Publisher Health

You may not realise it, but “nudge” has been used by businesses, policy-makers and governments for years to prod the public into making different choices. Small changes in our environment can “nudge” us into different behaviours without restricting the options available to us. For example, printing the low-calorie options in bold on a menu, or showing the calorie information, might change what we choose to eat. But does the public support this? And how do subtleties in how ‘nudge’ interventions are designed affect support, if at all? Research led by the Universities of Göttingen and Bonn set out to examine public support for nudge scenarios with different design variations, each aimed at promoting healthy and/or sustainable food choices. The researchers showed there were two promising ways to improve public support for nudging strategies: reducing the effort people must expend to avoid the nudged option they would usually want to follow; and improving the transparency of the nudge. The results were published in BMC Public Health.
People can be nudged to make a certain choice by making it the default option. For instance, rather than offering butter automatically at a restaurant by default, restaurants could make it so that butter is only available upon active request. This type of nudge — known as a “default nudge” — can be effective, but it can be unpopular relative to other nudging strategies. Researchers set out to analyse consumer reaction by conducting an online survey on a sample (N = 451) of German adults, who were presented with five nudge scenarios and prompted to rate their support for each. Participants were also asked in each scenario to indicate what their typical behaviour would be (i.e., would you usually eat butter in a restaurant), the extent to which they perceived the nudge to intrude upon their freedom of choice, and how effective they believed the nudge would be. Participants then answered the same questions for a variation of each nudge scenario in which one aspect of the design was changed, allowing the researchers to pinpoint how these design variations affected public support.
The researchers discovered that some designs were more promising than others for improving public support. For instance, reducing the effort needed to opt out of the nudged option — such as by presenting vegetarian dishes on the first pages of a menu followed by meat dishes, rather than providing only a vegetarian menu on the table with a menu with meat options available on request — increased support. Similarly, increasing the transparency of the nudge itself, such as by asking participants whether they preferred a pre-filled ‘climate friendly’ online grocery cart rather than simply offering it by default, increased support. With regard to predicting the level of support, the perception that nudges intruded upon free choice was the most important driver of non-acceptance, whereas the perception of effectiveness was the most salient driver of acceptance.
“Understanding public support — and its drivers — is important for designing politically viable, ethical, and effective nudges,” says first author Simone Wahnschafft at Göttingen University’s Sustainable Food Systems research group. “We were surprised to find that the personal circumstances of our participants and whether their own behaviour would be affected by the nudge had little effect on their support. We found that the perception of upholding free choice and of effectiveness were key to public support.” This study opens up avenues for future research into how ‘sweet spots’ can be found for default nudges that are both effective and widely supported.
This research was made possible thanks to funding from the German Research Foundation (DFG).

