Research from the University of Bath, published on No Smoking Day 2025, shows that integrating smoking cessation support into NHS Talking Therapies for depression and anxiety increases quit rates. This is an important step in addressing the high rates of smoking in this population.

Led by Dr. Gemma Taylor at the University of Bath, alongside researchers from several other institutions, the study published in Addiction, also found that adding smoking support to mental health treatment didn’t disrupt therapy. Instead, it offered a practical way to tackle mental and physical health together.

The trial was conducted across four NHS trusts in the Midlands, London and the South-west of England between 2019 and 2021. It tested the practicality of integrating smoking cessation support with cognitive behavioral therapy (CBT) for depression and anxiety.

A total of 135 people were split into two groups:

• One group received 12 sessions of smoking cessation support as part of their CBT session.
• The other group had standard CBT and were given information about quitting smoking after treatment.

Researchers followed up at three and six months to measure engagement, satisfaction, smoking habits, and mental health outcomes.

Key findings:

• Quit rates at six months: At six months, 15% of the combined treatment group had quit smoking entirely—more than two and a half times the quit rate of the control group (6%).
• Impact of CBT on smoking cessation in depression: A Cochrane review reported an 8.8% quit rate for standard smoking cessation treatments among individuals with depression. Findings from the ESCAPE trial reveal that incorporating cognitive-behavioral therapy (CBT) nearly doubles this rate.

The researchers think this study could open the door to bringing smoking cessation support into more mental health services. Therapists are backing the intervention, saying it is both helpful and easy to use, improving clients’ mental and physical health.

Responding to the promising findings, lead researcher Dr. Gemma Taylor from the Department of Psychology at the University of Bath said, “People with depression and anxiety are twice as likely to smoke and quitting is one of the most powerful ways to improve both physical and mental health.

“This study shows that by addressing smoking alongside mental health treatment, the NHS can offer patients a chance to break free from a deadly cycle, improving their well-being in a way that’s practical, effective and life-changing.”

Hazel Cheeseman, Chief Executive of Action on Smoking and Health (ASH) said, “The NHS is letting down people who both smoke and live with depression and anxiety by addressing these issues in silos. By combining treatment, people will see both their physical and mental health improve with long-term benefits to them and the health care system.

“If Wes Streeting wants to shift the NHS from ‘sickness to prevention,’ it must find smarter ways to improve people’s health. This is a ready-made solution that can be slotted into existing services. We will be calling for follow-up studies to see if outcomes can be replicated and services scaled up for all.”

Mark Rowland, Chair of the Mental Health and Smoking Partnership and Chief Executive of the Mental Health Foundation said, “Quitting smoking not only reduces your risk of cancer and heart disease, it is also one of the best ways to improve your mental health and well-being.

“This study shows that the NHS could be doing much more to support people struggling with their mental health to quit smoking. We hope to see a rapid expansion of this model to help more people break out of the cycle of stress and addiction caused by smoking.”

Tom Ayres, Director of the National Collaborating Center for Mental Health said, “People with mental health conditions are just as motivated to quit smoking as the general population but face greater barriers to doing so.

“This research shows that stop smoking support can be embedded in Talking Therapies programs to help people address their tobacco addiction alongside their mental health. This approach should be scaled up to ensure that people with mental health conditions get the support they need to be smoke-free.

Dr. Gemma Taylor said, “Expanding smoking cessation within NHS mental health services isn’t just a smart choice—it’s a crucial step toward improving patient outcomes and building healthier communities.”

People with depression and anxiety are twice as likely to smoke compared to the general population, with 26% of this group in the UK identified as smoking. NHS Talking Therapies were accessed by 1.2 million people in 2024, meaning this smoking support could reach up to 300,000 people who smoke each year.

Evidence suggests that smoking may be contributing to poor mental health. A recent study by Dr. Taylor shows that stopping smoking improves mental health as much as taking anti-depressants.

This study provides a practical and novel way to address high smoking rates in this population and improve physical health inequalities experienced by people with depression and anxiety.

Public health advice on the safe consumption of glycerol-containing slush ice drinks, also known as slushees, may need revising, conclude researchers after carrying out a detailed review of the medical notes of 21 children who became acutely unwell shortly after drinking one of these products.

Their findings, published in the journal Archives of Disease in Childhood, show that in each case the child became acutely unwell with a cluster of symptoms soon after drinking a slush ice drink, which the researchers refer to as glycerol intoxication syndrome.

