Publisher Health

A research study led by the University of Oxford provides a transformational new insight into how antimicrobial resistance (AMR) emerges in patients with bacterial infections. The findings, published today in the journal Nature Communications, could help develop more effective interventions to prevent AMR infections developing in vulnerable patients.
The study’s findings challenge the traditional view that people are generally infected by a single genetic clone (or ‘strain’) of pathogenic bacteria, and that resistance to antibiotic treatment evolves because of natural selection for new genetic mutations that occur during the infection. The results suggest that instead patients are commonly co-infected by multiple pathogen clones, with resistance emerging as a result of selection for pre-existing resistant clones, rather than new mutations.
The researchers used a novel approach which studied changes in the genetic diversity and antibiotic resistance of a pathogenic bacteria species (Pseudomonas aeruginosa) collected from patients before and after antibiotic treatment. The samples were isolated from 35 intensive care unit (ICU) patients in 12 European hospitals. Pseudomonas aeruginosa is an opportunistic pathogen that is an important cause of hospital-acquired infections, particularly in immunocompromised and critically ill patients, and is thought to cause more than 550,000 deaths globally each year.
Each patient was screened for Pseudomonas aeruginosa soon after being admitted to ICU, with samples then collected at regular intervals thereafter. The researchers used a combination of genomic analyses and antibiotic challenge tests to quantify within-patient bacterial diversity and antibiotic resistance.
Most patients in the study (approximately two thirds) were infected by a single Pseudomonas strain. AMR evolved in some of these patients due to the spread of new resistance mutations that occurred during infection, supporting the conventional model of resistance acquisition. Surprisingly, the authors found that the remaining third of patients were actually infected by multiple strains of Pseudomonas.
Crucially, resistance increased by about 20% more when patients with mixed strain infections were treated with antibiotics, compared to patients with single strain infections. The rapid increase in resistance in patients with mixed strain infections was driven by natural selection for pre-existing resistant strains that were already present at the onset of antibiotic treatment. These strains usually made up a minority of the pathogen population that was present at the start of antibiotic treatment, but the antibiotic resistance genes that they carried gave them a strong selective advantage under antibiotic treatment.

However, although AMR emerged more quickly in multi-strain infections, the findings suggest it may also be lost more rapidly in these conditions. When samples from single strain and mixed strain patients were cultured in the absence of antibiotics, the AMR strains grew more slowly compared with non-AMR strains. This supports the hypothesis that AMR genes carry fitness trade-offs, such that they are selected against when no antibiotics are present. These trade-offs were stronger in mixed strain populations than in single strain populations, suggesting that within-host diversity can also drive the loss of resistance in the absence of antibiotic treatment.
According to the researchers, the findings suggest that interventions aimed at limiting the spread of bacteria between patients (such as improved sanitation and infection control measures) may be a more effective intervention to combat AMR than interventions that aim to prevent new resistance mutations arising during infection, such as drugs that decrease the bacterial mutation rate. This is likely to be especially important in settings where the infection rate is high, such as patients with compromised immunity.
The findings also suggest that clinical tests should move towards capturing the diversity of pathogen strains present in infections, rather than testing for only a small number of pathogen isolates (based on the assumption that the pathogen population is effectively clonal). This could enable more accurate predictions of whether antibiotic treatments will succeed or fail in individual patients, similar to how measurements of diversity in cancer cell populations can help predict the success of chemotherapy.
Lead researcher Professor Craig Maclean, from the University of Oxford’s Department of Biology, said: ‘The key finding of this study is that resistance evolves rapidly in patients colonized by diverse Pseudomonas aeruginosa populations due to selection for pre-existing resistant strains. The rate at which resistance evolves in patients varies widely across pathogens, and we speculate that high levels of within-host diversity may explain why some pathogens, such as Pseudomonas, rapidly adapt to antibiotic treatment.’