Published2 hours agoShareclose panelShare pageCopy linkAbout sharingImage source, Hayley BeanBy Catherine SnowdonBBC NewsI have always been proud of donating blood. I have a relatively rare blood type (B-) and recently found out my blood is even more precious to the NHS, because it can be given to newborn babies.At my last donation session, the donor carer who was about to put the needle in my arm asked: “It must feel great being a Neo?” My baffled face prompted her to show me the bright blue tag that was waiting in the bowl to receive my bag of blood. Neo was written in large font on it. “Your blood is special, it’s going to help the tiniest of patients,” she explained.Neo stands for neonatal, which is the term used to describe a baby in the first 28 days of life.Image source, NHSBTAs my blood was collected I had a speed lesson about how blood is tested after donation. It turns out some patients – including infants – need specific blood. I wanted to learn more so I spoke to Dr Andy Charlton, a consultant in haematology and transfusion medicine at NHS Blood and Transplant.He explained that all donated blood is screened for HIV, hepatitis B, C, and E, as well as syphilis. Once that has been done, further tests and processes are carried out on some samples to ensure they are suitable for patients who have specific requirements. For instance, some people need blood that has been “washed” to remove proteins they have previously had allergic reactions to during transfusions. Common virusBlood that is destined for new babies, immunocompromised patients, pregnant women or to be transfused into a foetus in-uterine must be screened for a virus called cytomegalovirus or CMV. Part of the herpes virus family, it is very common and usually harmless, causing mild flu-like symptoms or none at all. But for some people it can be serious. In babies it can cause seizures, sight and hearing problems as well as damage to the liver and spleen. In rare cases it can be deadly.Estimates vary but it is thought that between 50 and 80% of adults in the UK have had CMV. As only about 2% of the eligible population in England currently give blood, finding enough donors who have not been exposed to the virus is crucial for supplies.The blood I donated the previous time was tested and came back clear of antibodies for CMV, meaning I had not been exposed and received the special tag. My blood will be tested for the virus every time I donate, to ensure I have not caught it in the interim.Immunity to the virus lives forever in white blood cells so if I ever catch it, my blood can no longer be given to these vulnerable patients.I am one of only 10,916 active donors in England who has CMV-free, B- blood. Over the last year 153,801 units of CMV negative blood products were requested by hospitals.Dr Charlton says demand for “specialised blood components” is increasing and urges people to come forward to donate.”We can’t thank our donors enough,” he says. “Every donation of blood is a gift of life and can save more than one person.” LifesaverNo-one understands the importance of blood donation better than Hayley Bean. Her daughter Willow’s life was saved soon after birth by a transfusion of CMV-free blood.Image source, Hayley BeanDuring pregnancy, Hayley was diagnosed with vasa previa, a dangerous condition in which the blood vessels from the placenta or umbilical cord block the birth canal.The vessels are at risk of rupture at any time and, because they obstruct the baby’s passage out of the uterus, natural birth is impossible. Hayley was admitted to hospital at 32 weeks for monitoring, and a Caesarean section was planned for 35 weeks.During the operation, Willow’s blood vessels burst, causing life-threatening bleeding.Image source, Hayley Bean”All the alarms were going off and people were running around,” recalls Hayley.”They got Willow out and I waited to hear that first cry. It was the worst moment of my life. She wasn’t breathing and had gone into shock. The neonatal team had to resuscitate her. After about 10 minutes I remember finally hearing a tiny cry.” Willow was taken to intensive care after a nurse quickly took a picture to show Hayley.”All I remember was how pale and swollen she looked,” she says.Hayley finally held Willow for the first time 12 hours after she was born.Image source, Heyley BeanWillow is now a thriving four-year-old, and Hayley is eternally grateful for the treatment her daughter received.”She was in intensive care for five days but there was no permanent damage, thanks to her getting that blood transfusion,” says Hayley.”She wouldn’t be here today except for the kindness of a stranger. Someone, somewhere made the choice to give blood, and it’s thanks to them that Willow is here today.”A few days after my first Neo donation, the text I had been waiting for came through. It told me which hospital my blood had been issued to. I smiled and wished the little one well.More on this storyGen Z and millennials encouraged to donate bloodPublished17 January’It’s my duty to give blood as often as I can’Published30 December 2023

