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Quality and safety of artificial intelligence generated health information, large language models and the generation of health disinformation, 25 year trends in cancer incidence and mortality among adults in the uk, cervical pessary versus vaginal progesterone in women with a singleton pregnancy, comparison of prior authorization across insurers, diagnostic accuracy of magnetically guided capsule endoscopy with a detachable string for detecting oesophagogastric varices in adults with cirrhosis, ultra-processed food exposure and adverse health outcomes, added benefit and revenues of oncology drugs approved by the ema, exposure to air pollution and hospital admission for cardiovascular diseases, short term exposure to low level ambient fine particulate matter and natural cause, cardiovascular, and respiratory morbidity, optimal timing of influenza vaccination in young children, effect of exercise for depression, association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes, duration of cpr and outcomes for adults with in-hospital cardiac arrest, clinical effectiveness of an online physical and mental health rehabilitation programme for post-covid-19 condition, atypia detected during breast screening and subsequent development of cancer, publishers’ and journals’ instructions to authors on use of generative ai in academic and scientific publishing, effectiveness of glp-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes, neurological development in children born moderately or late preterm, invasive breast cancer and breast cancer death after non-screen detected ductal carcinoma in situ, all cause and cause specific mortality in obsessive-compulsive disorder, acute rehabilitation following traumatic anterior shoulder dislocation, perinatal depression and risk of mortality, undisclosed financial conflicts of interest in dsm-5-tr, effect of risk mitigation guidance opioid and stimulant dispensations on mortality and acute care visits, update to living systematic review on sars-cov-2 positivity in offspring and timing of mother-to-child transmission, perinatal depression and its health impact, christmas 2023: common healthcare related instruments subjected to magnetic attraction study, using autoregressive integrated moving average models for time series analysis of observational data, demand for morning after pill following new year holiday, christmas 2023: christmas recipes from the great british bake off, effect of a doctor working during the festive period on population health: experiment using doctor who episodes, christmas 2023: analysis of barbie medical and science career dolls, christmas 2023: effect of chair placement on physicians’ behavior and patients’ satisfaction, management of chronic pain secondary to temporomandibular disorders, christmas 2023: projecting complete redaction of clinical trial protocols, christmas 2023: a drug target for erectile dysfunction to help improve fertility, sexual activity, and wellbeing, christmas 2023: efficacy of cola ingestion for oesophageal food bolus impaction, conservative management versus laparoscopic cholecystectomy in adults with gallstone disease, social media use and health risk behaviours in young people, untreated cervical intraepithelial neoplasia grade 2 and cervical cancer, air pollution deaths attributable to fossil fuels, implementation of a high sensitivity cardiac troponin i assay and risk of myocardial infarction or death at five years, covid-19 vaccine effectiveness against post-covid-19 condition, association between patient-surgeon gender concordance and mortality after surgery, intravascular imaging guided versus coronary angiography guided percutaneous coronary intervention, treatment of lower urinary tract symptoms in men in primary care using a conservative intervention, autism intervention meta-analysis of early childhood studies, effectiveness of the live zoster vaccine during the 10 years following vaccination, effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women, pyrotinib versus placebo in combination with trastuzumab and docetaxel in patients with her2 positive metastatic breast cancer, association of dcis size and margin status with risk of developing breast cancer post-treatment, racial differences in low value care among older patients in the us, pharmaceutical industry payments and delivery of low value cancer drugs, rosuvastatin versus atorvastatin in adults with coronary artery disease, clinical effectiveness of septoplasty versus medical management for nasal airways obstruction, ultrasound guided lavage with corticosteroid injection versus sham lavage with and without corticosteroid injection for calcific tendinopathy of shoulder, early versus delayed antihypertensive treatment in patients with acute ischaemic stroke, mortality risks associated with floods in 761 communities worldwide, interactive effects of ambient fine particulate matter and ozone on daily mortality in 372 cities, association between changes in carbohydrate intake and long term weight changes, future-case control crossover analysis for adjusting bias in case crossover studies, association between recently raised anticholinergic burden and risk of acute cardiovascular events, suboptimal gestational weight gain and neonatal outcomes in low and middle income countries: individual participant data meta-analysis, efficacy and safety of an inactivated virus-particle vaccine for sars-cov-2, effect of invitation letter in language of origin on screening attendance: randomised controlled trial in breastscreen norway, visits by nurse practitioners and physician assistants in the usa, non-erosive gastro-oesophageal reflux disease and oesophageal adenocarcinoma, venous thromboembolism with use of hormonal contraception and nsaids, food additive emulsifiers and risk of cardiovascular disease, balancing risks and benefits of cannabis use, promoting activity, independence, and stability in early dementia and mild cognitive impairment, effect of home cook interventions for salt reduction in china, cancer mortality after low dose exposure to ionising radiation, effect of a smartphone intervention among university students with unhealthy alcohol use, long term risk of death and readmission after hospital admission with covid-19 among older adults, mortality rates among patients successfully treated for hepatitis c, association between antenatal corticosteroids and risk of serious infection in children, the proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes, safety of ba.4-5 or ba.1 bivalent mrna booster vaccines, comparative effectiveness of booster vaccines among adults aged ≥50 years, third dose vaccine schedules against severe covid-19 during omicron predominance in nordic countries, private equity ownership and impacts on health outcomes, costs, and quality, healthcare disruption due to covid-19 and avoidable hospital admission, educational inequalities in mortality and their mediators among generations across four decades, prevalence and predictors of data and code sharing in the medical and health sciences, medicare eligibility and in-hospital treatment patterns and health outcomes for patients with trauma, therapeutic value of first versus supplemental indications of drugs in us and europe, hospital admissions linked to sars-cov-2 infection in children and adolescents, vitamin d supplementation and major cardiovascular events, menopausal hormone therapy and dementia, associations between modest reductions in kidney function and adverse outcomes in young adults, association between surgeon volume and patient outcomes after elective shoulder replacement surgery, risk prediction of covid-19 related death or hospital admission in adults testing positive for sars-cov-2, effectiveness of grace risk score in patients admitted to hospital with non-st elevation acute coronary syndrome, peer reviewers’ response to invitations by gender and geographical region, breast cancer mortality in women with early invasive breast cancer, mmr vaccine at age 6 months and hospitalisation for infection before age 12 months, recovery up to two years after sars-cov-2 infection, race-free estimated glomerular filtration rate equation in kidney transplant recipients, follow us on, content links.

