Fortis expands Uttar Pradesh Footprint with 550-bed Hospital in Lucknow

Lucknow: Fortis Healthcare has signed a collaboration agreement with Ekana Group, Lucknow, for operations and management of a 550-bedded greenfield super speciality hospital to be constructed near Gomti Nagar, Lucknow by the Ekana Group. 

Once completed, the facility will be positioned as Centre of Excellence for tertiary care services, bringing advanced medical infrastructure and global best practices to the state capital of Uttar Pradesh.

Speaking on the collaboration, Dr Ashutosh Raghuvanshi, MD & CEO, Fortis Healthcare, said, “We are delighted to partner with Ekana Group to bring a state-of-the-art tertiary healthcare facility to the heart of Lucknow.

Also Read:Fortis acquires Shrimann Superspecialty Hospital in Jalandhar for Rs 462 crore

Once operational, this new 550‑bed super‑specialty hospital near Gomti Nagar will significantly enhance access to advanced medical care for the city and its surrounding regions.

This collaboration marks Fortis Healthcare’s third major presence in Uttar Pradesh, joining our network hospitals in Noida and Greater Noida and underscores our steadfast commitment to expanding high‑quality healthcare across the state.”

Mr. Uday Sinha, Promoter of Ekana Group, said, “We are happy to join hands with one of the leading healthcare chains in India – Fortis Healthcare to develop a leading-edge tertiary care hospital, one that will significantly enhance access to advanced medical services and deliver patient care where it’s most needed.”

Medical Dialogues had earlier reported that in yet another clinical milestone, Fortis Hospital, Bannerghatta Road, Bengaluru, has advanced its robot-aided infrastructure with the launch of the TREAT program (Total Robot Enabled and Assisted Transplant) – a pioneering initiative in robot-assisted kidney transplantation. This state-of-the-art initiative marks a major leap forward in surgical excellence and patient care, especially with its historic milestone: the successful execution of simultaneous robotic surgeries for both donor and recipient — a first-of-its-kind clinical achievement in India.

Also Read:Manipal Outbids Blackstone, Fortis to Lead Race for Sahyadri Hospitals with Rs 6,838 Cr Offer

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AI-Powered Lifestyle System Reduces HbA1C and Medication dependence in Type 2 Diabetes: Study

Researchers have found in a new study that an AI-based personalized lifestyle management system could help patients with type 2 diabetes lower HbA1c levels and reduce dependence on glucose-lowering medications, offering a scalable and affordable approach to diabetes care. The study was published in the NEJM Catalyst Innovations in Care Delivery by Kevin M. and colleagues.

Even with significant progress in pharmacological treatments and digital health technologies, optimal glycemic control in T2D is still a worldwide challenge to reach and maintain. Lifestyle interventions are successful but hard to sustain in everyday clinical practice. Artificial intelligence (AI) and machine learning (ML) now offer the possibility of providing highly personalized and pragmatic advice that fills the gap between doctor’s recommendations and patient behavior.

The Twin Precision Treatment system combines wearables with Bluetooth-enabled devices (such as continuous glucose monitors), focused laboratory data, Internet of Things, AI-ML algorithms, and human guidance to deliver real-time, patient-specific advice.

This single-center randomized controlled trial recruited 150 adults with T2D with a body mass index (BMI) of ≥27. Participants were randomly assigned in a 2:1 ratio to the intervention group (INT, N=100) or the usual care group (UC, N=50). The main endpoint was to reach HbA1c <6.5% (<48 mmol/mol) off glucose-lowering therapy (other than metformin) at 12 months.

Secondary endpoints were:

• Maintenance of HbA1c <6.5% off medications for ≥90 days before 12 months

• Reaching HbA1c <6.5% off any glucose-lowering medications at 12 months and maintained ≥90 days

• HbA1c and weight change at 12 months

• Post hoc analyses of medication usage and quality-of-life scores.

