Researchers at the Technical University of Munich (TUM), Imperial College London, and the Hasso Plattner Institute (HPI) demonstrate that earlier calculations of AI model security are misleading. Attacks that aim to determine whether an individual’s data was used to train a model are known as membership inference attacks (MIAs). Until now, common medical AI models were considered largely secure against MIAs.

“Unfortunately, previous risk assessments have only ever measured the average risk across all patients. We examined the risk at the level of individual patients for the first time – and it paints a very different picture,” says TUM researcher Moritz Knolle, first author of the study. While the attacks were unsuccessful for a large proportion of the datasets, some patients could be linked to the models with near‑100 percent certainty. “This is not a tolerable risk. Health data is highly sensitive,” says Daniel Rückert, Professor of Artificial Intelligence in Healthcare and Medicine at TUM and, together with Professor Georg Kaissis (HPI), senior author of the study.

Different data types tested

The researchers attacked models based on seven established medical datasets. Each model relied on a different type of data, such as imaging data, electrocardiograms, or electronic health records. “An attacker needs three things to carry out a MIA,” explains Georg Kaissis, Professor of Digital Health: Human-Centered Transformative AI at the Hasso Plattner Institute. “First, access to the AI model being targeted, for example via a hospital network. Second, access to a data point for which they want to know whether it was included in the model, for example, data obtained in a cyberattack. Third, their own AI infrastructure – that is, computers running models based on the same type of data as the target model.”

With this setup, it would be possible, for example, to attack an AI model that uses blood test results to predict the likelihood of success of cancer immunotherapy. On its own, a blood test does not reveal whether a person has a disease. However, if an attacker can show that a specific data point was used to train the model, it becomes more likely that the patient has or had cancer.

Potential impact on individuals

Such digital attacks can have serious real-world consequences, as Moritz Knolle illustrates with a hypothetical example: “Imagine you were treated for cancer and made your data available for research,” says the medical informatics expert. “Years later – the cancer has not returned since then – you want to take out private supplemental insurance. However, an attacker has discovered that your data was used to train a tumor analysis model. This information reaches the insurer, for example through data analysis by third-party providers or corresponding risk profiles. You are then classified as a high-risk patient, with the corresponding premiums – and may never even find out why.”

The MIAs were particularly successful when targeted individuals belonged to groups that were underrepresented in the dataset. This could include certain anatomical characteristics in imaging data, but also data from minority groups. “This is especially serious because discrimination in AI also plays a role in medicine, and some models, for example, make less accurate predictions when the patient belongs to a minority group,” says Daniel Rückert.

Larger models show greater vulnerability

The researchers show that the attacks become more successful as the models grow larger and more complex. In the researchers’ view, the fact that high-performance models are particularly vulnerable indicates that the problem could become significantly more severe in the coming years if no countermeasures are taken.

They therefore advocate assessing the risks of new models at the level of individual patients before their release. Additional countermeasures include strict control of access to AI models. “There are already effective safeguards against MIAs that can be applied during model training. For example, differential privacy introduces small modifications into the training data that do not affect the model’s calculations but make MIAs significantly more difficult,” says Georg Kaissis.

Publication:

Knolle, M.A., Menten, M.J., Jungmann, F. et al. Disparate privacy risks from medical AI. Nature (2026). DOI:10.1038/s41586-026-10688-0.

Further information:

• Prof. Daniel Rückert holds the Chair of AI in Healthcare and Medicine at the TUM School of Medicine and Health and is a member of the TUM School of Computation, Information, and Technology, the Munich Data Science Institute (MDSI) as well as the Munich Center for Machine Learning (MCML).
• Original article: https://www.tum.de/en/news-and-events/all-news/press-releases/details/study-reveals-privacy-risks-in-medical-ai

“Our results showed that discharging older adults after an acute care hospital stay with a new prescription for these medications was associated with an increased hazard of falls requiring medical attention, further need for acute hospital care, and death in the 30 days after hospital discharge, whereas individuals with prior exposure did not experience the same increased hazards,” writes Dr. Lisa Burry, clinician scientist at Mount Sinai Hospital, Sinai Health and University of Toronto, Toronto, Ontario, with coauthors.

Falls are a major public health burden and affect older adults in particular. Sedatives and antipsychotics are associated with adverse events, and clinical guidance discourages prescribing these potentially inappropriate medications for older adults.