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Best Websites for Medical Research Papers: Top 10

Best Websites for Medical Research Papers: Online resources for medical research and information gathering are often used by doctors. This trend has greatly intensified over the past ten years. Nowadays, locating the right online resources is part of most doctors’ procedures. On the other hand, there is a wealth of information online. For doctors, who are under pressure to gather critical information in the shortest period possible, this can be an even bigger difficulty.

Both reliable and unreliable information can easily be found on the internet. The issue is that some of these sites are so well-designed that they can fool you. It’s why I spent so much time looking for reputable websites where doctors may get accurate information. The top 10 medical research paper websites are shown below.

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Top 10 Best Websites for Medical Research Papers

Visit the PubMed website at www.ncbi.nlm.nih.gov

The National Library of Medicine of the National Institutes of Health is responsible for maintaining the medical website PubMed. On this website, doctors can find abstracts as well as whole peer-reviewed papers on a range of medical topics. Doctors won’t have any trouble learning about cutting-edge methods or alternative treatments because the reading is written just for healthcare professionals. They will be able to increase their expertise in particular medical fields. Additionally, patients who come to your office might be directed there to make an informed decision.

This online resource has a simple search feature as well as a comprehensive search feature. A simple search is conducted by entering important parts of the subject into the search field. The easy search will be translated by PubMed, which will include appropriate medical subject headings (MeSH), field names, synonyms, and Boolean operators. This assists doctors in improving their search formulation.

2. Medscape

Visit the Medscape website at www.medscape.com

Medscape is a highly regarded medical website aimed at healthcare professionals. Both the information industry and the medical community have praised the website since its debut in 1995. Medscape has quickly gained a reputation as a reliable source of peer-reviewed knowledge within the medical community. Numerous value-added services are available for users’ use. To demonstrate its better grade, CBS purchased a third of the company. Additionally, it has a strategic partnership with AOL to broaden its medical reach.