Key Findings

Primary endpoint:

• Attained by 71.0% of INT participants (95% CI, 60.1–80.0)

• Attained by just 2.4% of UC participants (95% CI, 0.5–11.6)

• P<0.001

Glycemic target sustained ≥90 days before 12 months (except metformin):

• 52.5% in INT vs. 2.8% in UC (P<0.001)

Reduction in HbA1c at 12 months:

• INT: −1.3%

• UC: −0.3%

• P<0.001

Weight loss at 12 months:

• INT: −8.6%

• UC: −4.6%

• P<0.001

Medication use:

• Significant reduction in glucose-lowering pharmacotherapy in INT group

• No change of significance in UC group

• Quality of life and treatment satisfaction

• Mean improvement in INT group (exploratory analysis)

• No improvement in UC group

In this randomized trial of 150 adults with T2D, an AI-supported bundled system of sensors and coaching resulted in much more improved glycemic control, weight loss, and quality of life compared to standard care. Most importantly, it enabled huge de-escalation of glucose-lowering drugs, with 71% attaining HbA1c <6.5% off all medications except metformin versus 2.4% in controls. These findings demonstrate the revolutionary potential of precision medicine based on AI in type 2 diabetes treatment.

Reference:

Pantalone, K. M., Xiao, H., Bena, J., Morrison, S., Downie, S., Boyd, A. M., Shah, L., Willis, B., Beharry-Diaz, J., Milinovich, A., Joshi, S., Kaufman, F. R., & Mechanick, J. I. (2025). Type 2 diabetes pharmacotherapy DE-escalation through AI-enabled lifestyle modifications: A randomized clinical trial. NEJM Catalyst Innovations in Care Delivery, 6(9). https://doi.org/10.1056/cat.25.0016

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Early Rhythm Control Effective in Atrial Fibrillation Patients Regardless of Diabetes or Obesity Status: Study Shows

Germany: A secondary analysis of the EAST-AFNET 4 randomized clinical trial, published in JAMA Cardiology, has highlighted that early rhythm control therapy remains effective and safe in patients with atrial fibrillation (AF) irrespective of the presence of obesity or diabetes. The study was conducted by Andreas Metzner and colleagues from the German Center for Cardiovascular Research, Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany.   

The EAST-AFNET 4 trial, conducted across 11 European countries, evaluated whether initiating rhythm control therapy early in the course of AF could reduce major cardiovascular complications. Participants included individuals diagnosed with AF within the previous year who also had underlying cardiovascular conditions. In this prespecified secondary analysis, the investigators assessed whether body mass index (BMI) and diabetes status influenced the outcomes of early rhythm control compared to usual care.

The trial enrolled 1,086 participants with obesity (BMI ≥30) and 1,690 without obesity (BMI <30). The average age across all participants was 70 years, with nearly 47% being women.

The following were the key findings of the study:

  • Patients with obesity were younger on average and had a higher frequency of nonparoxysmal atrial fibrillation patterns compared to non-obese patients.
  • Obesity did not affect the impact of early rhythm control therapy, with similar benefits seen in both groups (BMI <30: 0.84; BMI ≥30: 0.69).
  • Among the 694 patients with diabetes, they were slightly younger and had higher CHA₂DS₂-VASc scores, indicating an increased baseline cardiovascular risk.
  • Diabetes did not alter the effectiveness of early rhythm control therapy, with hazard ratios being nearly identical for patients with and without diabetes (HR 0.77 vs HR 0.78).
  • Safety outcomes were comparable, as adverse event rates were consistent between diabetic and non-diabetic patients.
  • The primary composite outcome of cardiovascular death, stroke, hospitalization due to heart failure, or acute coronary syndrome showed consistent reduction with early rhythm control therapy, regardless of obesity or diabetes status.

According to the authors, these findings provide reassurance that early rhythm control strategies can be safely and effectively applied across a broad patient population, including those with metabolic risk factors such as high BMI and diabetes. This is particularly significant given the rising prevalence of both conditions worldwide and their known association with AF and adverse cardiovascular outcomes.

“The results emphasize the potential of early rhythm control as a standard approach for managing newly diagnosed AF, supporting its use even in patients with complex metabolic profiles. By demonstrating consistent benefits across different subgroups, the study strengthens the evidence base for adopting early rhythm control strategies in routine clinical practice for patients with AF and coexisting cardiovascular disease,’ the authors concluded.

Reference:

Metzner A, Willems S, Borof K, et al. Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation: A Secondary Analysis of the EAST-AFNET 4 Randomized Clinical Trial. JAMA Cardiol. Published online July 30, 2025. doi:10.1001/jamacardio.2025.2374

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Hypertriglyceridemia Linked to Abdominal Aortic Aneurysm Risk: Study

USA: Preclinical research published in Circulation suggests that hypertriglyceridemia plays a significant role in the development and rupture of abdominal aortic aneurysms (AAA).

AAA, a potentially fatal condition characterized by the dilation and rupture of the abdominal aorta, currently lacks effective pharmacological treatment. The study, led by Dr. Yaozhong Liu and colleagues from the University of Michigan Medical Center, aimed to explore the controversial and previously unclear link between triglyceride levels and AAA pathogenesis.