The clinical and biochemical features were similar in all of these children and included reduced consciousness, a sudden sharp drop in blood sugar (hypoglycemia), and a build-up of acid in the blood (metabolic acidosis).

Such symptoms, when they occur together, can indicate poisoning or inherited metabolic disorders, prompting further investigations.

Brightly colored slush ice drinks are designed to appeal to children, note the researchers. While the ingredients vary, most of those available in the UK and Ireland are ‘no-added sugar’ or ‘sugar-free’ products and contain glycerol (E422, also known as glycerin), they add.

Glycerol stops the ice from fully freezing, so maintaining the slush effect in the absence of a high sugar content, they explain.

With a view to informing public health policy and guidance for parents, the researchers scrutinized the medical notes of 21 children who had become acutely unwell after consuming a slush ice drink and had initially been diagnosed with hypoglycemia after their arrival in emergency care.

Apart from one child referred in 2009, all the others were referred for further review between 2018 and 2024.

Diagnosis was informed by lab test confirmation of at least two of the following: hypoglycemia; metabolic acidosis; glyceroluria (high levels of glycerol in the urine), and backed up by negative biochemical, enzyme, and/or genetic test results for underlying inherited metabolic disorders.

Information on sex was available for 18 of the children, just over half of whom (10; 56%) were male. Their average age was 3.5, but ranged from 2 to nearly 7.

How quickly they became ill was known for 15: in 14 (93%) this was within 60 minutes. Similarly, the state of consciousness was known for 17, and in 16 this was significantly and suddenly reduced. One child had a seizure. Urgent neuroimaging was carried out in four (33%) out of 12 children.

Twenty children had documented hypoglycemia (blood glucose 2.6 mmol/l or below); but in 13 (65%) this was even lower, indicating severe hypoglycemia. Metabolic acidosis was present in 16 of the 17 children for whom this information was available.

Twelve of 16 children had low levels of potassium, and eight out of nine in whom this was measured had falsely high blood fat levels (pseudohypertriglycerideremia). The researchers concluded that the children had glycerol intoxication syndrome.

All the children recovered quickly after initial resuscitation and stabilization of their blood glucose. They were discharged with advice to avoid slush ice drinks. Twenty did so and had no further episodes of hypoglycemia.

But one drank another slush ice drink at the age of 7 and developed symptoms within an hour, rapidly progressing to vomiting and drowsiness. The parents gave the child a glucose drink, and called an ambulance. When the paramedics arrived, the child’s blood glucose was back to normal and symptoms were already resolving.

Most of the cases in the series presented for emergency care between 2018 and 2024. And the researchers suggest, “A cause of the recent apparent surge in cases may be the reduced sugar content of these drinks, secondary to two main factors: first, public health and parental concerns about high sugar ingestion, and second, the introduction of a ‘sugar tax’ on high sugar (>5%)-containing drinks in Ireland and the UK in 2018 and 2019, respectively.”

These drinks, sold in countries where there’s no sugar tax, contain a much higher glucose content and often don’t contain any glycerol at all, they add.

Based on some of the cases in this series, the UK Food Standards Agency recommended that young children (4 and under) shouldn’t be given slush ice drinks containing glycerol, and that those aged 10 or younger should not have more than one.The Food Safety Authority of Ireland (FSAI) followed suit with similar guidance in 2024.

But the researchers believe that these recommendations may no longer be enough.

“There is poor transparency around slush ice drink glycerol concentration; estimating a safe dose is therefore not easy. It is also likely that speed and dose of ingestion, along with other aspects, such as whether the drink is consumed alongside a meal or during a fasting state, or consumed after high-intensity exercise, may be contributing factors,” they write.

“Food Standards Scotland and the FSAI suggested that 125 mg/kg of body weight per hour is the lowest dose that is associated with negative health effects. For a toddler, this may equate to 50–220 ml of a slush ice drink. The standard size drink sold in the UK and Ireland is 500 ml,” they point out.

Given that these drinks don’t confer any nutritional or health benefits, “recommendations on their safe consumption therefore need to be weighted towards safety,” they suggest.

And they conclude, “To ensure safe population-level recommendations can be easily interpreted at the individual parental level, and given the variability across an age cohort of weight, we suggest that recommendations should be based on weight rather than age. Alternatively, the recommended age threshold may need to be higher (8 years), to ensure the dose per weight would not be exceeded, given normal population variation in weight.”