Published20 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy Aurelia FosterHealth reporterNearly 1,000 people with advanced Parkinson’s disease are to benefit from a new treatment that involves wearing a portable kit 24 hours day.NHS England is to roll out the treatment, Produodopa, which uses a pump to steadily release medicine into the bloodstream round the clock.Many people currently need to take more than 20 pills a day to control their symptoms – with an inconsistent effect.Others have to be treated through a permanent feeding tube. Produodopa is a combination of two drugs – foslevodopa and foscarbidopa. It works by turning foslevodopa into the chemical dopamine, which helps transmit messages between the parts of the brain and nerves that control movement.That helps manage Parkinson’s symptoms, such as excessive movement or tremors.The infusion enters the patient’s bloodstream through a cannula under the skin and is controlled by a small, automatic pump, releasing a steady flow of the treatment 24 hours a day to stay on top of symptoms. It also has the option of a manual boost if needed.Many patients currently taking a large number of tablets to control their symptoms say they worsen later in the day and during the night.Parkinson’s implant restores man’s ability to walkTai Chi may slow Parkinson’s symptoms by years – studyCould Parkinson’s could be detected early with AI scans?James Palmer, NHS England’s medical director for specialised services, said the drug’s rollout was “great news”.”This important therapy will now offer a vital new option on the NHS for those who aren’t suitable for other treatments such as deep brain stimulation,” he said. “We hope it will help nearly 1,000 patients to manage their symptoms more effectively and go about their day with a better quality of life.”The drug has recently been approved for NHS use by the National Institute for Health and Care Excellence, after successful clinical trials.Image source, NHS EnglandJohn Whipps, 70, took part in the research and says his life is much more “plan-able” now that he is on the new treatment.”Before this, I was on nearly 20 tablets a day just for my Parkinson’s symptom control, and then all the other tablets on top of that,” he said.”And I would frequently wake in the middle of the night with internal tremors and take more tablets, but this pump just keeps running through the night.”I couldn’t plan to do anything, as you don’t know if you’re going to have an off day and need to stay at home.”Another participant in the trial, Phil, 52, from Cornwall, said he previously had to take 25 tablets daily and his symptoms fluctuated through the day, becoming worse at night.”At night, I was normally not able to turn over in bed, or get up for the toilet, and if I did manage it, I was at risk of falls,” he said.”Whilst wearing the pump, it delivered the drug whilst I was sleeping, enabling me to turn over at night, and get up for the toilet which made a huge difference at night.”It is hoped the new treatment will also some benefit patients who currently receive drugs through a permanently placed feeding tube into the gut.Parkinson’s disease, a condition in which parts of the brain become progressively damaged over many years, affects around 128,000 people in England, according the NHS.Parkinson’s UK describe it as “the fastest growing neurological condition in the world”.Laura Cockram, from the charity, said Produodopa could be a “life-changing option” for some people.”It won’t be suitable for everybody though, and people with Parkinson’s should speak to their consultant or Parkinson’s nurse to see whether it’s an option for them,” she added. More on this storyPesticide maker used ‘weak’ data on Parkinson’sPublished3 days agoParkinson’s implant restores man’s ability to walkPublished6 November 2023Tai chi may slow Parkinson’s symptoms, study findsPublished25 October 2023AI scans could detect Parkinson’s, scientists sayPublished22 August 2023Blood test spots Parkinson’s risk before symptomsPublished7 December 2023’There is life after Parkinson’s diagnosis’Published8 December 2023Related Internet LinksHomepage – Parkinson’s UKNHS EnglandNICE – The National Institute for Health and Care ExcellenceThe BBC is not responsible for the content of external sites.

The efficiency of oxygen supply to tissues is a factor in the severity of important diseases such as Covid-19 and heart conditions.
Scientists already know that the relationship between the length of a person’s index and ring fingers, known as the 2D:4D ratio is correlated with performance in distance running, age at heart attack and severity of Covid-19.
Now Swansea University digit ratio expert Professor John Manning has been working with colleagues to look more closely at the subject.
Their findings have just been published by the American Journal of Human Biology.
The research analysed 133 professional football players as they underwent a series of body measurements which included measuring digit lengths from hand scans. They also completed an incremental cardiopulmonary test to exhaustion on a treadmill.
Professor Manning, of the Applied Sports, Technology, Exercise and Medicine (A-STEM) research team, said: “With our partners from the Cyprus campus of the University of Central Lancashire, we have clarified the relationship between 2D:4D and oxygen metabolism in a sample of well-trained athletes.
“The players with long ring digits (4D) relative to their index digits (2D) have efficient oxygen metabolism such that they reach very high maximal oxygen consumption in an incremental cardiopulmonary test to exhaustion on a treadmill.”
Long ring digits relative to index digits are thought to be a marker of high testosterone levels in the womb. Testosterone has effects on oxygen metabolism through its influence on the energy producers (mitochondria) within cells.

He added: “Our findings are consistent with those from distance running, where long 4D is related to high performance, and heart disease and Covid-19 where long 4D is linked to low severity of disease.
“Overall, our study illustrates the value of using healthy well-trained athletes to clarify metabolic processes that are important in disease outcomes.”
The team say further work is now necessary to quantify these associations in women.
Professor Manning’s previous research has examined how the difference in finger length between a person’s left and right hand may provide vital information concerning outcomes from contracting Covid-19.