Information aggregation is one of its primary functions. Users can read around 50 peer-reviewed journals and full-text publications after registering for free on the site. They will also get access to trade magazines, medical textbooks, and medical news periodicals. Even though this site has information on almost every element of medicine, it is incredibly user-friendly. Each section of the site is accessible with one or two clicks, regardless of the page you are on. Users can utilize the search box at the bottom of each page to get any sort of information they need.

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Visit the WebMD website at www.webmd.com

An American organization with a focus on sharing health-related information is called WebMD. The website is among the top doctor websites based on unique monthly visits. The site’s services are available to both clients and medical professionals. It is the publisher of WebMD the Magazine, a publication geared at patients that is available in 85% of all waiting rooms in the US. They also own Medscape, a reputable internet resource used by numerous medical professionals in the US and abroad.

They feature a discussion forum where doctors and patients can freely exchange information. This can assist a doctor in providing insight to patients as well as gaining some through various interactions. WebMD is a great resource for clinicians who want a rapid overview of a new medical problem. You can also utilize their drug database to learn about new drugs that have been launched on the market. The majority of their posts usually include links to peer-reviewed evidence that you may utilize to draw your conclusions.

Also see : How To Make Your Brain Smarter and Faster

4. World Health Organization

Visit the WHO website at www.who.int.

The WHO is a United Nations specialized organization that focuses on international public health. It also hosts the WHO website at https://www.who.int. Although 61 countries have ratified the organization’s constitution, it operates in every part of the globe. Since its inception, the site has supplied extensive information about diseases such as HIV, Ebola, Malaria, Tuberculosis, and a variety of other ailments and fields. This may be the most important internet resource in the world if you are a medical doctor concerned with public health.

The site has a useful news part in addition to providing facts and statistics about significant public health situations. This section includes updates on current occurrences in the medical world. For example, you will be able to learn about numerous global trends. This includes topics such as child mortality, which is a significant problem in various parts of the world. This news area might be a valuable resource for people conducting studies on key worldwide public health topics.

5. UpToDate

Visit the UpToDate website at www.uptodate.com

UpToDate is a physician-authored evidence-based resource that aids in decision-making. As a result, it ensures that doctors make the best decision possible at the moment of treatment. The UpToDate resource is maintained by over 6,500 internationally known medical editors, authors, and peer-reviewers. They go through a rigorous editorial process to ensure that they compile the most up-to-date medical data into evidence-based, reliable recommendations that have been proved to improve care quality.

Over 1.3 million physicians in over 187 countries and over 90% of major medical centers in the United States use the resource. As a result, they can provide the greatest medical care possible. There have been over 80 research studies that show that extensive use of the resource leads to better medical care. According to the UpToDate website, it has been demonstrated to help shorten hospital stays, lessen mortality, and reduce unfavorable consequences.

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6. ClinicalKey

Visit the ClinicalKey website at www.clinicalkey.com

Elsevier owns ClinicalKey, a medical database tool. It provides access to an extensive medical library published by Elsevier. Elsevier’s Global Clinical Reference team developed the database. Over 2000 medical doctors from around the world were consulted over two years to construct the database. The main purpose of this resource is to provide solutions to clinical questions. It is directed toward doctors, hospitals, schools, and colleges. The resource is also available as a mobile app for Android and iOS.

ClinicalKey claims that all of its data is scientifically validated. As a result, resources like Goldman’s Cecil Medicine, Conn’s Current Therapy, and others are now available. The site is also easy to use, with a simple design and color palette that helps users easily find the information they need.

7. MedicineNet

Visit the MedicineNet website at www.medicinenet.com

WebMD owns MedicineNet.com, a medical information website. It provides users with newsletters, medical information, and much more. All of the information presented here is of the highest quality; it was prepared by board-certified physicians. The content is excellent for those who want to learn more about various health problems.

The website is simple to navigate. A helpful navigation bar and choices to peruse news or various themes are available. There’s also the option of looking through the most popular queries available. This site has a lot of information, but it’s effectively arranged into bulleted lists, subtopics, and multimedia to keep users interested. There are links in the text that go to even additional information to ensure that everything is as clear as possible.