The study of more than 1.86 million adults aged 66 years and older aimed to understand prescribing patterns to inform discharge prescribing in future. Based on ICES data, it looked at all patients discharged from hospital between April 2003 and August 2023. In total, 13% (246 440) filled at least 1 prescription for any sedative within 7 days of discharge, and about one-third (76 335) of them had not filled a prescription for a sedative within the 6-month period before hospitalization. The risk of falls was 20% higher in people with a new sedative prescription, and the risk of an emergency department visit, readmission, and death within 30 days was also increased.

“Although the overall absolute magnitude of the risk of adverse events identified was modest from a population perspective, the effects on patients and their families are clinically and socially important,” write the authors. “Moreover, given the volume of hospital admissions among older adults and the aging population, a modest increase in risk translates into a large impact on the health care system.”

The authors suggest caution when prescribing these medications on hospital discharge, ensuring medical follow-up 1 to 2 weeks after discharge to monitor patients, continue risk assessment, and review the need for the prescription.

“Given the identified associations, clinicians must consider whether new sedative prescriptions are essential or can be deprescribed or de-escalated before or shortly after hospital discharge. When ongoing sedative use is required, community support, such as falls or mobility assessments, and ongoing medication reviews may help mitigate risks,” the authors conclude.

Heart failure affects approximately 860,000 Canadians, is associated with reduced survival and quality of life, and is the third leading cause of hospitalization in the country. Heart failure with reduced ejection fraction (HFrEF) accounts for approximately half of these cases.

Despite high-quality evidence supporting the benefits of guideline-directed medical therapy (GDMT) for patients with HFrEF, which entails the rapid initiation of four distinct classes of medication collectively known as quadruple therapy, use of these medications remains suboptimal. This is in part due to inadequate access to heart failure specialists and clinics for many Canadian patients living with HFrEF. This high unmet need underscores the importance of alternative models that expand beyond physician-led GDMT management.

“Heart failure is a serious medical condition that has several effective medications that are underused across Canada,” says lead investigator Ricky Turgeon, BSc(Pharm), ACPR, PharmD, Faculty of Pharmaceutical Sciences, University of British Columbia. “Pharmacists and nurse practitioners are important members of the healthcare team who can help to improve medication use for heart failure.”

The researchers evaluated whether getting pharmacists and nurse practitioners to initiate and manage heart failure medications would be good value for money for the healthcare system by comparing two different scenarios using an economic model.

In the first scenario, patients with heart failure received the usual care currently experienced by most British Columbians with heart failure. In the second scenario, patients with heart failure received the usual care plus additional medication management from pharmacists and nurse practitioners. The investigators then modelled what would happen to these patients over time and tracked how long they would live, how often they would be hospitalized, and how much healthcare resources they would need.

It was estimated that within the first year of implementation, this added service would save approximately 10 lives and prevent 25 hospitalizations per every 1,000 patients who received the pharmacist- or nurse practitioner-led intervention.

“While this service would require additional funding, we demonstrated that this investment would be well justified given what the Canadian healthcare system is generally willing to pay,” notes Dr. Turgeon. “The size of this benefit was far beyond what was anticipated. As a pharmacist caring for people with heart failure, I find these results genuinely empowering. They show that we play an important role in improving patients’ lives while also easing pressure on the healthcare system. We have the evidence; now we need to implement this approach.”

By quantifying the clinical and economic impacts of these additional medication management services, this study provides healthcare system planners with the insights needed to effectively address persistent gaps in care for heart failure patients.

Co-lead investigator Kelly Mackay, MA, Cardiac Services BC, Provincial Health Services Authority, comments, “Our research offers a roadmap to improving patient outcomes while strengthening the sustainability of our health system. The research also provides Cardiac Services BC with the evidence and innovation needed to drive meaningful system change.”

“Expedited and increased access to quadruple therapy has the potential to save lives and reduce some of the pressures in British Columbia’s hospitals. We believe this model could also be successful in other Canadian provinces. We’re thrilled that this research presents such an effective—and feasible—way for more heart failure patients to receive this gold-standard treatment,” concludes co-investigator Nathaniel Hawkins, MBChB, MD, MPH, Cardiac Services BC, Provincial Health Services Authority, and Division of Cardiology, University of British Columbia.

Robert Fletcher of the University of Cambridge, Health Data Research UK and The George Institute, and study co-lead says:

“Levels of obesity in England have worsened since the pandemic, with nearly one in three people now affected.