He added: ‘The diagnostic methods that we use to study antibiotic resistance in patient samples have changed very slowly over time, and our findings underscore the importance of developing new diagnostic methods that will make it easier to assess the diversity of pathogen populations in patient samples’
The World Health Organization has declared AMR to be one of the top 10 global public health threats facing humanity. AMR occurs when bacteria, viruses, fungi and parasites no longer respond to medicines such as antibiotics, making infections increasingly difficult or impossible to treat. Of particular concern is the rapid spread of multi-resistant pathogenic bacteria, that cannot be treated with any existing antimicrobial medicines. In 2019, AMR was associated with nearly 5 million deaths worldwide.
Professor Willem van Schaik, Director of the Institute of Microbiology and Infection at the University of Birmingham (who was not directly involved with the study) said: ‘This study strongly suggests that clinical diagnostic procedures may need to be expanded to include more than one strain from a patient, to accurately capture the genetic diversity and antibiotic resistance potential of strains that colonise critically ill patients. It also highlights the importance of ongoing infection prevention efforts that aim to reduce the risk of hospitalised patients being colonised, and subsequently infected, by opportunistic pathogens during their hospital stay.’
Sharon Peacock, Professor of Microbiology and Public Health at the University of Cambridge (who was not directly involved with the study), said: ‘Multidrug-resistant infections caused by a range of organisms including Pseudomonas aeruginosa are a major challenge for patient management in ICU settings worldwide. The findings of this study add further evidence for the vital importance of infection prevention and control measures in ICUs and hospital settings more widely that reduce the risk of acquiring P. aeruginosa and other pathogenic organisms.’

Gulf War Illness (GWI) is a chronic multisymptom health condition affecting one-third of all veterans who served in the 1991 Gulf War, most of whom remain afflicted more than 30 years later. Common symptoms include fatigue, headaches, muscle aches, joint pain, diarrhea, insomnia and cognitive impairment.
The condition is believed to have been triggered by veterans’ exposure to environmental toxins. However, its exact mechanism in the body continues to be debated, making it difficult to diagnose and treat. The prevailing notion is that inflammation is the driving force of the symptoms, as inflammatory markers are modestly higher in affected veterans than in healthy controls. However, a rival hypothesis suggests mitochondria — the energy-producing organelle found in most cells — may be the true source of the symptoms.
In a new study, researchers at University of California San Diego School of Medicine put both ideas head-to-head, directly assessing mitochondrial impairment and inflammation in 36 individuals, 19 of whom were veterans with GWI. The findings, published July 12, 2023 in Scientific Reports, suggest that impaired mitochondrial function, and not inflammation, is the main driver of GWI symptoms and should be the primary target of future clinical interventions.
“This is a radical rethinking of the pathology of GWI,” said corresponding author Beatrice Golomb, MD, PhD, professor of medicine at UC San Diego School of Medicine. “For veterans who have long struggled to get effective care, this discovery could be a real game changer.”
To evaluate the respective roles of mitochondrial function and inflammation in GWI, the researchers acquired muscle biopsies from the study participants and measured the levels of mitochondrial respiratory chain function (MRCF). Inflammation was assessed through participants’ blood levels of high-sensitivity C-reactive protein (hsCRP), a common marker of peripheral inflammation.
The researchers then compared this data to the participants’ GWI symptoms and found that the severity of symptoms could be predicted by their degree of mitochondrial impairment, but not by their degree of inflammation. Further statistical analyses found that 17 of the 20 most common GWI symptoms were statistically related to mitochondrial function. In contrast, only one of the 20 symptoms met this criterion for inflammation.
Another set of analyses revealed that the degree to which participants’ mitochondria were compromised in converting fat to energy was strongly related to the degree of inflammation in GWI patients, but not in controls. Reduced activity of this process, called fatty acid oxidation, is known to trigger cell death, which then leads to inflammation. Thus the researchers say this suggests that mitochondrial dysfunction may be the reason inflammation is higher in GWI patients.
“Inflammation does appear to be linked to GWI, but our work suggests that it’s actually a side effect of the primary issue, which is impaired cell energy,” said Golomb.