A new study has found that extending state Medicaid coverage did not increase the likelihood of prescription opioid or benzodiazepine misuse among people who use drugs.

People who inject drugs and experience poverty are at an increased risk of health conditions such as HIV and tuberculosis, as well as overdose. While this population stands to benefit from health services provided through Medicaid expansion, prior reports have claimed that extending Medicaid coverage to this group encourages misuse of opioids.

A new study led by researchers at Boston University School of Public Health (BUSPH) and Emory University Rollins School of Public Health (Rollins SPH) vigorously refutes this claim.

Published in the Journal of Substance Use and Addiction Treatment, the study examined federal data on health and drug use among nearly 20,000 people who inject drugs and are low-income in the US, and found no association between Medicaid expansion and misuse of prescription opioids or benzodiazepines, drugs often prescribed for anxiety or insomnia.

Importantly, these findings present real-world data that disprove narratives claiming that Medicaid expansion has fueled the longstanding opioid crisis in America by increasing access to low-cost prescription opioids diverted for non-prescribed use.

The new study takes into account state-level opioid trends and individual-level characteristics—such as race, health status, and insurance coverage—that can affect how and to what extent people may access and utilize opioids. The researchers observed no increase in non-prescribed opioid use among low-income people who use drugs, a clinically and socially vulnerable population for which expanded Medicaid coverage could fulfill unmet and costly health needs.

If Congress advances a budget blueprint that cuts funding to Medicaid—which serves more than 1 in 5 people in the US—these critical needs could remain unmet.

“Our findings provide strong empirical data that indicate there is no link between Medicaid expansion and non-prescribed use of opioids and benzodiazepines,” says study lead and corresponding author Dr. Danielle Haley, assistant professor of community health sciences at BUSPH. “This insight allows us to focus on what we do know from the literature about Medicaid expansion—that there are potential life-saving benefits for people who use drugs.”

While the earlier stages of the opioid crisis were driven by an overprescribing of opioid pain medication, the US has made concerted efforts to address this problem, Dr. Haley adds.

“The timing of the opioid overdose crisis far predates the expansion of Medicaid, which began in 2014 under the Affordable Care Act,” she says. “What has really driven overdose deaths over the last several years are synthetic opioids, such as fentanyl. We need to support policies that ensure individuals have access to appropriate pain medication while advancing best practices for prescribing these drugs.”

For the study, Dr. Haley and colleagues from Rollins SPH, Johns Hopkins Bloomberg School of Public Health, and the Florida State University College of Nursing utilized three waves of federal health data in 2012, 2015, and 2018, among 19,728 people who inject drugs ages 18–64 who were enrolled in Medicaid with an income of 138 percent of the federal poverty line or below. The participants resided in 13 states, including 10 that expanded Medicaid and 3 that did not expand Medicaid.

After accounting for numerous factors, such as race/ethnicity, income, employment, health conditions, and access to drug monitoring programs, they observed no connection between Medicaid expansion and non-prescribed use of opioids or benzodiazepines among all of the participants—nor any association based specifically on race/ethnicity or HIV status.

The researchers hope the new findings help reduce persistent stigmas and structural inequities associated with opioid use among people who inject drugs.

“FDA-approved medications for opioid use disorder are very effective in treating opioid use disorder, and also reducing overdose,” Dr. Haley says. “There are multiple issues that still need to be addressed, but having health insurance is a critical gateway for people to access these life-saving services. It is important to address the barriers that Medicaid enrollees who inject drugs encounter in actually receiving the treatment and services their insurance provides.”

An exercise intervention aimed at elderly women was successful at reducing falls, especially among those with polypharmacy, a new study from the University of Eastern Finland and Kuopio University Hospital shows. The results were published in Scientific Reports.

The researchers also found that polypharmacy was associated with poorer results in functional tests measuring physical fitness. Polypharmacy was defined as the regular use of four or more medications.

“Our findings suggest that, in order to enhance fall prevention in the elderly population, efforts to increase physical activity should be targeted specifically at those using multiple medications,” says researcher Anna-Erika Tamminen of the Kuopio Musculoskeletal Research Unit at the University of Eastern Finland.

According to Research Director Toni Rikkonen, the effectiveness of the exercise intervention was, as expected, largely dependent on the initial fitness level: “Those with the poorest physical fitness initially benefitted the most.”