“We’re also seeing large disparities across the country: the percentage of adults affected by obesity in northeast England is six times higher than in central London. Differences on this scale are rarely seen in other areas of public health. The rise in new cases among young adults of childbearing age is especially concerning. Beyond the implications for their own long-term health, obesity is associated with infertility, adverse pregnancy outcomes, and child obesity, which may perpetuate intergenerational cycles of health inequality.”

Key findings:

Obesity is rising: Rates of new obesity cases increased overall by 4% in 2025 compared with before the COVID-19 pandemic.

Young adults hit hardest: The largest increases over time were seen in younger adults. Rates of new obesity cases rose by almost 20% in those aged 30-39, and by 16% in those aged 20-29, while rates fell among adults aged 60-79.

Risk rises with deprivation: Over the study period, rates of new obesity cases were 35% higher for people with the highest socioeconomic deprivation (those with the lowest incomes, highest unemployment, and poorest housing) compared with people with the lowest socioeconomic deprivation. The gap was wider still for women, where new cases were 54% higher among the most deprived, and widest for Asian women, at 94% higher.

Ethnicity and deprivation compound: The percentage of people living with obesity ranged from 4% among the most affluent White men aged 18–19 to 66% among the most socioeconomically deprived Black women aged 60–69 – nearly double the figure for the least-deprived White women of the same age.

Large geographical differences: The percentage of people affected by obesity in some areas of northeast England (48%) was nearly six times higher than that seen in the most affluent parts of central London (8.5%). The steepest increases over time were seen in areas with the lowest GDP per capita.

The person-level data analysed in this study has all direct identifiers such as names and NHS numbers removed before researchers access the data, which is then only accessible within NHS England’s Secure Data Environment. The data is only accessible by approved researchers working on approved, COVID-19 related research projects.

The researchers’ definition for obesity was a recorded body-mass index (BMI) of 30 or above, or a clinician’s diagnosis of obesity in a person’s health records. Their findings from this electronic health record study correspond well with the NHS Health Study for England, which samples households across the country, giving confidence in the extra depth of the insights this study is able to provide.

They looked at rates of new cases of obesity (incidence) and the percentage of people with obesity (prevalence) in the general population, as well as differences across sociodemographic groups and geographical regions.

Obesity is now more common than hypertension (high blood pressure) in the UK, and nearly three times as common as smoking. It is a chronic, complex disease linked with a whole host of conditions, including heart disease, stroke, cancer, diabetes, and kidney failure. As well as affecting individuals’ mental wellbeing, and placing growing pressure on both the healthcare system and the economy. These findings highlight the scale and urgency of the obesity crisis, and how it has worsened since the COVID-19 pandemic.

GLP-1 receptor agonist drugs, like Ozempic/Wegovy and Mounjaro, are known to be effective in managing obesity and are being more widely prescribed and used. The study did not set out to examine their impact.

“We don’t see any obvious reduction in obesity in our data following the introduction of GLP-1 receptor agonists, at least not within the current study period,” says Robert Fletcher. “However, the drugs on their own are unlikely to be the answer. At present, the majority are privately prescribed and the jabs are expensive, which poses a barrier for people from disadvantaged backgrounds. We need deep-seated change to the many social and economic factors that drive obesity in the first place.”

Naveed Sattar, one of the co-authors, Professor of Cardiometabolic Medicine at the University of Glasgow and Chair of the Obesity Health Care Goals Programme, agrees:

“Obesity is not primarily about will power. These new, powerful data indicate that those most at risk frequently reside in the most obesogenic environments and likely have the least agency to withstand such environments. To achieve lasting change, the UK must expand access to new treatments faster but also fundamentally reshape food and activity environments so that healthier choices occur with minimal conscious effort. Failure to act will drive further rises in multimorbidity and human suffering, with profound consequences for the NHS and the wider economy.”

Study co-lead Angela Wood, Professor at the University of Cambridge and Associate Director at the British Heart Foundation Data Science Centre, says:

“The COVID-19 pandemic has had a lasting impact on health and lifestyle behaviours. By analysing electronic health records from the entire adult population of England before, during, and after the pandemic, we have generated the most comprehensive evidence to date on how obesity risk and burden are increasingly diverging across multiple dimensions of inequality. These findings underscore the critical importance of secure access to whole-population health data to enable research, surveillance, and timely action to address widening health inequalities.”

The study, funded by the Wellcome Trust, Health Data Research UK, the British Heart Foundation, the National Institute for Health and Care Research Cambridge Biomedical Research Centre, the Cambridge British Heart Foundation Centre of Research Excellence, has been published in The Lancet Diabetes & Endocrinology.