The researchers also note that many GWI symptoms are expected outcomes of mitochondrial dysfunction. For example, muscles rely heavily on fat to fuel them, so if mitochondrial dysfunction leads to impaired fatty acid oxidation in GWI patients, this could explain the muscle aches and physical fatigue they often experience. Indeed, muscle symptoms in GWI correlated most strongly with the degree of impairment in mitochondrial fatty acid oxidation. Conversely, the brain relies mostly on sugar for energy, and brain symptoms in GWI related most strongly to impairment in mitochondrial energy production using sugar as a fuel.
The findings also have possible implications for other health conditions, including different forms of toxin exposure, aging and even heart disease. Many of these conditions are marked by increased inflammation, yet often do not respond well to anti-inflammatory drugs. Golomb and colleagues argue that mitochondrial impairment may be an underlying cause for these conditions, creating opportunities for new therapeutic strategies.
“This is the first time that direct evidence for the mitochondrial hypothesis of GWI has been reported,” said Golomb. “We hope that it will lead to improved treatment plans for the veterans who have long struggled with this mysterious illness.”
Co-authors of the study include: Roel Sanchez Baez, Jan M. Schilling, Mehul Dhanani, McKenzie J. Fannon, Brinton K. Berg, Bruce J. Miller, Pam R. Taub and Hemal H. Patel, all at UC San Diego.

Fluorine is found rarely in naturally occurring organic molecules. However, this chemical element is indispensable for the production of pharmaceuticals or agrochemicals. Synthetic chemistry has an important role to play in the development of new fluorine-containing molecular fragments. Simple, modular synthesis strategies are extremely valuable. A team led by Prof. Ryan Gilmour at the Organic Chemistry Institute at the University of Münster have now developed a cascade reaction that enabled multiple fluorination reactions to occur through the sequential generation of reactive intermediates. Using inexpensive organic catalysts and simple starting materials, the group has shown that the substrate can be manipulated through a type of “molecular origami” to generate a new class of di- and trifluorinated molecules in a single operation. The study is published in the journal Nature Communications.
The step-wise construction of complex fluorinated molecules may require multiple purification steps. This has implications in terms of costs, time-management and the generation of waste. Dr Joel Häfliger and Dr Louise Ruyet from Ryan Gilmour’s research group discovered that by fine-tuning the reaction conditions, multiple sequential reactions are possible in a one pot fashion. In this way, they generated three new classes of complex fluorinated products from simple cyclobutanol derivatives. “The strategy has parallels with the art of origami, where you fold complex figures from a simple piece of paper,” Louise Ruyet illustrates. “This principle can be transferred to our chemical method.
The multiple folding steps represents successive reactions. “Starting with our piece of paper — the cyclobutanol-derivative — an intermediate compound is produced. This compound can be processed into different products depending on the reaction conditions,” says Joel Häfliger, the lead author of the paper. The key to the success of the approach was the use of an acidic medium to activate the substrate and produce an intermediate that can be intercepted by a catalytic cycle. The team synthesised a fluorinated analogue of the agent Nafenopin, which is used for hypolipidaemia — a strikingly low lipid level in the blood — as an application example.

The mixture of honey and vinegar, also known as oxymel, has been used as a medical treatment throughout history and now scientists have established that this combination could have modern applications in the treatment of wounds.
New research, published in Microbiology, is the first comprehensive exploration of how the mixture could be applied to modern medicine and improve treatments for infections.
Bacterial infections can be difficult to treat, particularly when they are protected within a biofilm. A biofilm is a complex system of bacteria which can attach tightly to surfaces, like flesh in a wound infection. Bacteria which are protected in a biofilm are difficult to kill, and treatments today are not always effective at removing them.
Previous research has shown how effective some natural remedies can be at treating infections. Manuka honey has been proven to possess antimicrobial properties and aid wound healing and vinegar is also proven to be a useful antiseptic.
Doctors have utelised this information in medicine today. While they use manuka honey to treat antibiotic resistant infections they only use acetic acid, the active component of vinegar and do not currently combine the two.
Dr Erin Connelly, Dr Freya Harrison and their team from the University of Warwick are the first to explore what happens when both honey and vinegar are combined and applied to biofilms of bacteria grown in the laboratory.