Visual design can be overpowering from a design standpoint at times. All of the elements appear to be competing for the user’s attention. To avoid losing focus when using the site, it is necessary to have a certain topic in mind. Regardless, this site will provide you with high-quality information. All of the content on this site is produced and evaluated by medical experts, and the articles are well referenced.

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8. American Medical Association

Visit the AMA website at www.ama-assn.org

The American Medical Association’s website provides scientific and health information to the medical community and the general public. The site is a fantastic location to stay up to date on medical policy and law. It frequently represents the medical community in meetings with members of Congress and other government bodies. The agency is responsible for creating criteria for medical schools and internship programs. This is the place to be if you’re a medical professional who wants to learn about quack treatments and medical charlatans.

This is a fantastic resource for medical professionals seeking knowledge on a variety of topics. It explains how doctors can handle their practice’s finances, for example. This will also be a great resource for doctors who want to open a practice in rural America. More than just medical advancements and related legislation are covered on the site. The website covers all aspects of being a doctor. This site will be extremely useful if you are a young doctor who is unfamiliar with any element of medicine.

9. National Institutes of Health

Visit the National Institutes of Health website at www.nih.gov

The National Institutes of Health (NIH) is a US government-run organization. It is governed by the Department of Health and Human Services and exists to perform medical research. It is made up of over 27 different institutions and institutes, all of which are committed to medical research. This is a valuable resource for doctors in a variety of professions. It provides free access to valuable peer-reviewed material. The National Institutes of Health website is extremely valuable in any branch of medicine. Its goals include determining the etiology of disease, as well as disease prevention, detection, diagnosis, treatment, and control.

The National Institutes of Health frequently engages in research initiatives and then publishes the results online after a thorough assessment. As a result of ongoing research, medical doctors in the United States can improve their abilities and knowledge. The NIH has been engaged in around 17 medical breakthroughs, demonstrating how dependable its research is. These breakthroughs have contributed to transforming healthcare in the United States and around the world. If you’re a doctor looking for ground-breaking research, the NIH is a great place to start.

Also see: Best Apps for Medical Students and Doctors

10. Epocrates

Visit the Epocrates website at www.epocrates.com

Epocrates is a medical reference app that includes disease, diagnostics, medicines, and patient management information. Doctors and other medical professionals are the target audience for the app. Drug dosing, drug interactions, medical news, disease management, and disease diagnosis are all available to users.

Information is gathered from reliable sources such as the FDA and then digitally structured to aid in decision-making during patient care. The software also can identify medications among its other features. Hundreds of risk assessment tools, therapy advice, and coding look-ups are also available. Epocrates is the app to have if you are a doctor who wants a rapid medical reference to numerous parts of medicine.

This app is also notable for being free. Medical students and professionals have given it high marks. It is also worth noting the user interface. It makes finding any information that one requires simple. The medicine formularies provided by Epocrates for numerous insurance companies are pretty impressive. It assists doctors in prescribing medication that is covered by the patient’s insurance policy, lowering the copay.

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Many factual and non-factual websites on the internet claim to serve the medical community. It can be tough to tell them apart, though. The list above might be a helpful resource for people looking for information to help them conduct research and better serve their patients.

Edeh Samuel Chukwuemeka, ACMC, is a lawyer and a certified mediator/conciliator in Nigeria. He is also a developer with knowledge in various programming languages. Samuel is determined to leverage his skills in technology, SEO, and legal practice to revolutionize the legal profession worldwide by creating web and mobile applications that simplify legal research. Sam is also passionate about educating and providing valuable information to people.

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• NATURE INDEX
• 13 March 2024

Four change-makers seek impact in medical research

• Amy Coombs 0 &
• Sandy Ong 1

Amy Coombs is a freelance science writer in Chicago, Illinois.

You can also search for this author in PubMed   Google Scholar

Sandy Ong is a freelance writer based in Singapore.