The researchers conducted a secondary analysis of the Kuopio Fall Prevention Study data. The randomized controlled trial included 914 women, with the median age being 76.5 years at the onset of the study. Half of the women were randomized into an exercise intervention group and half into a control group.

All participants underwent fitness tests at the beginning of the study, and again one and two years later. Medication use was assessed with a baseline questionnaire, and participants were divided into six groups based on the number of medications used. Falls were monitored for about two years through biweekly SMS queries sent to participants.

The exercise intervention included guided exercise sessions twice a week for the first six months, with tai chi on one day and circuit training on the other. For the following six months, participants had free access to the city’s recreational sports facilities.

During the follow-up, 1,380 falls were reported, of which 739 resulted in injury and pain, and 63 in a fracture. The lowest risk of fall was among women with polypharmacy who participated in the exercise intervention. Their risk was 29% lower than that of the control group using zero to one medications and not participating in the intervention.

Previous studies have associated polypharmacy with an increased risk of fall. However, in this study, polypharmacy did not affect the number of falls in the control group. Furthermore, no association was observed between the number of medications used and the number of fractures. Fitness test results were best among those who used zero to one medications in both the control and intervention groups, and the poorest among those using multiple medications throughout the follow-up.

Oscar-winning actor Gene Hackman and his wife Betsy Arakawa were found dead, along with their pet dog, at their home in Santa Fe, New Mexico in February 2025, sparking intense online speculation about the cause of death.

In March, New Mexico’s chief medical examiner, Dr. Heather Jerrell, announced that Hackman, who was in the advanced stages of Alzheimer’s disease, died from hypertensive and atherosclerotic cardiovascular disease—a combination of high blood pressure and a buildup of plaque in the arteries. Arakawa, however, died around a week before her husband from hantavirus pulmonary syndrome—an infection transmitted to humans from rodent feces, urine and saliva.

It’s unknown how Arakawa contracted hantavirus. Usually, (farmers and forestry workers) are most at risk of exposure to infected rodents.

There are at least 38 recognized species of hantavirus across the world, 24 of which cause disease in humans. It’s considered a rare virus but it’s also likely to be underdiagnosed in many areas of the world because the initial symptoms can be mistaken for cold and flu-like viral infections.

Hantaviruses are typically divided into “old-world” and “new-world” types. Old world hantaviruses are found in Europe and Asia, including the puumala hantavirus, which uses the bank vole as its host, and the Hantaan virus and Seoul virus, carried by the striped field mouse and the common brown rat. These hantaviruses cause hemorrhagic fever with renal syndrome (HFRS)—bleeding from various areas of the body and varying degrees of kidney impairment. Estimated to affect 150,000 people annually, this condition is usually reversible. Some patients may develop nephropathia epidemica—a milder form of the virus.

New world hantaviruses, found in North and South America, result in hantavirus pulmonary syndrome (HPS), which tends to be more severe than HFRS. It affects the lungs and heart, impairing the delivery of oxygen around the body. In North America, the most common type of hantavirus is the sin nombre virus spread by the deer mouse. In South America, the andes virus, often carried by the long-tailed pygmy rice rat, is most common.

Hantavirus transmission

The disease is caused by inhaling rodent feces, urine or saliva—often from disturbing rodent nests and droppings while cleaning. More rarely, hantavirus is transmitted by bites and scratches from infected animals.

A small number of studies have documented human-to-human spread of the andes strain in South America, but a systematic review of the research didn’t find enough evidence of human-to-human transmission.

The incubation period of hantavirus is relatively long, typically two to three weeks, but can be as long as six weeks. This may be why cases are underreported—patients may forget the potential exposure event. Diagnosis is usually based on symptoms and history, although laboratory tests can detect antibodies to hantavirus in human serum.

The virus causes a change in the permeability of the cells that line blood vessels so that fluid leaks out in places it shouldn’t, such as the lungs and kidneys. It also reduces the number of platelets in the blood, reducing blood clotting so that blood leaks from organs and vessels. The hantavirus also appears to prevent apoptosis—when the body kills cells in response viral infection—so the body is unable to get rid of infected cells as efficiently, which prolongs the virus.

The severity of the virus depends on a number of factors, including age and genetic predisposition. People over the age of 70 are most likely to die of hantavirus, while some human leukocyte antigens– the immune system markers that check which cells belong in your body and which do not—show an increased risk of severe disease.