A new study published in Atmospheric Environment by researchers at the University of North Carolina at Chapel Hill analyzed space and time trends for fine particulate matter (PM2.5) in the continental United States to track the progress of regulatory actions by federal, state and local authorities aimed at curbing air pollution. The team found that while the annual average concentration for PM2.5 had been significantly reduced, its chemical composition had changed during the study period of 2006 to 2020. Their analysis suggests targeted strategies to reduce specific pollutants for different regions of the U.S. may be more effective in further reducing total air pollution and PM2.5 -related adverse health effects. PM2.5, an airborne pollutant, is a mix of multiple chemical species and includes fine particles less than 2.5 microns in size. PM2.5 has been linked to many adverse human health effects including premature death. It also can reduce visibility by creating haze in the air.
“The results from this study are especially timely given the EPA’s revision of the health-based standard for PM2.5 from 12 µg/m3 to 9 µg/m3 that was just announced this month,” said Saravanan Arunachalam, senior author of the study and deputy director of the UNC Institute for the Environment. “States with monitors that are exceeding the new standard for PM2.5 will be looking to understand the chemical constituents of PM2.5, and how they have changed over time, and this will be key to developing emissions reductions policies to address potential future nonattainment designations.”
Using data from the U.S. EPA Air Quality System (AQS), the research team assessed trends across the 48 contiguous U.S. states. Chemicals found in PM2.5 in the U.S. include sulfate, ammonium, nitrate, organic carbon, elemental carbon and other trace elements, which come from a variety of human-created and natural sources.
The biggest air quality improvements during this 15-year period that was analyzed were observed in areas with the worst baseline air quality. The Ohio Valley and southeastern states, for example, had the biggest improvements due to regulations on emissions sources such as coal-burning power plants and industry. Sulfur dioxide emissions, a byproduct of fossil fuel combustion, decreased 91.5% from power plants during the study period. Most of the sulfur dioxide emissions in the study came from the Ohio Valley and the southeastern U.S. A spike in poor air quality along the West Coast in 2020 was likely due to widespread forest fires.
Although across the U.S. sulfate and ammonium levels have declined, the researchers suggest looking at mitigating other sources of carbon in the environment to further improve air quality, given the increasing contribution of carbon to total PM2.5. High pollution days have waned in recent years, but primary organic carbon peaked during winter months due to the reduced formation rate of secondary organic aerosols at low temperatures.
These regional differences, the researchers point out, show that regionally targeted approaches to air pollution mitigation will further improve the country’s air quality and decrease healthcare expenses for air pollution-related health issues and further save human lives.
“Different chemical constituents of PM2.5 are linked to various emissions sources, thus, the development of future emissions control strategies to reduce PM2.5 concentrations should be based on the comprehensive analysis of spatiotemporal trends of PM2.5 chemical composition and deep understanding of the relationships between changes in emissions and ambient concentrations,” said Bin Cheng, a co-author and research associate at the Institute.
“The results from this study will also contribute to future epidemiological studies to identify specific PM2.5 components that affect human health more than others,” added Arunachalam.

Neuroscientists at Macquarie University in Australia have developed a single-dose genetic medicine that has been proven to halt the progression of both ALS and frontotemporal dementia (FTD) in mice — and may even offer the potential to reverse some of the effects of the fatal diseases.
It may also hold opportunities for treating more common forms of dementia, such as Alzheimer’s disease.
The new treatment, dubbed CTx1000, targets pathological build-ups of the protein TDP-43 in cells in the brain and spinal cord, which has been It has been associated with ALS, FTD and other forms of dementia.
The Macquarie University research team, led by Professor Lars Ittner, hopes to see CTx1000 begin human clinical trials in as little as two years.
Cells like neurons produce TDP‑43 naturally, and it is important for their healthy function. Under certain conditions, it accumulates in the wrong part of the cells, clogging them and preventing them from working properly.
For the past 15 years, a Macquarie University research team led by Professor Lars Ittner has been looking for the causes of this pathological build-up of TDP-43, along with ways to clear the blockages and prevent them from forming in the first place.
Professor Ittner says their research has furthered their understanding of MND and FTD and their causes. “We discovered for the first time that where there is pathological TDP-43, there is also an increase in a second protein, 14‑3‑3,” he says.