Using Mendelian randomization, the researchers analyzed genetic, proteomic, and metabolomic data to assess the causal role of lipid-related pathways in AAA risk. Their findings revealed a strong association between elevated triglyceride-rich lipoproteins and increased susceptibility to AAA. Experimental models involving mice with different degrees of hypertriglyceridemia—such as Lpl-deficient, Apoa5-deficient, and human APOC3 transgenic mice—provided further evidence supporting this link.

The following were the key findings of the study:

  • In the angiotensin II–induced AAA model, mice with severe hypertriglyceridemia, especially those lacking Lpl, showed a high rate of aortic rupture.
  • Apoa5-deficient mice exhibited rapid progression of abdominal aortic aneurysm (AAA).
  • Human APOC3 transgenic mice developed both aortic dissection and rupture.
  • The severity of outcomes was directly proportional to triglyceride concentrations, indicating a dose-dependent effect.
  • Elevated triglycerides and palmitate impaired the maturation of lysyl oxidase (LOX), an enzyme essential for extracellular matrix stability.
  • Reduced LOX activity weakened the aortic wall, facilitating aneurysm formation.
  • Local restoration of LOX expression in the aorta counteracted the aneurysm-promoting effects of hypertriglyceridemia, underscoring its key role in AAA pathogenesis.

To evaluate potential therapeutic strategies, the team administered an antisense oligonucleotide (ASO) targeting angiopoietin-like protein 3 (ANGPTL3), a liver-derived regulator of triglyceride metabolism. This intervention effectively reduced triglyceride levels and significantly slowed AAA progression in both human APOC3 transgenic and Apoe-deficient mice.

The study emphasizes that managing triglyceride-rich lipoproteins may represent a viable therapeutic avenue for AAA. It also highlights the promise of ASO therapy against ANGPTL3 as a targeted approach to mitigate AAA risk, particularly in individuals with a genetic predisposition.

Despite its robust findings, the study acknowledged some limitations. The extreme hypertriglyceridemia observed in certain animal models may not fully reflect human conditions, and concurrent changes in cholesterol levels could confound interpretations. Furthermore, while palmitate’s role in LOX inhibition is clear, the direct evidence of its accumulation in the aorta is still lacking.

“The comprehensive analysis strengthens the understanding of hypertriglyceridemia as a critical factor in AAA development and rupture. The findings emphasize the need for further experimental and clinical research to develop triglyceride-lowering strategies as potential interventions for this life-threatening vascular disease,” the authors concluded.

Reference:

https://doi.org/10.1161/CIRCULATIONAHA.125.074737

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Heart-healthy habits also prevent cancer, Alzheimer’s, COPD, other diseases, Emory study finds

A new study from Emory University reveals that maintaining optimal cardiovascular health can significantly improve overall physical and psychological well-being.

Published today in the Journal of the American Heart Association, the study synthesizes findings from nearly 500 peer-reviewed studies. It confirms that the benefits of heart-healthy behaviors extend far beyond the heart, positively impacting brain function, vision, hearing, muscle strength, and even reducing the risk of chronic diseases such as cancer and dementia.

“While we recently learned that heart-health and brain health are closely tied, in this review we found that almost every organ system and bodily function from head to toe benefit from a heart-healthy lifestyle,” says Liliana Aguayo, PhD, MPH, research assistant professor at the Emory University Nell Hodgson Woodruff School of Nursing and core faculty member at Emory’s Global Diabetes Research Center, who led the study.

The review is the first of its kind to systematically examine how the American Heart Association’s Life’s Simple 7™ metrics-which include not smoking, healthy eating, regular physical activity, maintaining a healthy weight, and managing blood pressure, cholesterol, and blood sugar-influence health outcomes across multiple organ systems. The updated Life’s Essential 8™ also includes sleep as a key factor.

Among the key findings were that those with heart-healthy habits:

  • Were more likely to maintain their brain and lung function, vision and hearing, and keep their teeth and muscle strength as they age.
  • Experienced lower levels of cortisol and stress and lower frequencies of several chronic diseases, including cancer, COPD, pneumonia, Alzheimer’s disease, dementia, fatty liver disease, type 2 diabetes, depression, and kidney and end-stage renal disease.
  • Had a higher self-reported quality of life and a lower risk of adverse pregnancy outcomes, sleep-disordered breathing, metabolic syndrome, erectile dysfunction, functional disability and mobility problems, and all-cause mortality.
  • Experienced lower medical expenditures, health care utilization, and non-cardiovascular disease costs.

