with consequences for the next generation.”
This research is part-funded by Wellcome. A full list of funders can be found in the acknowledgements in the publication.
Notes Launched in 2021 by the Wellcome Sanger Institute, nanorate sequencing (NanoSeq), is a method that makes it possible to study how genetic changes occur in human tissue whilst maintaining high accuracy. The method reduces error rates to less than five errors per billion calls which is much lower than typical somatic mutation rates. Blood samples were taken to ensure that mutations studied in sperm were only in sperm cells. The researchers split the data into age groups: 26-42 years (younger men), 43-58 years (middle-aged), and 59-74 years (older men). Sunyaev, S. et al. (2025) ‘Hotspots of human mutation point to clonal expansions in spermatogonia’. Nature. DOI: 10.1038/s41586-025-09579-7 In a complementary study (Lawson, A. et al) researchers at the Sanger Institute have reported using targeted NanoSeq to uncover hidden mutations that occur naturally in bodies, providing insight into the earliest steps of cancer development and the role of mutations in different diseases. This team also collaborated with the TwinsUK study at King’s College London. They applied targeted NanoSeq to cheek and blood samples from more than 1,000 volunteers to uncover a rich landscape of mutations in healthy tissues, which can be applied to future research into aging and diseases. Targeted NanoSeq is the same tool used in the above study. DOI: 10.1038/s41586-025-09584-w