Having identified the gap, researchers began by investigating the effects of combinations of two medical-grade honey ointments with natural vinegar or acetic acid. They wanted to find out how effective the treatment is at killing microbes, and which combination worked best.
They were also curious to know if whole vinegar is more antibacterial than just acetic acid. Dr Erin Connelly, a researcher on the study, said, “In our survey of premodern recipes we noticed a pattern of combining honey and vinegar to wash or dress wounds and swellings, and this inspired us to focus on that combination in our analysis.”
By comparing the use of vinegar and acetic acid alone, then in combination with medical-grade honey, the researchers found that it was specifically the combination of the two substances which was best. “We applied a low dose of honey, that alone didn’t kill the bacteria, and a low dose of acetic acid that also could not kill the bacteria alone,” according to Dr Harrison. “These doses are lower than those that wound care nurses currently use on patients. But when we put these low doses together, we saw a large number of bacteria dying which is really exciting. We really need to investigate whether combining these substances could help patients who are not responding to either substance used alone.”
The researchers also found that some natural vinegars had a greater ability to kill bacteria than an equivalent dose of pure acetic acid. In particular, pomegranate vinegars are interesting candidates for further study; these had strong antibacterial activity and, like acetic acid, had activity when combined with honey.
Whilst more research needs to take place to understand the mechanism and best dose combinations of the combined honey and vinegar, these promising results have proved exciting enough that the researchers now propose to take a modern version of oxymel into the clinical trial stage.
Professor Joseph Hardwicke, Consultant Plastic and Reconstructive Surgeon at University Hospitals Coventry and Warwickshire explains “This is an exciting area of research to use traditional remedies in the modern NHS. The burden of wound care and infections is increasing year by year, with causative conditions such as diabetes on the rise. Maybe the knowledge of our ancestors can be used to enhance the current care we can provide to our patients, at a lower cost.”

Researchers from the School of Public Health at TAU’s Faculty of Medicine examined the anthropometric data of about 3,000 Israeli women and men and concluded that body fat percentage is a much more reliable indicator of an individual’s overall health and cardiometabolic risk than the BMI index, widely used in clinics today. The researchers suggest that body fat percentage should become the gold standard in this respect and recommend equipping clinics all over Israel with suitable devices.
The study — the largest of its kind ever conducted in Israel — was led by Prof. Yftach Gepner and PhD student Yair Lahav, in collaboration with Aviv Kfir. It and was based on data from the Yair Lahav Nutrition Center in Tel Aviv. The paper was published in Frontiers in Nutrition.
Prof. Gepner: “Israel is a leader in childhood obesity and more than 60% of the country’s adults are defined as overweight. The prevailing index in this respect is BMI, based on weight and height measures, which is considered a standard indicator of an individual’s general health. However, despite the obvious intuitive connection between excess weight and obesity, the actual measure for obesity is the body’s fat content, with the maximum normal values set at 25% for males and 35% for females. Higher fat content is defined as obesity and can cause a range of potentially life-threatening cardiometabolic diseases: heart disease, diabetes, fatty liver, kidney dysfunction, and more. The disparity between the two indexes has generated a phenomenon called ‘the paradox of obesity with normal weight’ — higher than normal body fat percentage in normal-weight individuals. In this study we examined the prevalence of this phenomenon in Israel’s adult population.”
The researchers analyzed the anthropometric data of 3,000 Israeli women and men, accumulated over several years: BMI scores; DXA scans (using X-rays to measure body composition, including fat content); and cardiometabolic blood markers. About one third of the participants, 1,000 individuals, were found to be within the normal weight range. Of these, 38.5% of the women and 26.5% of the men were identified as ‘obese with normal weight’ — having excess fat content despite their normal weight. Matching body fat percentage with blood markers for each of these individuals, the study found a significant correlation between ‘obesity with normal weight’ and high levels of sugar, fat, and cholesterol — major risk factors for a range of cardiometabolic diseases. At the same time, 30% of the men and 10% of the women identified as overweight were found to have a normal body fat percentage.