The study was supported in part by the American Heart Association and the National Institutes of Health. It calls for further research in underrepresented populations, including children and pregnant women, and emphasizes the need to understand how even minor lifestyle improvements yield significant health benefits.

Reference:

Liliana Aguayo, Cardiovascular Health, 2010 to 2020: A Systematic Review of a Decade of Research on Life’s Simple 7, Journal of the American Heart Association, https://doi.org/10.1161/JAHA.124.038566 

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Metformin Improves Lung Function and Symptom Control in Asthma Patients with Metabolic Syndrome: Study

A new study published in the Annals of Medicine and Surgery showed that metformin use in patients with both asthma and metabolic syndrome significantly improved ACT scores, FEV₁, and FVC.

A major global health concern that affects people of all ages is asthma. Nearly 235 million people are thought to have asthma globally, with high-income nations having the highest frequency and rising incidence. More severe and frequent asthma episodes as well as worse asthma management may be linked to MetS.

As a possible therapy for MetS, metformin has been proposed; this medication may lower airway responsiveness, improve asthma management, and minimize ED visits. However, the majority of the data that is currently available focuses only on people with diabetes. Thus, this study was carried out by Hossein Mehravaran and colleagues to examine the effects of metformin in individuals who both had asthma and MetS.

Metformin hydrochloride or an identical placebo was administered to 2 groups of individuals (55 in each group) who had both asthma and MetS at the same time. After 3 months, the patients were evaluated for clinical outcomes, pulmonary function test parameters, C-reactive protein (CRP) levels, asthma control tests (ACTs), frequency of asthma episodes, emergency department visits, and hospitalization rate.

ACT score, O2 saturation, anthropometric indices, blood sugar management, CRP, and lipid profile all improved statistically significantly in the metformin group as compared to the placebo group (all P < 0.05).

Furthermore, after adjusting for the confounding effects of baseline parameters and sex, the multivariate analysis revealed that the metformin group had significantly higher forced expiratory volume in 1 second (FEV1) (P = 0.014, and effect size = 5.6%) and forced vital capacity (FVC) (P = 0.001, and effect size = 9.2%).

The metformin group showed a tendency to have lower rates of hospitalization, ED visits, and severe asthma episodes, but the effects were not statistically significant (P > 0.05).

Overall, the findings demonstrated that giving metformin to individuals who have both asthma and MetS simultaneously improves the patients’ lipid profile indices, body composition parameters, short- and long-term blood sugar management, and vital signs. Additionally, it leads to increases in ACT score, FEV1, and FVC, all of which contribute to improved pulmonary function, and it significantly lowers CRP levels, an inflammatory marker. 

Source:

Mehravaran, H., Bahar, A., Hajimohammadi, F., Kashi, Z., Aliyali, M., Varshoei, F., Alizadeh-Navaei, R., Yazdani Charati, J., Kashefizadeh, A., Gheibi, M., & Ghadirzadeh, E. (2025). Metformin effects on respiratory and metabolic outcomes in asthma and metabolic syndrome: a double-blind, randomized, placebo-controlled clinical trial. Annals of Medicine and Surgery (2012), 87(8), 4861–4869. https://doi.org/10.1097/MS9.0000000000003552

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Destinex Liquid Biopsy Accurately Detects Early Gastric Cancer: Study Shows

USA: A recent multicenter study published in JAMA Surgery has demonstrated the potential of an exosome-based liquid biopsy assay, Destinex, for the early and noninvasive detection of gastric cancer (GC). The study, led by Silei Sui from the Department of Molecular Diagnostics and Experimental Therapeutics, Beckman Research Institute of City of Hope, California, evaluated the clinical utility of microRNA (miRNA) signatures as biomarkers for screening and diagnosis.

Gastric cancer remains the third leading cause of cancer-related deaths globally, with late diagnosis being a key factor driving poor outcomes. Current reliance on endoscopy for screening is limited by its invasive nature and high cost, highlighting the urgent need for reliable blood-based tests. To address this gap, the DESTINEX study developed and validated a diagnostic assay using exosome-derived miRNAs to detect GC at an early stage.