Overall, the plant-based products contained more additives, more ingredients and more E-numbers than their animal-based counterparts.

A team from the Institute for Optimum Nutrition in London (a provider of university-accredited courses in nutrition) led the research which is published today in the peer-reviewed journal, Food Additives & Contaminants: Part A.

Joseph Whittaker, Vivienne Alexa Robinson and Elouise Redmayne looked at 71 like-for-like pairs of animal-based and plant-based products from an unidentified UK supermarket, that were available on the shelves in late-October 2025.

The team matched the products with each other based on a variety of factors such as the ingredients, packaging, and size, to achieve the closest match possible. So, for instance, almond milk was paired with normal milk, vegan brownies with dairy-based brownies, and plant-based meat with regular meat. Other products included were lasagne, coleslaw, pesto, mayonnaise, yoghurt and cake.

The product range used was marketed as plant-based, but all the products were also vegan.

Overall, results showed:

• the total number of food additives in the plant-based products was 199 compared with 100 in their corresponding animal-based equivalents.
• the total ingredients in the plant-based range was 1,566. In the animal-based range, it was 1,110.
• there were 39 E-numbers in the plant-based range and 31 in the animal-based set. (In total, 50 E-numbers were identified, of which 20 appeared in both groups.)

Across additives, ingredients and E-numbers, the difference between plant-based and animal-based was most stark in dairy, meat and fish products and their plant-based replacement.

“We found roughly twice as many food additives in the total sample of plant-based products compared to animal-based ones: 199 versus 100,” states senior author Joseph Whittaker, a lecturer at ION.

“However, even though we found that plant-based products had more food additives this does not necessarily mean an increased health risk. First, we only analysed one product range so we can’t make generalisations to all plant-based products. Second, we didn’t assess the quantity or concentration of food additives used, nor how much or how often people eat these products, so, essentially, we don’t know the level of exposure of food additives from these products. And last, all food additives used in these products have passed UK food safety regulations.”

Plant-based eating is on the rise. UK survey data shows a trend of declining meat consumption – from 103.7 to 86.3 g per capita per day in the decade to 2018–2019*. US dietary survey data reveals that the proportion of adults consuming a plant-based diet increased from 14.4% to 17.2% between 1999–2000 and 2017–2020**. And a Flemish study found that the number of adult ‘flexitarians’ rose from 5.3% to 9.2% from 2011 to 2020***.

Joseph adds: “Our study comes at a particularly important time as plant-based diets are increasing in popularity and more people are turning to plant-based alternatives products, but people are also concerned about the number of food additives in their food. This is known as the ‘clean label trend’. They are also trying to avoid ultra-processed foods and their potential negative effects upon health, although our study wasn’t focused on this.”

The main limitation of the research carried out was the limited sample of products used – from just one supermarket range.

The author team suggest future research should aim to see if the findings are replicated in other product ranges, including different brands and products available in other countries. “If future findings are consistent with ours, we could start to generalise more about plant-based products and be more certain in our conclusions,” Joe adds.

“One really interesting area that our study did not assess is the level of processing of plant-based products” he concludes. “It may be the case that many of these products are highly processed, and people switching to a plant-based diet and using a lot of these products, may end up on a highly refined diet. I think further research should test this, particularly as these diets are so popular now.

“I would argue that plant-based dieters should focus on whole-foods that are naturally plant-based, rather than trying to replicate animal-based foods. By necessity many plant-based alternative foods use food additives and refined ingredients, as foods like plant-based meat do not exist in nature.”

Research cited: * Stewart et al. 2021. **Sullivan et al. 2024. *** Deliens et al. 2022.

The research found that self-directed CBT-CP was associated with modest improvements in pain interference at four months, with those gains sustained through to twelve months. Participants in the self-directed group also showed small to moderate improvements across a range of secondary outcomes at four months. Notably, session-completion rates were higher among those using the self-directed format compared with those receiving clinician-delivered therapy.

Chronic pain affects a significant proportion of the population and places a substantial burden on healthcare systems. CBT is an established psychological treatment for chronic pain, but access to clinician-delivered therapy can be limited by availability, cost, and logistical barriers. The findings suggest that scalable, self-directed formats could help address this gap, potentially increasing the overall uptake of an evidence-based intervention.

The authors conclude that self-directed CBT-CP may represent an effective and more accessible alternative to traditional clinician-delivered care, with implications for how psychological pain management services are designed and delivered.