Prof. Gepner: “Our findings were somewhat alarming, indicating that obesity with normal weight is much more common in Israel than we had assumed. Moreover, these individuals, being within the norm according to the prevailing BMI index, usually pass ‘under the radar’. Unlike people who are identified as overweight, they receive no treatment or instructions for changing their nutrition or lifestyle — which places them at an even greater risk for cardiometabolic diseases.”
Based on their findings, the researchers concluded that body fat percentage is a more reliable indicator of an individual’s general health than BMI. Consequently, they suggest that body fat percentage should become the prevailing standard of health, and recommend some convenient and accessible tools for this purpose: skinfold measurements that estimate body fat based on the thickness of the fat layer under the skin; and a user-friendly device measuring the body’s electrical conductivity, already used in many fitness centers.
Prof. Gepner: “Our study found that obesity with normal weight is very common in Israel, much more than we had previously assumed, and that it is significantly correlated with substantial health risks. And yet, people who are ‘obese with normal weight’ are not identified by today’s prevailing index, BMI. We also found that body fat percentage is a much more reliable indicator than BMI with regard to an individual’s general health. Therefore, we recommend equipping all clinics with suitable devices for measuring body fat content, and gradually turning it into the gold standard both in Israel and worldwide, to prevent disease and early mortality.”

Chronic pain can seriously restrict our lives, preventing us from reaching our full professional potential, enjoying hobbies, and even participating in meaningful life events with friends and family out of fear that certain activities may lead to additional pain and suffering. Avoiding experiences associated with pain can be an adaptive behavior. But, as Eveliina Glogan, Peixin Liu, and Ann Meulders (Maastricht University) demonstrate in a recent Psychological Science article, when we learn to avoid one activity that has caused pain in the past, it can also lead us to avoid conceptually related activities that we may be able to complete painlessly.
“When avoidance generalizes to such safe movements and activities, it can become problematic,” Glogan said in an interview. “For example, needless avoidance can come at the cost of other valued activities, such as playing with one’s children, and can even culminate in disability due to reduced activity levels.” This generalization can extend not only to physically similar tasks (e.g., from mopping to vacuuming) but also across entire categories of conceptually related activities, such as cleaning or sports.
Glogan, Liu, and Meulders investigated how generalized avoidance occurs in healthy individuals through a study of 40 people without chronic pain.
To establish what they consired a painful shock, each participant wore a set of two electrodes that delivered increasingly strong electric shocks. Once the participant rated the pain as an 8 out of 10 in severity (described as “significantly painful and demanding some effort to tolerate”), the shocks stopped and the practice phase of the experiment began.
During this phase, participants were instructed to complete digital “gardening” and “cleaning” tasks by using a joystick to move a tool, such as a wheelbarrow or a mop, toward an appropriate item, such as a pile of grass or puddle of water, across a computer screen. In the first eight practice trials, participants were able to choose one of two routes to the item: a direct, efficient route that allowed them to complete the task with one movement of the joystick and a longer, inefficient route that required them to move the tool to the item twice.
In the subsequent acquisition trials, however, every time participants completed the tasks from one category (mopping and vacuuming for cleaning or raking and using a wheelbarrow for gardening), they were 80% likely to receive a painful shock while using the direct route. But they never received a shock while using the indirect route or while completing tasks from the other category (the “safe” category). Before each trial, participants used a scale of 0 to 100 to report how painful they expected each route to be and how fearful they were of using them.

Once participants had the opportunity to learn about which tasks were likely to cause pain, they completed a generalization phase that included a mix of eight additional gardening and cleaning tasks and the same measures of expected pain and fear. Although mopping/vacuuming or raking/wheelbarrowing using the direct route continued to result in a painful shock, participants could complete the new tasks from both categories using either route without getting zapped.
By the end of the acquisition phase, participants were more than 5 times more likely to choose the longer, pain-free route to complete tasks in which the direct route had previously resulted in them getting shocked. Participants also reported higher pain expectations and fear in relation to the direct route before completing these tasks, and these higher pain expectations and fear extended to tasks that had never resulted in pain, albeit to a lesser extent. This suggests that although participants had learned to fear experiencing pain on the direct route during certain tasks, they were not entirely certain that the “safe” tasks were really safe either, Glogan and colleagues wrote.