The case-control study analyzed 809 specimens from 480 participants across major referral centers, including Nagoya University Hospital in Japan and three leading South Korean institutions: Ajou University Hospital, Asan Medical Center, and Samsung Medical Center. The research followed a comprehensive biomarker development pipeline, involving discovery, training, validation, and evaluation phases. Data collection spanned from 2016 to 2020, with analysis completed between 2022 and 2024.

The study revealed the following findings:

  • In both training and validation cohorts, the Destinex assay showed strong diagnostic accuracy.
  • The 10-miRNA signature recorded an area under the curve (AUC) of 96.3% in the training set and 95.3% in the validation set.
  • For early-stage (pT1) gastric cancer, the assay achieved an AUC of 96.8%, highlighting its sensitivity and specificity for detecting disease at a stage suitable for curative treatment.
  • A notable reduction in miRNA expression levels in postsurgical serum samples confirmed the specificity of the biomarker panel.

“These findings suggest that the Destinex assay could significantly strengthen existing gastric cancer screening strategies and improve early diagnosis rates,” the authors noted. With its high sensitivity and specificity, Destinex could be an important noninvasive complement to current screening protocols, potentially reducing dependence on invasive endoscopy for initial detection.

Despite the promising results, the study acknowledged certain limitations. The patient cohorts had uneven age and sex distribution, and patients with chronic atrophic gastritis and intestinal metaplasia were not included. Moreover, the validation was limited to Asian populations, highlighting the need for further multinational studies to confirm its diagnostic efficacy across diverse demographics. The authors also emphasized the necessity of expanding research to evaluate its performance in other gastrointestinal cancers.

The DESTINEX study’s findings highlight a major advancement in liquid biopsy technology for gastrointestinal oncology. By leveraging exosomal miRNAs and machine learning algorithms, the Destinex assay offers a robust, noninvasive option for early detection of gastric cancer, with the potential to transform clinical practice and significantly improve patient outcomes worldwide.

Reference:

Sui S, Xu C, Kanda M, et al. Exosomal Liquid Biopsy for the Early Detection of Gastric Cancer: The DESTINEX Multicenter Study. JAMA Surg. Published online July 30, 2025. doi:10.1001/jamasurg.2025.2493

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Amino acid glutamine important for eye health, finds study

The retina places a large energy demand on the body, in part due to the activity of photoreceptors.

These specialized cells are responsible for receiving light and transmitting visual information to the brain.

Photoreceptor death is the cause of vision loss in many retinal diseases, and there are no effective therapies that improve their survival.

In a paper published in eLife, University of Michigan researchers studied the dependence of photoreceptors on glutamine.

Their results indicate that maintaining the balance of amino acids in these cells is important for photoreceptor health.

The energy requirements of photoreceptors make them vulnerable to small changes in metabolism.

Previous studies focused on glucose as the primary fuel source for these cells.

Currently, therapy that exploits photoreceptor dependence on glucose is being tested in a clinical trial for patients with retinal degeneration.

“Photoreceptors are one of the most metabolically demanding cells in the body, which led us to wonder whether they depend on fuel sources other than glucose for their survival,” said Thomas Wubben, M.D., Ph.D., assistant professor of ophthalmology and visual sciences.

“We looked at glutamine because it is the most abundant amino acid in the blood.”

Glutamine feeds into several pathways, helping cells build other amino acids, including glutamate and aspartate, protein and DNA.

To confirm glutamine’s role in vision, the researchers used mice that lacked the enzyme glutaminase, which breaks down glutamine into glutamate.

They compared these mice to control mice by measuring the thickness of their retinas.

Mice that lacked glutaminase had a rapid reduction in retinal thickness with loss of photoreceptor number and function.

Glutamine plays a role in several cellular processes.

To understand why glutamine is important to photoreceptor survival, the team measured the levels of different molecules in control mice and those that lacked glutaminase.

When mice lacked the enzyme, they had lower levels of glutamate and aspartate.

These amino acids, in turn, help the cells build proteins that are required for photoreceptor function.

The researchers also found that decreased amino acid levels activated the integrated stress response, which is known to trigger cell death if it remains active for too long.

When they inhibited the stress response, the team found that the retinal thickness increased.

“We are now focused on understanding which pathways depend on glutamine and whether they can be targeted by drugs or supplements,” Wubben said.

Glutamine to glutamate conversion pathways are negatively impacted in models of human retinal disease.

“It is possible that resetting metabolism can help prevent vision loss and blindness.”