SIRI ELDEVIK HÅBERG: Lines of enquiry

Siri Eldevik Håberg studies whether environmental factors such as smoking are linked to subtle changes to the human genome. Credit: Fredrik Naumann/Panos Pictures for Nature

As a medical student, Siri Eldevik Håberg became fascinated with how the health of a baby can be affected during pregnancy . Smoking, for example, is a proven risk factor for respiratory infection in fetuses — a finding supported by one of Håberg’s earliest studies, which scoured data from tens of thousands of births in Norway to investigate outcomes for a small subset of women who had smoked during, but not after, pregnancy 1 . The analysis was based on data from the Mother, Father, and Child Cohort Study (MoBa) at the Norwegian Institute of Public Health (NIPH) in Oslo, which today holds biological samples and survey information for nearly 300,000 participants.

Nature Index 2024 Health sciences

Håberg conducted her postdoctoral work in the United States, where she joined a group at the National Institute of Environmental Health Sciences in Durham, North Carolina. She contributed data analysis to a team that examined 1,062 blood samples from MoBa, drawn from the umbilical cord at the delivery of a baby, and identified 10 genes that were altered in infants born to women who smoked while pregnant. The 2012 study provided important evidence for how non-heritable smoking exposure can cause certain epigenetic effects — subtle changes to the genome that impact the reading of DNA but do not alter the DNA sequence 2 . “We are only beginning to understand the gravity of epigenetic changes during development,” says Håberg.

Now, as director of the Centre for Fertility and Health at the NIPH, Håberg is investigating ways to combine MoBa data with statistics from Norwegian registries on factors such as vaccinations, prescriptions, education and economic status. In one project, she and her colleagues matched babies from the 2012 study with data collected by the Medical Birth Registry of Norway and found that reduced birth weight was strongly correlated with smoking during pregnancy 3 .

Having investigated the effects of smoking on fetal health, Håberg was interested in other factors that could cause epigenetic changes linked to development. In a 2022 study published by Nature Communications 4 , she and her co-authors compared rates of DNA methylation — a process that affects levels of gene expression — for almost 2,000 MoBa newborns. Roughly half of the babies were conceived naturally and half through reproductive technologies such as in vitro fertilization. Even after controlling for the parents’ DNA methylation rates, differences were found in more than 100 genes, including those related to growth and development. The findings might pave the way for big-data approaches to studies related to reproductive technologies.

Håberg is passionate about connecting specialists from her team with interdisciplinary groups from around the world so that they can explore large amounts of data that hold clues about fetal health. One such project is comparing MoBa data with information from the Danish National Birth Cohort. “It all comes down to finding exciting new ways for teams of specialists to work together,” she says. “It’s great to see so many resources dedicated to questions of early embryonic development.” — Amy Coombs

NARMIN GHAFFARI LALEH: Deeper vision

Narmin Ghaffari Laleh. Credit: Courtesy of Narmin Ghaffari Laleh

As a university student studying medical photonics in Jena, Germany, Narmin Ghaffari Laleh was inspired to use her programming skills to help patients and doctors. She sought work experience at local medical-device company, Carl Zeiss Meditec, to explore the use of artificial intelligence (AI) in improving medical-image analysis. Her work there concentrated on eye imaging, where conventional methods of analysis use systems that read each row of pixels, identifying features such as the cornea, lens and retina by tracking their colours and the distance between them. Common variables such as glasses can throw such systems off, however. “These kinds of programs work well until someone puts on glasses or contact lenses and takes a photo,” says Ghaffari Laleh, who was a master’s student at Fredrich Schiller University of Jena at the time.

The model developed by Ghaffari Laleh and her colleagues at the company used deep learning — a machine-learning technique that can identify complex patterns. In testing, their system analysed images with variables such as glasses with greater accuracy and less human oversight than previous methods. “I saw the potential for this sort of program to impact other areas of medicine, because the machine-learning techniques were rapidly becoming more sophisticated and could handle more data, all without the traditional human reviewer,” says Ghaffari Laleh, who built on these findings in her 2020 master’s thesis.

Ghaffari Laleh began her PhD at RWTH Aachen University in Aachen, Germany, in the field of computational pathology — an emerging area of research that aims to improve patient care by using advances in AI and big data. Her focus was on developing systems that can more accurately and efficiently identify visual indicators of cancer and other diseases than methods that rely solely on human specialists. These systems could be particularly useful in the analysis of tissue samples that have been prepared for microscope slides and stained with the widely used haematoxylin and eosin (H&E) dye, which turns cell structures different shades of purple, blue and pink, she says.