“The two proteins interact, resulting in these build-ups in the cells,” he says.
“From this, we were able to isolate a short peptide that controls this interaction, and that’s what we used to create CTx1000.
“When we administered it in the lab, it dissolved the build-ups, tagging TDP-43 proteins for recycling by the body, and prevented new ones from forming.
“Importantly, CTx1000 targets only pathological TDP-43, allowing the healthy version of the protein to be produced and go about its work unhindered.”
Professor Ittner says this makes CTx1000 incredibly safe, and they have seen no adverse effects in their studies.
Lead author of the paper, Professor Yazi Ke, says in lab conditions, CTx1000 stopped ALS and FTD from progressing even at very advanced stages, and resolved the behavioural symptoms associated with FTD.

“We have great hopes that when this progresses to human trials, it will not only stop people from dying from both ALS and FTD, but even allow patients to regaining some of the lost function through rehabilitation,” she says.
CTx1000 is one of the key discoveries being championed by Celosia Therapeutics, a Macquarie University spin-out company formed in 2022 to help bring the groundbreaking work of the University’s neuroscientists from the lab to patients.
Celosia Therapeutics is actively seeking investment to facilitate CTx1000 to progress to clinical trial stage.
About ALS and FTD
Also known as motor neuron disease (MND), ALS causes the progressive loss of the neurons that allow the brain and spine to communicate with the muscles.
In its early stages, patients experience muscle weakness, but as the disease progresses, they gradually lose the ability to walk, speak, swallow and breathe unaided. Most people with ALS die within two to five years of diagnosis.
While there is a genetic therapy showing promise for one form of familial ALS, there are few treatments available for the sporadic ALS that makes up 90 per cent of all cases.
Of those, the most effective can only extend a patient’s life by up to five months. All require frequent doses, and some come with side effects that are difficult to cope with.
FTD is one of the rarer forms of dementia, but it is the second-most common form in people younger than 65. Actor Bruce Willis was diagnosed with FTD in 2023.
It does not always have obvious physical symptoms, but it results in cognitive decline coupled with behavioural symptoms including anxiety, loss of inhibition, personality change, and impaired judgment. Patients may live for more than 10 years after diagnosis, but it is ultimately fatal.
There is currently no treatment for FTD.

A revolutionary nanomaterial with huge potential to tackle multiple global challenges could be developed further without acute risk to human health, research suggests.
Carefully controlled inhalation of a specific type of graphene — the world’s thinnest, super strong and super flexible material — has no short-term adverse effects on lung or cardiovascular function, the study shows.
The first controlled exposure clinical trial in people was carried out using thin, ultra-pure graphene oxide — a water-compatible form of the material.
Researchers say further work is needed to find out whether higher doses of this graphene oxide material or other forms of graphene would have a different effect.
The team is also keen to establish whether longer exposure to the material, which is thousands of times thinner than a human hair, would carry additional health risks.
There has been a surge of interest in developing graphene — a material first isolated by scientists in 2004 and which has been hailed as a ‘wonder’ material. Possible applications include electronics, phone screens, clothing, paints and water purification.
Graphene is actively being explored around the world to assist with targeted therapeutics against cancer and other health conditions, and also in the form of implantable devices and sensors. Before medical use, however, all nanomaterials need to be tested for any potential adverse effects.

Researchers from the Universities of Edinburgh and Manchester recruited 14 volunteers to take part in the study under carefully controlled exposure and clinical monitoring conditions.
The volunteers breathed the material through a face mask for two hours while cycling in a purpose-designed mobile exposure chamber brought to Edinburgh from the National Public Health Institute in the Netherlands.
Effects on lung function, blood pressure, blood clotting and inflammation in the blood were measured — before the exposure and at two-hour intervals. A few weeks later, the volunteers were asked to return to the clinic for repeated controlled exposures to a different size of graphene oxide, or clean air for comparison.
There were no adverse effects on lung function, blood pressure or the majority of other biological parameters looked at.
Researchers noticed a slight suggestion that inhalation of the material may influence the way the blood clots, but they stress this effect was very small.
Dr Mark Miller, of the University of Edinburgh’s Centre for Cardiovascular Science, said: “Nanomaterials such as graphene hold such great promise, but we must ensure they are manufactured in a way that is safe before they can be used more widely in our lives.