By the end of the experiment, the avoidance of previously painful actions had also generalized to other tasks in the same category even though using the direct route to complete these tasks never resulted in experiencing pain. Overall, participants were 1.8 times more likely to take the indirect route when completing new tasks from the same category as previously painful tasks — for example, cleaning activities like washing dishes or dusting if taking the direct path to mopping and vacuuming had previously caused them pain — than they were during new tasks from the safe category.
Additionally, participants reported fearing and expecting more pain from the direct route during the new tasks from the pain-associated category than from the safe category. They also reported higher fear and pain expectations related to taking the direct route during the new tasks from the safe category than during familiar safe tasks.
Although Glogan and colleagues’ previous research supports the view that people generalize pain expectations across categories of activities according to their perceptual similarities, this research suggests that generalized avoidance may also be based on the conceptual similarities individuals assign to tasks, Glogan explained in the interview. This amounts to the difference between perceptually linking vacuuming and mopping because they involve physically similar movements and conceptually linking mopping, dishwashing, and dusting because they are related to the same category — cleaning.
Psychological factors, rather than physical ones like the severity of an injury, have been shown to be the best predictors of which patients will experience chronic pain, Meulders said in a separate interview, so increasing our understanding of how pain avoidance generalizes could help improve treatment outcomes.
“Fears and avoidant behavior can spread in idiosyncratic ways, and it’s so important to tap into those semantic networks and find out the specific categories that people have if you want to treat them,” Meulders added.
Future work is needed to explore how these findings may apply to people with chronic pain, who are thought to generalize pain avoidance more broadly than healthy individuals, Glogan and Meulders said.

Prostate cancer is a leading cause of death among American men, and it’s resistant to one of the most powerful chemotherapy medications — cisplatin. Now, researchers reporting in ACS Central Science have developed the first therapy of its kind that disrupts prostate cancer cells’ metabolism and releases cisplatin into the weakened cells, causing them to die. In mouse models, an orally administered version shrunk tumors substantially.
Cisplatin attacks testicular, breast, bladder, lung and ovarian cancer cells, damages their DNA and effectively destroys tumors. However, it’s not effective against prostate cancer for reasons that are unclear to scientists, and many advanced cases of the disease don’t respond to other therapies, such as androgen deprivation. Previously, researchers have shown in mouse models that as the disease advances, tumor cells shift from glycolysis toward fatty acid oxidation to support their growth and division. So, Shanta Dhar and colleagues from Sylvester Comprehensive Cancer Center at the University of Miami wanted to develop a therapy that would inhibit fatty acid oxidation in cancer cells by targeting a mitochondrial protein that is vital to the metabolic process, making the cells susceptible to cisplatin.
The researchers verified that human prostate cancer cells thrive using fatty acid oxidation by assessing the biopsies of 38 people with the disease. Then they screened several cisplatin-containing prodrug compounds, which release the platinum-based molecule when they’re broken down, to see if they could inhibit fatty acid oxidation. The cisplatin prodrug Platin-L, which has a cisplatin molecule bound to a 12-carbon fatty acid on one side and succinate on the other side, had the greatest effect by binding to a key protein required for long chain fatty acid transport, a primary step in this metabolic process. And in trials, Platin-L reduced the growth of prostate cancer cells by over 50% in several different cell lines.
To develop a treatment that could be taken orally, the researchers encapsulated Platin-L in nanoparticles made with a biocompatible polymer that targeted prostate cancer cells. They administered the nanoparticles to mouse models with cisplatin-resistant prostate cancer and observed that the tumors shrunk, whereas tumors in animals treated with saline or cisplatin grew. Additionally, the Platin-L nanoparticle-treated mice had steady body weight, increased survival rates and didn’t display peripheral neuropathy. Because the treatment affects fatty acid metabolism, which can be elevated in other types of cancers, the researchers say their type of additive Platin-L therapy may also be applicable to additional aggressive and chemotherapy-resistant cancers.