The study was led by corresponding author Alicia Heapy, PhD, and is published in JAMA (doi:10.1001/jama.2026.7861). The full text is freely accessible here.

The analysis found that while healthy behaviour and lifestyle interventions remain an essential foundation of any effective weight management programme — delivering meaningful weight loss and improvements in body composition on their own — adding pharmacotherapy produced the strongest outcomes. Crucially, the study’s authors characterise medication not merely as a supplementary tool, but as a core component of treatment when combined with lifestyle change.

The review assessed short-term outcomes typically measured over six to twelve months, tracking improvements in body mass index (BMI) and BMI z score, a metric used to contextualise weight relative to age and sex in children and adolescents. Long-term sustainability and safety were also monitored across the included studies.

The findings come as obesity rates in children and adolescents continue to rise globally, placing growing pressure on clinicians and health systems to identify effective, evidence-based treatment approaches. The results suggest a shift in how pharmacotherapy should be framed in paediatric obesity care — not as a last resort or add-on, but as an integral element of a combined strategy.

The study was led by corresponding author Bjorn T. Tam, PhD, and is published in JAMA Pediatrics (doi:10.1001/jamapediatrics.2026.2248). The full text is freely accessible here.

Meanwhile, traditional, in-person visits to the doctor’s office have rebounded since the pandemic. And although digital medicine has become a routine part of healthcare, it is supplementing rather than replacing in-person care. This evolution, researchers say, is reshaping how hospitals and clinics operate daily.

These are the main conclusions of the study, which was led by researchers at NYU Langone Health and represents the largest review ever performed on communications recorded by Epic electronic health records. The team’s analysis involved more than 140 million patient records from 2,067 hospitals and 47,100 health clinics in the US. As part of the study, the researchers evaluated over 8 billion patient-provider interactions that took place between January 2020 and December 2025.

Publishing in the Journal of the American Medical Association (JAMA) online June 22, the study team found that online portal messages more than doubled between 2020 and 2025 (by 153 percent). By contrast, total telephone calls decreased by 6 percent over the same period. The number of Americans with an active Epic health record went from 94 million in 2020 to 140 million in 2025. Thirty percent of active patients on Epic (42 million) sent a portal health app message to their clinician during the first three months of 2025.

Patient portal visits, however, are not replacing in-office visits, which have returned to an average of between two and three per year per patient. Messages from patients to healthcare providers have doubled since the pandemic, from an average pace of 2.2 per year in early 2020 to 5.4 per year in late 2025.

“Our study shows that use of patient portals, health apps, and messaging are now a routine part of everyday patient care across America, not simply side channels used occasionally,” said study senior investigator Michal A. Mankowski, PhD.

Dr. Mankowski, an assistant professor in the Department of Surgery at NYU Grossman School of Medicine, said the study demonstrates that patients now have much more direct access to physicians and other clinicians.

“Our findings reveal that while digital health tools have become a core part of healthcare, delivery is becoming more continuous, timeless, and no longer tied to scheduled appointments during routine work hours,” said Dr. Mankowski.

Among the study’s other findings was that since 2020, Americans have, as logged in Epic record systems, booked at least 1.77 billion in-person visits to health clinics, sent 1.34 billion messages to their healthcare providers, and received some 3.25 billion online portal messages from providers. Also documented in Epic were 1.59 billion telephone calls and 146 million virtual telehealth portal visits.

Study co-investigator Dorry L. Segev, MD, PhD, said that the digital delivery of healthcare does not replace the old ways of working; it just adds another layer of more steps to existing workflows. To manage this new patient reality, hospitals, clinics, and healthcare workers have to plan future staffing and support.

“Modern delivery of healthcare means increasingly that healthcare providers will have to balance their digital workload on top of their traditional clinical workload,” said Dr. Segev, a professor and vice chair in the Department of Surgery at NYU Grossman School of Medicine. “Clinical staff will need to be trained in mastering the tools of messaging in healthcare; in using AI support programs, including chatbots that can frame content to minimize its complexity; and in making the most effective use of clinician time needed for online billing and online counseling,” said Dr. Segev, who is also a profession in NYU Grossman’s Department of Population Health.

Already, he noted, NYU Langone uses AI support tools to speed up drafting of physician and provider notes.

Dr. Segev said the team next plans to look more specifically at digital-use trends within healthcare systems, including NYU Langone, to break down any regional and outpatient clinic-specific shifts that could affect operational planning.