“Being able to explore the safety of this unique material in human volunteers is a huge step forward in our understanding of how graphene could affect the body. With careful design we can safely make the most of nanotechnology.”
Professor Kostas Kostarelos, of the University of Manchester and the Catalan Institute of Nanoscience and Nanotechnology (ICN2) in Barcelona, said: “This is the first-ever controlled study involving healthy people to demonstrate that very pure forms of graphene oxide — of a specific size distribution and surface character — can be further developed in a way that would minimise the risk to human health.
“It has taken us more than 10 years to develop the knowledge to carry out this research, from a materials and biological science point of view, but also from the clinical capacity to carry out such controlled studies safely by assembling some of the world’s leading experts in this field.”
Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, said: “The discovery that this type of graphene can be developed safely, with minimal short term side effects, could open the door to the development of new devices, treatment innovations and monitoring techniques.
“We look forward to seeing larger studies over a longer timeframe to better understand how we can safely use nanomaterials like graphene to make leaps in delivering lifesaving drugs to patients.”

Having a heart attack significantly increases the risk of developing other serious long-term health conditions, a major new study shows.
Researchers at the University of Leeds have analysed more than 145 million records covering every adult patient admitted to hospital over a nine-year period to establish the risk of long-term health outcomes following a heart attack — in the largest study of its kind.
Whilst heart attacks are a serious and life-threatening condition, the British Heart Foundation estimates that nowadays more than seven in 10 people survive them, provided they receive quick and emergency treatment to get the blood flowing to the heart muscle again. Yet previous research has shown that heart attacks can have health implications for patients including further conditions which affect the heart and circulatory system, but also conditions affecting other parts of the body and mental health conditions.
The new research, part funded by The British Heart Foundation and Wellcome, shows that patients who had a heart attack went on to develop further conditions at a much higher rate than people of the same age and sex who had not had one.
Up to a third of patients went on to develop heart or kidney failure, 7% had further heart attacks and 38% died from any cause within the nine-year study period.
Heart failure, atrial fibrillation, stroke, peripheral arterial disease, severe bleeding, kidney failure, type 2 diabetes and depression all occurred more frequently for people who had a heart attack compared with those who did not; but the risk of cancer was lower overall, and the risk of dementia did not differ overall.
The study also identified that people from more socioeconomically deprived backgrounds were more likely to die or develop serious long-term health conditions following a heart attack. In particular, those from more deprived backgrounds were more likely to develop heart and kidney failure, compared to people from less deprived backgrounds of a similar age.

Lead author Dr Marlous Hall, Associate Professor of Cardiovascular Epidemiology in Leeds’ School of Medicine and Multimorbidity Research in the Leeds Institute for Data Analytics (LIDA), said: “There are around 1.4 million heart attack survivors in the UK who are at high risk of developing further serious health conditions. Our study provides accessible online information of the risk of these health outcomes for specific age, sex and socioeconomic deprivation groups so that individuals surviving a heart attack can be well informed about their future risks, in order to support informed healthcare decision making with their doctor.
“Effective communication of the likely course of disease and risk of adverse long-term outcomes between patients and healthcare professionals can promote positive lifestyle changes, encourage patients to stick to treatment, and improve patient understanding and quality of life.”
“Our study highlights the need for individual care plans to be revised to take into account the higher demand for care caused by survivorship.”
The researchers analysed the records of all individuals aged 18 years and over, who were admitted to one of 229 NHS Trusts in England between 1 January 2008 and 31 January, 2017. This amounted to 145,912,852 hospitalisations among 34,116,257 individuals. There were 433,361 reports of people who had a heart attack for the first time. The average age of heart attack patients was 67 years, and 66% of patients were male.
The study looked at 11 non-fatal health outcomes detailed below, plus death from any cause, and compared the results to a control group of 2,001,310 individuals.
Health outcomes
The research showed a significantly increased risk of developing some conditions following a heart attack, when compared to the control group of patients.