Leprosy has existed since at least Biblical times, yet scientists still don’t know exactly how Mycobacterium leprae causes the disease’s symptoms. Though antibiotics can treat the illness, researchers are concerned about the increase in drug-resistant strains. Now, a team reporting in ACS Central Science has begun to understand the unique role certain immune receptors play in leprosy infections in mice, which could lead to new types of treatments for this disease and others in humans.
Thousands of people are currently affected by leprosy — also known as Hansen’s disease — according to the World Health Organization. The disease can cause skin lesions, nerve damage and paralysis. Once considered debilitating, antibiotics can now knock out an infection quickly and effectively. However, drug-resistant M. leprae strains have developed, prompting scientists to search for new treatment options. As a first step, researchers have started to decipher the exact way the bacterium interacts with the immune system. The cell walls of mycobacteria like M. leprae have a thick lipid layer containing glycolipids — a combination of sugar and fat molecules — that the human immune system can recognize and act against. So, Jeroen D. C. Codée, Sho Yamasaki and colleagues wanted to better understand which glycolipids are responsible for leprosy’s symptoms, and how they interact with the immune system.
The team extracted and synthesized the complex glycolipids from M. leprae, then exposed them to reporter cells expressing immune receptors. The component that activated the most cells was PGL-III, a precursor to the bacterium’s most common glycolipid, PGL-I. The team also discovered that this glycolipid used only its terminal sugar to bind an immune receptor called Mincle — a unique interaction not previously reported. Additionally, when mice without the Mincle receptor were exposed to M. leprae, they experienced worse infections than those with the receptor, suggesting that it plays an important role in the natural immune response against leprosy infection. As a result, targeting this receptor or the PGL-III glycolipid could offer an alternative to the current, antibiotic-heavy treatment for leprosy. Even more, the researchers say that the special structure-activity relationship between Mincle and PGL-III could be replicated to create other immunostimulatory drugs in the future.

Providing access to housing, debt, and benefit advice within food banks could help lift people out of poverty — according to a University of East Anglia study.
Researchers worked with Norwich Foodbank centres, part of the Trussell Trust, on a pilot project that saw representatives from Citizens Advice and Shelter posted within the service.
The ‘Making a Difference’ initiative meant that people forced to use a food bank were also able to access advice on a range of issues — from housing and debt to benefits.
It is now hoped that this scheme will be rolled out to foodbanks nationally.
Lead researcher Dr Sarah Hanson, from UEA’s School of Health Sciences, said: “As the cost-of-living crisis continues, more and more people are turning to food banks because they simply can’t afford to eat.
“This might be because they have had an acute change in circumstances, are on a low income, in debt, or because their benefits have either changed or been delayed.

“We wanted to see whether making more support available to people at food banks would help — so that they would no longer need to rely on emergency food.
“We know that signposting, for example giving information about other local organisations, is not enough. This is because people’s issues are complex and need a more holistic approach.”
The Norwich Foodbank has supported 11,797 people in the last year. This has shot up from 8,905 people in 2015.
The ‘Making a Difference’ project is a pilot advisory scheme in the region with staff from Shelter and Citizen’s Advice posted within some of its food banks.
The UEA team interviewed food bank volunteers and advice workers, to provide lived experience feedback on the scheme.

Dr Hanson said: “One of the main things that emerged was that having a person-centred, holistic, and compassionate approach is essential for clients with complex needs that cut across many different services.
“It can be very difficult for people to navigate the benefit system, the housing system, social services — you need a joined-up approach with advisers that can help on a number of levels.
“A lot of people are missing out on benefits such as Healthy Start vouchers and pension credit — because they don’t realise that they are entitled to them.
“Many people visiting food banks have poor mental or physical health, as well as personal trauma. Having advisers available at the point of need means that people don’t have to tell their stories multiple times to different organisations.
“We found that the service is reaching very vulnerable people who fall through the gaps, in the heart of really deprived communities. These people may have previously found advice services inaccessible, and they are too often socially excluded from opportunities and services that could support them.
“Importantly, the initiative is empowering clients by treating them with dignity and sensitivity in often distressing circumstances,” she added.