It isn’t known how long immunity following hantavirus infection lasts, but immunoglobulin G antibodies—a type of protein that helps the body fight infections from viruses and bacteria—are likely to protect against subsequent symptomatic infection from the same strain. However, given the large number of hantavirus species, having had one form would be unlikely to protect against catching a different form.

Symptoms

Infection with either old or new world strains start with similar viral symptoms: fever, headache, fatigue, muscle pains, abdominal issues including nausea, vomiting, diarrhea and abdominal pains. The old and new strains have different disease progression. Both strains should be treated promptly to reduce risk of death.

In old-world infections leading to HFRS, patients move from the generic symptoms to low blood pressure and then reduced urinary output. Patients may need dialysis to protect the kidneys. Those infected will then experience increased urinary output to clear the excess fluid collected in the previous stage of the disease. Finally, patients enter the convalescent phase with fatigue and muscle pains.

In HPS from new-world hantavirus strains, symptoms usually appear within eight weeks of exposure. Three to five days of generic symptoms are followed by rapid deterioration as fluid fills the lungs making breathing difficult. Many patients require mechanical ventilation such as extracorporeal membrane oxygenation—a kind of life support where blood is pumped outside of the body to a heart-lung machine. In the final stage of the disease, urine output will increase significantly as the body attempts to expel excess fluid. With early treatment, most people with HPS fully recover with no lasting effects—but mortality rate can be as high as 40%.

Treatments

Treatment is targeted towards symptom management with oxygen therapy. Antiviral medication ribavirin has shown in trials to be more beneficial for HFRS than HPS. A hantavirus vaccine trailed in South Korea generated a good immune response and was well tolerated for prevention of HFRS but wider results are unclear.

As always, prevention is better than cure and the most effective way to prevent hantavirus infection in humans is to keep surroundings free from rodents. But, this is easier said than done—so cleaning with disinfectant is essential to ensure areas are free of rodent fluids and feces. Allow disinfectant or bleach to soak the area for at least five minutes before cleaning with absorbent materials. Gloves and a mask, of course, should be worn at all times.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The best way to avoid getting bitten by a venomous snake is to not go looking for one in the first place.

Like eating well and exercising to feel better, the avoidance approach is fully backed by science. A new study from University of Florida Health researchers analyzed 20 years of snakebite cases seen at UF Health Shands Hospital in Gainesville. The results were published in the Transactions of The Royal Society of Tropical Medicine and Hygiene.

“This is the first time we’ve evaluated two decades of venomous snakebites here,” said senior author and assistant professor of medicine Norman L. Beatty, M.D., FACP.

Researchers analyzed 546 de-identified patient records from 2002 to 2022 and highlighted notable conclusions—for instance, that a third of the snakebites analyzed were preventable and caused by people intentionally engaging with wild snakes.

“Typically, people’s experiences with getting bitten are due to an interaction that was inadvertent—they stumble upon a snake or reach for something without seeing one camouflaged,” Beatty said. “In this case, people were seeking them out. There were a few individuals who were bitten on more than one occasion.”

Most (77.8%) of the snakebites occurred in adult men while they were handling wild snakes, and most of the bites were perpetrated by the diminutive pygmy rattlesnake and the cottonmouth. The latter is named for the white lining of its mouth, which it displays when threatened.

“I was less surprised to see those species emerge as some of the most common ones people were bitten by, but the robust presence of other, less common species in the data—like the eastern coral snake, southern copperhead, timber rattlesnake and the eastern diamondback rattlesnake, was interesting,” Beatty said.

The eastern diamondback rattlesnake is one of the most venomous snakes in North America.

Most patients were bitten on their hands and fingers and about 10% of them attempted outdated self-treatments no longer recommended by doctors—like sucking out the venom.

Initially, the study began as a medical student research project, thanks to a handful of medical students who worked with Beatty to review the cases. The intention was to dive deep into the circumstances of each encounter and learn more about the treatment given, as well as the outcomes.

Fourth-year medical student River Grace, the paper’s first author, said the work struck a personal note.

“My dad is a reptile biologist, so I’ve grown up around snakes my whole life,” Grace said. “He was bitten by a venomous snake many years ago and ended up hospitalized for multiple weeks, so it was interesting to keep that experience in mind while going over the data.”

Grace noted that it typically took those bitten over an hour on average to travel from where the bite occurred to the hospital.

“It seems like the reason for that was people not knowing exactly what to do once they’d been bitten, or underestimating the severity of the bite,” he said. “Some would just sit at home for hours.”