For the study, the team used Epic Cosmos, a national dataset of the electronic health records of more than 300 million American patients. The dataset includes information from a majority of hospitals and clinics that use Epic, the nation’s largest vendor of electronic health record systems, which had no role in performing the study.

Funding support for the study was provided by NYU Langone.

Along with Drs. Mankowski and Segev, NYU Langone researchers involved in the study were lead investigator Jane J. Long, MD, and co-investigators Mara A. McAdams DeMarco, PhD; Mark D. Schwartz, MD; Joshua Chodosh, MD; and Eric K. Oermann, MD.

Dr. Mankowski was recently elected to serve on the governing board of Epic Cosmos. Dr. Schwartz reported being president-elect of the Society of General Internal Medicine. Dr. Segev has received consulting and/or speaking honoraria from Sanofi, CareDx, Moderna, AstraZeneca, Roche, Optum, OrganOx, Hansa, and Biosidus and is a journal editor for Springer. None of these activities are related to the current JAMA study. NYU Langone is managing the terms and conditions of these relationships in accordance with its policies and procedures.

In a study published June 19 in Science Immunology, researchers evaluated a two-part vaccination against genital herpes. With the technique, the first part — a typical intramuscular injection like you would receive for a flu shot, for example — is followed by the introduction of nanoparticles to the vagina, where herpes infection occurs in women.

The idea is the initial injection “primes” the immune system while the second localized treatment “pulls” immune activity right to where infection takes place. This study extends the original “prime and pull” approach by developing a new nanoparticle that effectively induces local immunity.

“We’ve found that, in preclinical experiments, this approach is a safe way to recruit the right immune cells in the right place to generate protective immunity,” said senior author Akiko Iwasaki, Sterling Professor of Immunobiology at Yale School of Medicine.

A two-pronged vaccine for genital herpes immunity

Efforts to develop a genital herpes vaccine have uncovered a key limitation of typical intramuscular injections: They do not establish robust immune cell populations or antibodies against the herpes virus at the vaginal lining where the virus is introduced in women. This limits the extent of immune attack against the herpes virus.

To address this challenge, the Iwasaki lab has explored methods to “pull” an immune response to the vaginal lining. They first tested whether introducing chemokines — proteins that can direct immune cells — to the vagina could establish immunity there. That technique led to only partial protection against herpes as it did not engage necessary immune cells called B cells.

They then evaluated a DNA molecule that stimulates the immune system. While it did reduce the amount of virus at the vagina, it also caused inflammation.

So the researchers wondered if combining the two methods might yield the best of both worlds.

“We had these two really promising strategies in the lab, but each had some shortcoming,” said Sachin Bhagchandani, a postdoc in Iwasaki’s lab and lead author of the study. “So we set out to formulate a particle that could overcome those shortcomings.”

Nanoparticles prevent herpes infection

The result of that work is BEACON (Bioactive Enhanced Adjuvant Chemokine Oligonucleotide Nanoparticles). The researchers made these nanoparticles by linking a piece of immunostimulating DNA to a chemokine.

“Sachin led this work, creating a nanoparticle that was stable and effective, which was no small feat,” said Iwasaki, who is also a professor of dermatology and of epidemiology, as well as an investigator with the Howard Hughes Medical Institute.

For the study, the researchers first primed female mice with an intramuscular vaccination against the herpes virus and then applied BEACON and virus antigen intravaginally. They found that BEACON established strong immune cell and antibody responses against the herpes virus in the vaginal tissue and that it lasted long term, at least six months.

When exposed to the herpes virus, mice given the “prime and pull” treatment were highly resistant to infection: 80% displayed no signs of disease over six months. That’s compared with just 40% of mice that received the intramuscular injection alone.

“That showed us that this approach could be profoundly impactful, establishing local immune responses for a significantly long period of time,” said Bhagchandani.

Further, BEACON enabled the researchers to target the right cells for generating immunity, rather than broadly affecting all cells. This meant they needed less of the DNA molecule than they used in previous experiments, and this smaller amount prevented the development of inflammation.

“This formulation is quite remarkable in that way,” said Iwasaki.

A vaccine for humans

The researchers are now evaluating whether this “prime and pull” method can be used to treat infection as well as prevent it. They’re also thinking about what this might look like for people.

“We’re collaborating with the Appel lab at Stanford to see if we can turn BEACON into translatable formulation, such as a vaginal suppository,” said Bhagchandani. “We’re also exploring a nasal approach wherein the ‘pull’ happens in the nose, which would allow this kind of treatment to work for men as well.”