In 2022, Ghaffari Laleh co-authored a paper 5 describing how AI could consistently categorize tumours in kidney-tissue slides. “With deep learning, we can detect patterns that the human eye cannot see,” she says.

For a separate study 6 , the team showed how AI trained to identify mutations in a protein associated with bladder cancer could outperform a uropathologist in analysing tissue samples stained with H&E. “We do not aim to replace the urologist, but deep-learning can offer additional analysis,” says Ghaffari Laleh.

To test whether these methods can move to clinical applications, Ghaffari Laleh dedicated her PhD thesis to investigating how applicable these kinds of AI systems could be to a variety of diseases and patient demographics. Her dissertation is pending defence in March.

Ghaffari Laleh hopes to apply her skills to help medical professionals in developing countries who cannot afford to run advanced diagnostics and who struggle to recruit and train skilled professionals. “AI is a much more affordable option,” she says. “If a deep-learning model can analyse data from diverse patient groups from a wide range of countries, then hospitals that lack resources can ship samples for diagnosis.” She’s also working on AI that can read text 7 , ultrasound and radiology image data, with hopes that they can speed up the work of doctors and other specialists worldwide. — Amy Coombs

TAL PATALON: Prolific polymath

Tal Patalon. Credit: Asaf Brenner

Tal Patalon prides herself on being able to pivot her work to where she thinks her expertise, and that of her team, will be most effective. “For me, it’s all about clinical impact,” she says. As head of Kahn-Sagol-Maccabi (KSM) in Tel Aviv — the research and innovation centre of Maccabi Healthcare Services, one of Israel’s largest health-care providers — Patalon is interested in a range of medical conditions, including parvovirus, mpox, cancer and coeliac disease.

Having the capacity to launch research projects quickly proved invaluable to Patalon and her team during the COVID-19 pandemic, when global treatment and vaccination protocols changed rapidly to keep up with the evolution of the disease. In 2021, as the highly contagious Delta wave was surging through Israel, Patalon co-led a team that scoured the health records of almost 125,000 Israelis, charting coronavirus incidence, symptoms and hospitalization rates over three months.

The team discovered that vaccinated people who had not previously tested positive for COVID-19 were 13 times more likely to be infected by the new variant, compared with previously infected individuals who were unvaccinated. The results showed that the SARS-CoV-2 virus that causes COVID-19 confers a natural immunity to those who have been infected, providing valuable evidence that vaccinating them wasn’t an immediate priority 8 . “It was a very big achievement for us,” says Patalon.

Extracting new insights from the vast amounts of public-health data that are being collected globally is key to advancing treatments and keeping one step ahead of infectious diseases, says Patalon. As part of her role at KSM, she oversees the Tipa Biobank, Israel’s largest biosample repository, comprising more than one million blood samples from some 200,000 Maccabi patients. In addition to one-off samples from patients, the biobank collects serial samples — successive samples from the same patient over a period of time. Serial samples are “very rare and highly valuable for research”, says Patalon, especially when it comes to analysing biological changes before and after a diagnosis.

KSM also manages some 30 years’ worth of electronic medical records from more than 2.7 million patients collected by 32 hospital networks that are affiliated with Maccabi. By sharing these data, which have been deidentified, with researchers around the world, Patalon hopes to inform artificial-intelligence-powered innovations in diagnosis and treatment. “These collaborations, I believe, will create the future of medicine,” she says.

Being adaptable as a researcher and a leader is crucial, particularly in times of crisis, says Patalon, whose team has been deeply affected by the war in Gaza .

“This is a time that requires a lot of patience, empathy, emotional support and the building of good relationships. We have to come out of this situation stronger.” — Sandy Ong

SARAH LUO: Hunting hunger pathways

Sarah Luo’s team discovered one of the brain’s many feeding regulatory centres. Credit: Agency for Science, Technology and Research (A*STAR)

Sarah Luo’s fascination with neuroscience sparked when, as an undergraduate student at the University of Wisconsin-Madison in Wisconsin, she was introduced to the work of British neurologist and author, Oliver Sacks.