Floridians share their home with a variety of scaly neighbors who don’t always welcome visitors—accidental or not. Ultimately, thanks to the timely care of providers, only three snake bites were fatal. However, antivenom is no panacea. Those who are lucky enough to receive it in time can still incur complications from the original snake bites, like tissue damage, or even a fatal allergic reaction to the antivenom itself.

Consequently, researchers look toward improving the processes used to triage snake bites in the emergency room, ensuring that providers are equipped with the knowledge and the know-how to shorten time to treatment.

“In the future, we think we’d love to get involved in enhancing provider education so everyone in the health care setting is confident in being able to identify and administer antivenom as quickly and safely as possible,” Grace said.

Northwestern Medicine scientists have uncovered new insights into how neurofilaments act like Velcro in neurodegenerative diseases, clogging up the brain and preventing normal function, according to a study published in the journal JCI Insight.

Giant axonal neuropathy (GAN) is a rare, genetic neurodegenerative disorder in which large nerve fibers in the brain (axons) abnormally accumulate clumps of cytoskeletal proteins called neurofilaments. Neurofilaments have also been linked to multiple neurodegenerative disorders, including Parkinson’s Disease, dementia and amyotrophic lateral sclerosis (ALS).

Previous research has shown that the buildup of neurofilaments in GAN is caused by a lack of gigaxonin, a protein that helps break down filaments. However, the exact mechanisms that control this process have not been well understood, said Puneet Opal, MD, ’95 Ph.D., the Lewis John Pollock Professor of Neurology in the Division of Movement Disorders and of Cell and Developmental Biology, and senior author of the study.

“We wanted to understand whether there could be an alternative pathway for degrading proteins which could be upregulated when the gigaxonin pathway is mutated,” said Opal, who also directs the Denning Ataxia Center.

In the study, Opal and his collaborators employed a combination of genetic and RNA interference (RNAi) approaches to study the brains of mice which lacked gigaxonin.

They observed that the cellular recycling processes were disrupted because the neurofilaments acted like Velcro in the brain, preventing organelles from moving, according to the study.

Additionally, the cellular recycling plants—called lysosomes—were missing key digestive enzymes responsible for breaking down waste products, the scientists found.

“These vesicles can’t reach the garbage can—lysosomes,” Opal said. “So, the neurofilaments cannot be degraded by that. Additionally, the neurofilaments create docking sites for proteins and organelles normally, but in the disease, these sites are a little bit garbled.”

By monitoring lysosomal activity in mice with GAN, the investigators also found that Transcription factor EB (TFEB), a protein essential for the creation of healthy lysosomes, became trapped in the neurofilaments, preventing it from moving around the cell.

“This dual problem basically causes a snowballing effect where the protein cannot be degraded by its normal pathway,” Opal said. “This explains why children with this disease become worse and worse with age.”

The findings are also useful for understanding other neurodegenerative diseases which feature neurofilament accumulations, such as Parkinson’s and Alzheimer’s disease, Opal said.

“When you have these other diseases, when so much else is going on, it’s difficult to pinpoint the role of neurofilaments,” Opal said. “But here, with this genetic disease, we basically honed in on this very singular pathway.”

On the heels of this discovery, Opal said he and his collaborators hope to create new drugs which can reverse the accumulation of neurofilaments.

In a Duke Health-led survey, patients who were shown messages written either by artificial intelligence (AI) or human clinicians indicated a preference for responses drafted by AI over a human. That preference was diminished, though not erased, when told AI was involved.

The study, published March 11 in JAMA Network Open, showed high overall satisfaction with communications written both by AI and humans, despite their preference for AI. This suggests that letting patients know AI was used does not greatly reduce confidence in the message.

“Every health system is grappling with this issue of whether we disclose the use of AI and how,” said senior author Anand Chowdhury, M.D., assistant professor in the Department of Medicine at Duke University School of Medicine. “There is a desire to be transparent, and a desire to have satisfied patients. If we disclose AI, what do we lose? That is what our study intended to measure.”

Chowdhury and colleagues sent a series of surveys to members of the Duke University Health System patient advisory committee. This is a group of Duke Health patients and community members who help inform how Duke Health communicates with and cares for patients. More than 1,400 people responded to at least one of the surveys.

The surveys focused on three clinical topics, including routine medication refill request (a low seriousness topic), medication side effect question (moderate seriousness), and potential cancer on imaging (high seriousness).