While further down the road, the researchers aim to test this method in human clinical trials, because ultimately, the goal is to develop a vaccine for humans.

“A lot of the suffering patients go through is not just physical; it’s mental and societal,” said Iwasaki. “But viruses are the same — whether it’s the flu or Epstein-Barr virus or herpes simplex, it’s not the person’s fault that they caught it. And yet there’s a lot of stigma. We hope that this kind of strategy will prevent diseases that affect people in a profound way.”

Two succinct articles in CMAJ (Canadian Medical Association Journal) provide information about each disease for clinicians.

Hantavirus:

1. A nationally notifiable disease in Canada — In Canada, 4 to 5 cases are confirmed every year and must be reported. These are usually acquired from rodents in agricultural settings in Manitoba, Saskatchewan, Alberta, and British Columbia. The Andes strain is unique as it can be transmitted from person to person.
2. Causes 2 clinical symptoms — Strains in the Americas, which include the Andes virus featured recently in the news, cause hantavirus cardiopulmonary syndrome. The European and Asian strains cause hemorrhagic fever and kidney dysfunction. Both forms take about 2 to 4 weeks to incubate, and symptoms include fever, headache, muscle aches, and abdominal pain.
3. Serology and polymerase chain reaction (PCR) tests are diagnostic — The National Microbiology Laboratory in Winnipeg performs these tests.
4. Supportive treatment — As there is no specific antiviral treatment or vaccine for hantavirus, treatment is supportive to help alleviate symptoms.
5. IPAC protocols are essential — Patients with suspected Andes strain infection must be isolated with airborne, droplet, and contact precautions, with infectious diseases experts involved and public health notified.

Ebola virus disease:

1. Sporadic outbreaks have occurred in Central and West Africa since 1976 — There are 3 main viruses that can infect humans, and evidence suggests they come from fruit bats. Ebola virus is spread via person-to-person contact through bodily fluids like vomit, sperm, diarrhea, and blood, as well as by touching infected surfaces or objects. The current outbreak in the Democratic Republic of Congo is Bundibugyo ebolavirus, with a fatality rate of 30% to 50%.
2. Fewer than 50% of patients have hemorrhagic symptoms — Symptoms include fever of 38°C or higher, fatigue, muscle pain, and gastrointestinal distress. Incubation is 2 to 21 days, and diagnosis is made with PCR testing.
3. People with potential symptoms and exposure risk should be tested — People who have travelled to countries with Ebola virus disease or who have been in close contact with infected people or bats, primates, or game from the affected areas should be tested.
4. Stringent IPAC must be used for suspected cases — Health Canada has a detailed process for screening, assessment, and IPAC precautions, which must include a fit-tested N95 respirator, face shield, gloves, and fluid-impermeable gear for full protection.
5. Important advances in prevention and management of the disease have been made — Vaccines to prevent Zaire ebolavirus are very effective, and 2 antivirals can reduce mortality from 50% to 35%. However, there are no current vaccines or medications to prevent or treat Bundibugyo ebolavirus, for which supportive care is the main approach.

At least 30 million people have already tested their DNA through genealogical services, with the market valued at $3.5 billion USD in 2022.

But according to Dr Susan Moore, a retired Australian university researcher in social and developmental psychology, the decision to gift, or take, a DNA test requires more consideration than most people realise.

The risks and rewards

In her new book The Psychology of Genealogy, Dr Moore explores the complex emotions behind DNA testing, drawing on research and real-life cases to reveal the rewards and risks.

“Should you give DNA kits as gifts? It can be fun; it can be risky,” Dr Moore says. “Do first think carefully about how your intended recipient might cope with unexpected outcomes.”

Dr Moore warns that the psychological stakes are higher than many realise. DNA tests can uncover family secrets, reveal misattributed paternity, expose donor conception, and even connect people to hundreds of previously unknown half-siblings – all scenarios that have become increasingly common as databases expand.

Considerations to bear in mind

Moore outlines several psychological considerations that make DNA testing far more complex than a simple curiosity exercise.

“Hobbyist family historians are uncovering joyful and inspiring stories of the past as well as sad and unsettling secrets of their ancestry, Dr Moore explains.

“Records and DNA matches provide boosts, challenges and even threats to one’s sense of self, and this is occurring at unprecedented levels.”