Known for his empathic approach to patients with conditions such as amnesia, face blindness and Tourette’s syndrome, Sacks “brought a very humanizing perspective to brain disorders”, says Luo. “He showed how even minute changes in certain regions of the brain could lead to profound effects on cognition and behaviour.”

Today, Luo runs a lab at Singapore’s Agency for Science, Technology and Research (A*STAR), where she studies the connection between hunger and the brain to help patients with metabolic disorders such as diabetes and fatty liver disease. She first studied this connection as a postdoctoral fellow in an adjacent lab, where she was part of a team that discovered a mechanism that regulates feeding.

For many years, researchers had assumed that hunger is regulated by two types of neurons: one that drives hunger and another that suppresses it. But when Luo and her colleagues ran experiments that stimulated certain neurons in a region of the brain called the tuberal nucleus, they could prompt mice to start eating even when they weren’t hungry 9 . “There are actually many feeding regulatory centres in the brain, and we discovered one of them,” she says.

These other centres can deal with “more diverse aspects of eating behaviour”, says Luo, including environmental cues that can incite hunger. In a series of follow-up experiments 10 , Luo and her colleagues observed that when mice were placed in the same feeding chamber where the neurons in the tuberal nucleus had been activated the previous week, they would immediately start eating, even if it was outside their normal feeding times. The results suggest that these neurons not only influence basic feeding behaviour, but also integrate memory and contextual cues into the eating process, says Luo.

Humans experience similar cues. Visiting a favourite restaurant, for example, or returning to the family home can spark an appetite.

“Your neurons might become activated, just because of the environment you’re in,” says Luo. “Those signals might cause you to eat, even if you’re not actually hungry.”

Luo and her team at A*STAR hope to develop treatments that will help to curb excessive food consumption in people with obesity and metabolic conditions by blocking or activating certain neural signals. The trick, she says, is to find and target pathways that run between the brain and organs such as the liver and kidneys, which are more accessible than neural pathways in the brain.

“It would be very invasive to implant an electrode in the brain to activate or inhibit these pathways,” says Luo. But activating pathways that connect to these regions in the brain — by using vagal nerve stimulation, for example, which is a technique used to treat epilepsy that involves implanting a pulse generator under the skin on the chest — would be a more viable option. “Then maybe there will be an easier route for developing therapies to target some of these metabolic diseases,” says Luo. — Sandy Ong

Nature 627 , S8-S10 (2024)

doi: https://doi.org/10.1038/d41586-024-00754-w

This article is part of Nature Index 2024 Health sciences , an editorially independent supplement. Advertisers have no influence over the content.

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News releases.

News Release

Monday, March 18, 2024

NIH studies find severe symptoms of “Havana Syndrome,” but no evidence of MRI-detectable brain injury or biological abnormalities

Compared to healthy volunteers, affected U.S. government personnel did not exhibit differences that would explain symptoms.

Using advanced imaging techniques and in-depth clinical assessments, a research team at the National Institutes of Health (NIH) found no significant evidence of MRI-detectable brain injury, nor differences in most clinical measures compared to controls, among a group of federal employees who experienced anomalous health incidents (AHIs). These incidents, including hearing noise and experiencing head pressure followed by headache, dizziness, cognitive dysfunction and other symptoms, have been described in the news media as “Havana Syndrome” since U.S. government personnel stationed in Havana first reported the incidents. Scientists at the NIH Clinical Center conducted the research over the course of nearly five years and published their findings in two papers in JAMA today.

“Our goal was to conduct thorough, objective and reproducible evaluations to see if we could identify structural brain or biological differences in people who reported AHIs,” said Leighton Chan, M.D., chief, rehabilitation medicine and acting chief scientific officer, NIH Clinical Center, and lead author on one of the papers. “While we did not identify significant differences in participants with AHIs, it’s important to acknowledge that these symptoms are very real, cause significant disruption in the lives of those affected and can be quite prolonged, disabling and difficult to treat.”

Researchers designed multiple methods to evaluate more than 80 U.S. government employees and their adult family members, mostly stationed abroad, who had reported an AHI and compared them to matched healthy controls. The control groups included healthy volunteers who had similar work assignments but did not report AHIs. In this study, participants underwent a battery of clinical, auditory, balance, visual, neuropsychological and blood biomarkers testing. In addition, they received different types of MRI scans aimed at investigating volume, structure and function of the brain.