Human responses were provided by a multidisciplinary team of physicians who were asked to write a realistic response to each survey scenario based on how they typically draft responses to patients. The generative AI responses were written using ChatGPT and were reviewed for accuracy by the study physicians who made minimal changes to the responses.

For each survey, participants were asked to review a vignette that presented one of the clinical topics. Each vignette included a response from either AI or human clinicians, along with either a disclosure or no disclosure telling them who the author was. They were then asked to rate their overall satisfaction with the response, usefulness of the information, and how cared for they felt during the interaction.

Comparing authors, patients preferred AI-drafted messages by an average difference of 0.30 points on 5-point scale for satisfaction. The AI communications tended to be longer, included more details, and likely seemed more empathetic than human-drafted messages.

“Our study shows us that patients have a slight preference for messages written by AI, even though they are slightly less satisfied when the disclosure informs them that AI was involved,” said first author Joanna S. Cavalier, M.D., assistant professor in the Department of Medicine at Duke University School of Medicine.

When they looked at the difference in satisfaction when participants were told AI was involved, disclosing AI led to lower satisfaction, though not by much: 0.1 points on the 5-point scale. Regardless of the actual author, patients were overall more satisfied with messages when they were not told AI was involved in drafting the response.

“These findings are particularly important in the context of research showing that patients have higher satisfaction when they can connect electronically with their clinicians,” Chowdhury said.

“At the same time, clinicians express burnout when their in-basket is full, making the use of automated tools highly attractive to ease that burden,” Chowdhury said. “Ultimately, these findings give us confidence to use technologies like this to potentially help our clinicians reduce burnout, while still doing the right thing and telling our patients when we use AI.”

In addition to Chowdhury and Cavalier, study authors include Benjamin A. Goldstein, Vardit Ravitsky, Jean-Christophe Bélisle-Pipon, Armando Bedoya, Jennifer Maddocks, Sam Klotman, Matt Roman, Jessica Sperling, Chun Xu, and Eric G Poon.

Vaccine effectiveness relies on creating a strong antibody response that can be reactivated to fight future infections. Now, researchers from Japan report that antibody-producing cells are destined for longevity from the moment they are born.

In a study published in the Journal of Experimental Medicine, a multi-institutional research team led by Osaka University reveals that a key cell population involved in long-term immunity to infection is programmed early in its lifecycle to travel to protected sites in the body.

Plasma cells originate in lymphoid (immune) tissues and then migrate to protected sites throughout the body, where they produce large amounts of antibodies in response to infection-related substances. Long-lived plasma cells (LLPCs), which are important for protection from reinfection, are thought to migrate specifically to the bone marrow.

“The importance of LLPCs to immunity is well known,” says Wataru Ise, lead author of the study. “However, it is unclear how plasma cells generated in lymphoid tissues migrate to the bone marrow, where they can survive for a long time.”

To investigate this, the researchers looked at the different types of proteins expressed by plasma cells that had just been produced by lymphoid tissues compared with the proteins expressed by plasma cells that successfully made it to the bone marrow.

“The results were very clear,” explains Tomohiro Kurosaki, senior author. “We found that high expression of a single protein called integrin β7 was an excellent marker for plasma cells migrating to the bone marrow.”

When the researchers explored how integrin β7^hi cells could home to the right location, they found that these cells also express high levels of the transcription factor KLF2, which prompts them to move out of lymphoid tissue and into the blood. Importantly, decreased expression of the gene encoding KLF2 or its target S1pr1, reduced the ability of mice to develop resistance to flu.

“Our findings show that the migration program of plasma cells is established in their tissue of origin and plays a critical role in determining the durability of the antibody response,” says Ise.

Given that a durable antibody response is key to vaccine effectiveness, the findings from this study could be used to improve vaccines. Promoting plasma cell migration and survival in protected sites like the bone marrow could mean establishing lasting immunity to dangerous infections.

It will likely be weeks before public health agencies know the full extent of measles exposure in Virginia and Maryland following the discovery of an infected person living in Howard County, officials said.

The Maryland Department of Health reported Sunday that an unidentified patient tested positive for the highly contagious virus after recently traveling internationally to an unspecified country. That person had been in the Washington Dulles International Airport, including the baggage claim area and through Terminal A on March 5 and, two days later, was in the Johns Hopkins Howard County Medical Center Pediatric Emergency Department, according to the state health department.