For some, unexpected results can fundamentally challenge their sense of self and family belonging, something psychologists call ‘identity disruption’. The book references cases where individuals discovered their biological father was actually their mother’s fertility doctor, or where ‘late discovery’ of adoption or donor conception occurred through DNA testing.

“At the personal level, these may be findings that cause you great distress, that destabilise your sense of who you are, that initially at least, you would have preferred not to know. Once known however, they cannot be unknown,” Dr Moore explains.

“While some will be able to integrate this new information into their understanding of selfhood, family relationships and belongingness, others will struggle with acceptance, trust and feelings of betrayal.”

Beyond personal revelations, there are also legitimate worries about data security. In 2023 hackers accessed DNA data of 7 million users of one of the most popular DNA testing providers, and the company’s subsequent financial troubles raised questions about what happens to genetic data if companies fold.

Why do these tests appeal to us?

Despite the risks, many of us are drawn to these tests as they appeal to what Dr Moore describes as fundamental human needs. She explains that family history exploration, including DNA testing, fulfils deep psychological drivers.

This includes the search for identity, and influences on our character. Understanding family history strengthens social identity and creates a sense of belonging to something larger than oneself.

It also provides intellectual challenge and a sense of purpose, and Dr Moore suggests curiosity itself is a main driver.

“Curiosity is a great motivator. How exciting it can be to discoverer the identity of an ancestor, solve a family mystery, prove or disprove family ‘legends’ or discover previously unknown living relatives,” she explains.

“Indeed, genealogists regularly report elation and joy as they unearth lost relatives, discover the identity of a ‘missing’ ancestor, or otherwise break down ‘brick walls’ (genealogical puzzles that seem to resist solutions due to missing, inaccurate or hard-to-access records).”

To test or not to test

So, should you gift that DNA kit this Father’s Day? Dr Moore offers nuanced guidance to anyone considering buying a test for themselves or a loved one.

She explains: “Yes, if you want to explore your ancestry further, and you have the time and patience to do some reading and learning – first about how to make the most of your data, and second about how to interact respectfully and ethically when contacting matches.”

But she’s clear about when to reconsider.

She warns: “No, unless you’re prepared for surprises, some of them perhaps unpleasant, or if you’re very worried about privacy breaches.”

The key, Dr Moore suggests, is to have an honest conversation before gifting. Does Dad actually want to know? Is he prepared for unexpected discoveries? Has he considered the privacy implications?

For those who do decide to test, Dr Moore emphasises the importance of approaching results with support systems in place and realistic expectations about what DNA can and cannot reveal.

“DNA gives you some new and interesting clues to your family tree structure, but the hard work of making sense of those clues must still be done,” she explains.

The extent of these potentially blinding injuries prompts the report authors to call for clear manufacturer warnings amid the rising popularity of these devices and the absence of standardised guidelines on their use.

The young man in question had developed floaters (small dark specks in the field of vision) and occasional flashing lights (photopsia) over the preceding 6 days in his right eye, with no obvious cause, such as a blow to the head.

Close examination revealed multiple retinal tears and bruising (commotio retinae) in both eyes, and retinal dialysis in the right eye. Retinal dialysis is a specific type of tear, where the retina separates from its attachment, potentially causing permanent sight loss if left untreated.

When questioned further, the man admitted to using a percussive massage gun around and directly on both his eyes, for several minutes at a time, every week for 3 months, to relieve the feeling of tiredness.

Percussive massage guns deliver rapid, concentrated pulses of pressure to soft tissues, and are often used to boost muscle strength and relieve musculoskeletal pain, explain the report authors.

He was successfully treated with laser therapy, with no lasting detrimental impact on his sight—most likely because he sought prompt treatment once symptoms developed, the authors suggest.

This is just one case, and published reports of eye problems associated with massage gun use are rare, they highlight.

“However, cases of lens pathology, acute angle closure glaucoma, and retinal detachment have been described,” they note.

“There are two known cases of profound vision impairment associated with massage gun use, along with a further case of successfully treated isolated traumatic cataract without retinal injury or lasting visual compromise,” they add.

“Little is known regarding the safety profile of percussive massage guns. In this case, the massage gun was commercially purchased and used without professional guidance. The patient reported no awareness of any warnings in the operating instructions against ocular use,” they point out.

They conclude: “This rare presentation highlights the potential for significant retinal injury. It also underscores the need for cautious massage gun use, careful history taking in unexpected clinical scenarios, and clear manufacturer warnings against improper application.”