In this study, researchers obtained multiple measurements and used several methods and models to analyze the data. This was done to ensure the findings were highly reproducible, meaning similar results were found regardless of how many times participants were evaluated or their data statistically analyzed. Scientists also used deep phenotyping, which is an analysis of observable traits or biochemical characteristics of an individual, to assess any correlations between clinically reported symptoms and neuroimaging findings.

For the imaging portion of the study, participants underwent MRI scans an average of 80 days following symptom onset, although some participants had an MRI as soon as 14 days after reporting an AHI. Using thorough and robust methodology, which resulted in highly reproducible MRI metrics, the researchers were unable to identify a consistent set of imaging abnormalities that might differentiate participants with AHIs from controls.

“A lack of evidence for an MRI-detectable difference between individuals with AHIs and controls does not exclude that an adverse event impacting the brain occurred at the time of the AHI,” said Carlo Pierpaoli, M.D., Ph.D., senior investigator and chief of the Laboratory on Quantitative Medical Imaging at the National Institute of Biomedical Imaging and Bioengineering, part of NIH, and lead author on the neuroimaging paper. “It is possible that individuals with an AHI may be experiencing the results of an event that led to their symptoms, but the injury did not produce the long-term neuroimaging changes that are typically observed after severe trauma or stroke. We hope these results will alleviate concerns about AHI being associated with severe neurodegenerative changes in the brain.”

Similarly, there were no significant differences between individuals reporting AHIs and matched controls with respect to most clinical, research and biomarker measures, except for certain self-reported measures. Compared to controls, participants with AHIs self-reported significantly increased symptoms of fatigue, post-traumatic stress and depression. Forty-one percent of participants in the AHI group, from nearly every geographic area, met the criteria for functional neurological disorders (FNDs), a group of common neurological movement disorders caused by an abnormality in how the brain functions, or had significant somatic symptoms. FNDs can be associated with depression and anxiety, and high stress. Most of the AHI group with FND met specific criteria to enable the diagnosis of persistent postural-perceptual dizziness, also known as PPPD. Symptoms of PPPD include dizziness, non-spinning vertigo and fluctuating unsteadiness provoked by environmental or social stimuli that cannot be explained by some other neurologic disorder.

“The post-traumatic stress and mood symptoms reported are not surprising given the ongoing concerns of many of the participants,” said Louis French, Psy.D., neuropsychologist and deputy director of the National Intrepid Center of Excellence at Walter Reed National Military Medical Center and a co-investigator on the study. “Often these individuals have had significant disruption to their lives and continue to have concerns about their health and their future. This level of stress can have significant negative impacts on the recovery process.”

The researchers note that if the symptoms were caused by some external phenomenon, they are without persistent or detectable patho-physiologic changes. Additionally, it is possible that the physiologic markers of an external phenomenon are no longer detectable or cannot be identified with the current methodologies and sample size.

About the NIH Clinical Center: The NIH Clinical Center is the clinical research hospital for the National Institutes of Health. Through clinical research, clinician-investigators translate laboratory discoveries into better treatments, therapies and interventions to improve the nation's health. More information: https://clinicalcenter.nih.gov .

About the National Institute of Biomedical Imaging and Bioengineering (NIBIB): NIBIB’s mission is to improve health by leading the development and accelerating the application of biomedical technologies. The Institute is committed to integrating the physical and engineering sciences with the life sciences to advance basic research and medical care. NIBIB supports emerging technology research and development within its internal laboratories and through grants, collaborations, and training. More information is available at the NIBIB website: https://www.nibib.nih.gov .

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

NIH…Turning Discovery Into Health ®

Pierpaoli C, Nayak A, Hafiz R, et al. Neuroimaging Findings in United States Government Personnel and their Family Members Involved in Anomalous Health Incidents. JAMA. Published online March 18, 2024. doi: 10.1001/jama.2024.2424

Chan L, Hallett M, Zalewski C, et al. Clinical, Biomarker, and Research Tests Among United States Government Personnel and their Family Members Involved in Anomalous Health Incidents. JAMA. Published online March 10, 2024. doi: 10.1001/jama.2024.2413

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