Public health officials are urging anyone who may have been exposed to watch for symptoms—which mimic cold symptoms, plus a high fever and rash that starts as flat, red spots—until March 26. If symptoms manifest, people should isolate themselves at home and contact a health care provider before showing up at a health center. As of Monday afternoon, no other measles infections had been reported in Maryland.

Johns Hopkins Howard County Medical Center has notified anyone who may have encountered the infected patient, according to the hospital. No new infections have been found, said spokesperson Tia Mason.

Dr. Greg Schrank, an infectious diseases expert at the University Of Maryland Medical Center, said measles typically has an incubation period of up to three weeks.

“It might be a week or longer before we start to see any exposed individuals who develop infection to start to present with symptoms,” Schrank said.

Will that happen? It depends, he said.

“I think it’s hard to predict. It really depends on who was exposed. One thing we can lean on a bit here in Maryland is that we generally have a very highly immunized population, especially to measles.”

Cases in 12 different parts of the country

Meanwhile, the Virginia Department of Health is working with the Centers for Disease Control and Prevention to identify people on the flight into Dulles who may have been exposed, said department spokesperson Brookie Crawford. The department declined to say how many people have been contacted.

Before the Maryland case, the CDC had tracked at least 222 measles cases in 12 different parts of the United States. The vast majority, 198, were in Texas. New Mexico has seen at least 10 cases.

This Maryland case was not connected to the Texas and New Mexico outbreaks, according to the state Department of Health.

Public health officials have provided no information on the infected Maryland resident. The Howard County Public School System sent a message to parents stating that it had not received any indication that the person was a student or staff member.

Maryland counted one measles infection last year, one in 2023 and, before that, five cases in 2019. The 2024 and 2023 cases also involved international travel, said Dr. Lucia Donatelli, who leads the Maryland Department of Health’s Center for Immunization.

“One of the messages that I really want to get out there is that, prior to international travel, when you’re planning a trip overseas, make sure you’re up to date on your vaccinations,” Donatelli said.

Swelling of the brain

While measles often looks only like a rash, it can cause a variety of health complications and even lead to death, especially in the very young.

According to the Centers for Disease Control and Prevention, symptoms of an infection typically one to two weeks after exposure to the virus. Common symptoms include high fever (sometimes 104 degrees or higher), coughing, runny noses, and red, watery eyes. A rash usually comes three to five days after the first symptoms start.

Children younger than 5, adults over 20, pregnant women and people with weakened immune systems are most likely to suffer complications. About 10% of children infected will get ear infections, and about 5% of them will get pneumonia—the leading cause of death in measles-infected young children.

In much rarer cases (about one out of 1,000 cases), infected children will develop swelling of the brain, which can lead to convulsions and result in deafness or permanent intellectual disabilities, according to the CDC.

Infections in pregnant women can lead to premature births and/or low birth weights.

In 2023, health experts estimate that about 107,500 people died globally from measles.

“As a mother, I know that every parent wants to do what’s best for their child; we all do,” said Monique Soileau-Burke, a pediatrician at The Pediatric Center in Columbia. “And vaccinating your children is the best way to keep them healthy, keep them safe and keep them from any long-term consequences that they may have after getting the measles or any other vaccine-preventable disease.”

‘Go out and get vaccinated’

Measles is spread through the air when an infected person coughs or sneezes. Infected droplets can remain in the room for two hours and infect those exposed to it by breathing or touching infected objects.

People with measles can spread the virus four days before and four days after a rash appears.

A single infected person can spread measles to 12–18 people who are susceptible to the virus, health experts say.

Vaccination is the best way to prevent infection. According to the CDC, two doses of the MMR (measles, mumps and rubella) vaccine are about 97% effective at preventing measles; one dose is about 93% effective. Children are generally vaccinated after their first birthday but may be inoculated when they’re as young as 6 months, especially if they will travel internationally, according to the Maryland Department of Health.

Epidemiologists say that at least 95% of a given population must be vaccinated to prevent widespread infections. Federal data show that more than 96% of Maryland kindergartners had received two doses of the MMR vaccine during the 2023–24 school year—one of the highest vaccination rates in the country. The national average is 92.7%, according to the CDC.

A State of Maryland survey put actual vaccination rates among this age group during that period at an even higher 99%.

“We have very high vaccination rates in general,” said Donatelli. “Having said that, we do have pockets of the population that we know are undervaccinated. So, if you haven’t gotten the MMR vaccine and you’re not fully vaccinated, this is the time to reconsider and go out and get vaccinated.”

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