But while the scheme is helping food bank clients, the researchers found that frontline staff may need some help themselves.
Dr Hanson said: “We heard that being on the frontline can impact mental health. It is therefore important that anyone who is listening to and supporting people in crisis in a very challenging landscape, should have access to support themselves.”
Rhiannon Barrow?, Trussell Trust financial inclusion manager for the Eastof England, said: “The partnership between UEA and Norwich Foodbank was one of the first collaborations between a university and a Trussell Trust Foodbank.
“The evaluation of the ‘Making a Difference’ project demonstrates the effectiveness of working in partnership with organisations so individuals are supported holistically and don’t have to be retraumatised by repeating their stories.
“The evaluation also enabled reflection and a space to discuss continuous improvement to enable Norwich Foodbank to better serve their community and support staff and volunteers, which they always strive to do.”
Hannah Worsley, Norwich Foodbank project manager, said: “We were delighted to work with the UEA research team to independently evaluate and understand our project, in terms of what we expected the outcomes to be and what some actual outcomes were.
“The interviews with our volunteers, and Citizen’s Advice and Shelter advisors’ insights, along with the research provided by UEA, gave us a thorough and better understanding of what this work is currently achieving for those we serve and, most importantly, how we can improve the service for our clients.”
Nidhi Mittal, pathfinder lead at the Trussell Trust, said: “The UEA study, funded via the Trussell Trust Pathfinder programme, is an innovative piece of work that provides valuable insights into the impact that financial inclusion services embedded within a holistic model of support can have on reducing the need for emergency food parcels.
“The Pathfinder programme at Trussell Trust aims to support innovation and learning on how we can address underlying causes of poverty in the UK, and this study led by UEA offers some excellent testimony for the work of Norwich foodbank and a base of valuable learning and knowledge for our wider foodbank network and partners.”
‘A qualitative exploration of a Financial Inclusion service in an English foodbank’ is published in the journal Perspectives In Public Health.

The hunting community in Ittoqqotoormiit (Scoresby Sound), Northeast Greenland, has some of the world’s highest concentrations of PFAS in their blood, even though they live far away from sources of contamination with per- and polyfluoroalkyl substances (PFAS).
PFAS is used in almost all industries and is found in many products such as textiles, carpets, shoes, food packaging, cosmetics, fire foam and pesticides.
The substances are long-range transported to the Arctic via the atmosphere and ocean currents. When they are released to the environment, PFAS is bio-magnified through the food chain. Predators at top of the food chain, such as ringed seals, toothed whales and polar bears therefore contain high PFAS concentrations, and the high levels in the indigenous population of East Greenland are hence primarily originating from their food.
The study, which has just been published in the   journal Lancet Planetary Health, shows that 92% of residents in Ittoqqortoormiit have far more PFAS in the body than the European Food Safety Authority (EFSA) recommends to avoid damage to the immune system.
In addition, 86% of the inhabitants have blood values that are higher than EFSA’s threshold value for serious risk of damage to the immune system.
A global problem
The recently published study shows that the pollution with PFAS is critical in many parts of the world, and Christian Sonne emphasizes that national and regional legislation must go hand in hand with the UN’s sustainable development goals and the Stockholm Convention in order to phase out PFAS.
“If measures are not taken quickly, such as a ban on PFAS and the use of alternatives to PFAS, pollution of the environment will continue to threaten public health around the world,” says professor Christian Sonne.
On 7 February 2023, the European Chemicals Agency published a proposal to limit the production, use and marketing of more than 10,000 PFAS substances in the EU. The purpose of the proposal is to limit the spread of PFAS substances. As a rule, the use of PFAS will be banned in general in EU, but unfortunately not in various pesticides. Similar actions are under way in the US.
The researchers behind the study show that PFAS levels in the blood are generally higher in the European countries and North America compared to countries in Asia and Africa. The highest concentrations are found (in descending order) in Greenland, the Faroe Islands, Denmark, Australia, Sweden, Norway, Malaysia, USA, Taiwan, Greece, Poland, Spain and Iceland.