Most likely was heart failure, with 29.6% of the study group going on to develop the condition within nine years of their heart attack, compared with 9.8% of the control group over the same time frame.
Kidney failure developed in 27.2% of the patients in the study group, compared with 19.8% of the control group.
Some 22.3% of the study group went on to develop atrial fibrillation, compared with 16.8% of the control group.
And new hospitalisation for diabetes was seen in 17% of the study group, compared with 14.3% of the control group.
Other conditions were:
Severe bleeding — Study group: 19%; Control group: 18.4%
Cerebrovascular disease — Study group: 12.5%; Control group: 11.6%
Peripheral arterial disease — Study group: 6.5%; Control group: 4.06%
Death from any cause — Study group: 37.8%; Control group: 35.3%
Overall, hospitalisation records indicating depression occurred in 8.9% of people after a heart attack — which was 6% more likely following a heart attack than in the control group. Women were more likely to develop depression after a heart attack than men, especially those who had their heart attack at a younger age. 21.5% of women who were under the age of 40 at the time of their heart attack had hospitalisation records for depression compared with 11.5% of men in the same age category.
There was no overall difference in the risk of dementia following a heart attack compared with the control group. Whilst the risk of vascular dementia was more likely in the study group, the difference observed was small (study group 2.3%; control group 2.1%).
In contrast with other health outcomes the research showed that cancer was less pronounced in the study group than in the control group. Some 13.5% of the study group went on to develop cancer after their heart attack, but this compared with 21.5% of the control group. Researchers believe there are likely many factors affecting this finding but the specific reasons for fewer cancers after a heart attack remain unclear and require further investigation.
Morag Foreman, Head of Discovery Researchers at Wellcome, said: “This research provides valuable insight into the types of support and interventions that may be needed for patients following a heart attack, helping both doctors and patients make informed decisions during recovery and beyond.”
“This research shows how cohort studies and analysis of large data sets can further our understanding of key health challenges and demonstrates the value to supporting discovery research in the field of population and public health. As survival rates following a heart attack improve, understanding the longer-term impacts on physical and mental health is crucial.”
Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, said: “While more people than ever are surviving heart attacks, there can be longer term consequences. Particularly after a major heart attack, people can be left with irreparable damage to their heart, putting them at increased risk of heart failure.
“This study sheds further light on how heart attacks are associated with increased risk of developing other serious health conditions, including heart failure and atrial fibrillation. It also found that those from more socioeconomically deprived backgrounds are at greater risk of further ill health after a heart attack, and at a younger age. The research suggests that these patients may benefit from additional support and monitoring to help reduce their risk of developing further health conditions.
“It is vital NHS has the resource, including staff, infrastructure and equipment, to deliver the care that patients need to help them stay in the best possible health for longer.”

Infertility is a widespread problem: worldwide, one in eight couples fail to fulfil their desire to have children within a year — or even at all. In half the cases, this is due to fertility disorders that stem from the male. However, it is difficult to identify the genetic causes of such fertility disorders in humans. Researchers lack data on the quality of semen and on molecular markers from sufficiently large cohorts of healthy men of reproductive age.
The path to a better understanding of which genes and mechanisms control male fertility therefore lies via suitable laboratory animals — in this case, bulls.
A research team led by Hubert Pausch, Professor of Animal Genomics at ETH Zurich, studied young bulls to investigate in detail which genes are active in different tissues of the animals’ reproductive organs and how this affects their fertility. Their study was recently published in the journal Nature Communications.
For this investigation, the researchers from the Institute of Agricultural Sciences used samples of testicles, epididymis and vas deferens from 118 freshly slaughtered bulls of reproductive age. The animals were not killed specifically for the research.
One thing the scientists characterised using these biopsies was the bulls’ transcriptomes — in other words, all the messenger RNAs present in each kind of tissue, which represent the gene transcripts. This enabled the team to find out which genes are active in which of the three tissues. Based on that knowledge, they created corresponding transcriptome profiles for the bulls. They then compared these profiles with those of humans and mice.
Many genes involved
Through this research, the team discovered a large number of genes and their variants that are associated with fertility in bulls. Most of the genes found are also likely to be relevant to male fertility in humans. In evolutionary terms, the regulation of male fertility is “highly conserved,” Xena Mapel, first author of the study explains. This means that the genes responsible for reproduction function similarly across mammals.

“These genes are closely linked to poor fertility in bulls,” Mapel says. “Such subfertile bulls don’t show up during conventional ejaculate screening. However, they can be reliably detected with our new marker genes.”
Unusual animal model
Although cattle are an unusual choice of animal model, they are ideal for such studies. For one thing, the genes of breeding bulls are well understood, and for another, breeding organisations obtain ejaculate from the animals twice a week as part of normal operations. This is analysed in detail before being diluted and used to inseminate hundreds of cows — or is discarded if the quality of the ejaculate is poor.
The bull cohort analysed here also has the great advantage that all the animals are similar in age. “This cohort is very homogeneous. If we had to carry out a comparable study on men, we’d have to rely on voluntary donors, potentially across all possible age groups. This would give us data that’s very difficult to compare.”
Data on the fertility of young men is collected annually from Swiss recruits to the armed forces, but this can hardly be used for such analyses. “We don’t know what influences the men were exposed to before they took the fertility test, which will be different for every test subject. Furthermore, it’s practically impossible to obtain tissue samples from their reproductive tract, as that would entail an invasive medical procedure.”
Findings to benefit livestock breeders
It is still unclear how the new findings will be incorporated into human fertility research, but they are already paving the way for better diagnostics with which to identify the corresponding genes and their variants in breeding bulls. That means livestock breeders will likely be the first to benefit from the findings, since they will help to minimise financial losses from failed artificial inseminations.
Currently, every bull’s ejaculate is tested for quality before use and the calves’ genomes are analysed; however, some infertile bulls still slip through. If a breeder inseminates cows with semen from an infertile bull, the cows will not become pregnant. And with each insemination costing 80 Swiss francs, that can soon eat up a breeder’s budget: a typical Swiss dairy farm spends several thousand Swiss francs a year on artificially inseminating its herd of cows. But it doesn’t end there: the unsuccessfully inseminated cows often cause further problems to the farmers, as they don’t give birth to calves and no longer produce milk, meaning the farmer has to replace them. And that costs money.
Artificial insemination is now standard in beef and dairy cattle husbandry, and also in pig breeding. In Switzerland, around 800,000 cows are artificially inseminated every year. Natural matings — when a bull mates with a cow naturally — take place only very rarely. “Raising a bull isn’t easy. Most farmers don’t have the space for such a large animal,” Pausch says.

The NewsGrowing numbers of children and adolescents are being prescribed multiple psychiatric drugs to take simultaneously, according to a new study in the state of Maryland. The phenomenon is increasing despite warnings that psychotropic drug combinations in young people have not been tested for safety or studied for their impact on the developing brain.The study, published Friday in JAMA Open Network, looked at the prescribing patterns among patients 17 or younger enrolled in Medicaid in Maryland from 2015 to 2020. In this group, there was a 9.5 percent increase in the prevalence of “polypharmacy,” which the study defined as taking three or more different classes of psychiatric medications, including antidepressants, mood-stabilizing anticonvulsants, sedatives and drugs for A.D.H.D. and anxiety drugs.The Big PictureThe study looked at only one state, but state data have been used in the past to explore this issue, in part because of the relative ease of gathering data from Medicaid, the health insurance program administered by states.At the same time, some research using nationally weighted samples have revealed the increasing prevalence of polypharmacy among young people. One recent paper drew data from the National Ambulatory Medical Care Survey and found that in 2015, 40.7 percent of people aged 2 to 24 in the United States who took a medication for A.D.H.D. also took a second psychiatric drug. That figure had risen from 26 percent in 2006.The latest data from Maryland shows that, at least in one state, the practice continues to grow and “was significantly more likely among youths who were disabled or in foster care,” the new study noted.Mental health experts said that psychotropic medications can prove very helpful and that doctors have discretion to prescribe what they see fit. A concern among some experts is that many drugs used in frequently prescribed cocktails have not been approved for use in young people. And it is unclear how the simultaneous use of multiple psychotropic medications affects brain development long-term.The NumbersThe latest study looked at data from 126,972 people over the study period. It found that in 2015, 4.2 percent of Medicaid enrollees under the age of 17 in Maryland had overlapping prescriptions of three or more different classes of psychiatric medications. That figure rose to 4.6 percent in 2020.The numbers were higher for those in foster care, where the prevalence of polypharmacy rose to 11.3 percent from 10.8 percent.“The findings emphasize the importance of monitoring the use of psychotropic combinations, particularly among vulnerable populations, such as youths enrolled in Medicaid who have a disability or are in foster care,” the study concluded.