Reference:

Moloy T GoswamiEric WehShubha SubramanyaKatherine M WehHima Bindu DurumutlaHeather HagerNicholas MillerSraboni ChaudhuryAnthony AndrenPeter SajjakulnukitLi ZhangCagri BesirliCostas A LyssiotisThomas J Wubben (2025) Glutamine catabolism supports amino acid biosynthesis and suppresses the integrated stress response to promote photoreceptor survival eLife 13:RP100747. https://doi.org/10.7554/eLife.100747.3

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The Parity Factor: Understanding Its Role in Gestational Diabetes, finds study

Recent investigation assessed the relationship between parity and gestational diabetes mellitus (GDM) occurrence while considering additional influencing factors among a large cohort of Chinese women. The prevalence of GDM has significantly increased, particularly in China, driven by rising rates of obesity, advanced maternal age, and changing reproductive policies. GDM, associated with numerous adverse outcomes for both mothers and infants, necessitates a clearer understanding of its risk factors.

Understanding Parity’s Role

Parity, defined as the number of times a woman has given birth, has been inconsistently associated with GDM in existing literature. Some studies suggest that higher parity may reduce the risk due to physiological changes that enhance insulin sensitivity, while others indicate that it may increase risk. This study aimed to elucidate the independent effect of parity on GDM risk while adjusting for confounders including maternal age and pre-pregnancy body mass index (BMI), both recognized as significant GDM predictors.

Data Analysis and Findings

Data from 198,237 participants, collected via the Shenzhen Maternal and Child Health Information Management System, revealed significant variations in GDM prevalence with parity. The prevalence was higher among multiparous women compared to nulliparous, particularly in the 30-45 age group. Logistic regression models indicated that multiparae had a lower risk of GDM than primiparae, confirmed after controlling for age, education, ethnicity, and pre-pregnancy BMI. Notably, the interaction between maternal age and parity indicated that the protective effect of multiparity was more pronounced in women aged 20-29 years compared to older groups.

Possible Mechanisms Behind GDM Risk

Further analysis suggested that several psychosocial and physiological mechanisms might contribute to the observed decreased GDM risk in multiparous women. Multiparae generally possess greater prenatal awareness and adherence to health guidelines gained from previous pregnancies, potentially leading to better dietary and health management, reducing GDM risk. Moreover, higher physical activity levels due to socioeconomic conditions and social support among multiparous women may further mitigate stress and enhance pregnancy outcomes. Despite the robustness of the study, limitations included the reliance on clinical records for GDM diagnosis which may introduce bias and the single-center nature of the study affecting generalizability. The findings indicate the essentiality of addressing parity in GDM risk assessments, especially highlighting the need for targeted counseling in nulliparous women of advanced maternal age, aiming to effectively reduce GDM incidence through informed reproductive planning. Further research is warranted to explore the underlying mechanisms influencing parity and GDM risk.

Key Points

– -Prevalence and Context-: The study highlights a significant increase in the prevalence of gestational diabetes mellitus (GDM) in China, attributed to rising obesity rates, advanced maternal age, and shifting reproductive policies, underscoring the necessity for a deeper understanding of GDM risk factors.

– -Parity’s Inconsistent Association-: Parity’s relationship with GDM has been inconsistent in existing literature, with some studies suggesting higher parity might lower GDM risk due to enhanced insulin sensitivity, while others indicate it could increase risk. This investigation aimed to clarify the independent effects of parity on GDM, adjusting for confounding variables like maternal age and pre-pregnancy BMI.

– -Cohort Data and Findings-: An analysis of 198,237 participants from the Shenzhen Maternal and Child Health Information Management System demonstrated that multiparous women had a higher prevalence of GDM compared to nulliparous women, particularly within the 30-45 age bracket. Logistic regression showed that multiparae had a lower risk of GDM than primiparae once accounting for confounders.

– -Impact of Maternal Age on Parity-: The interaction between maternal age and parity revealed that the protective effect of multiparity against GDM risk was more significant in younger women (ages 20-29) than in older demographics, suggesting that age modulates the influence of parity on GDM risk.

– -Psychosocial and Physiological Mechanisms-: Analysis indicated potential psychosocial and physiological mechanisms contributing to reduced GDM risk in multiparous women, such as enhanced prenatal awareness and adherence to health guidelines from previous pregnancies, along with increased physical activity and social support.

– -Study Limitations and Implications-: Acknowledged limitations include reliance on clinical records for GDM diagnosis, which could introduce bias, and the study’s single-center approach affecting generalizability. Findings emphasize the importance of incorporating parity in GDM risk assessments, advocating for targeted counseling for nulliparous women of advanced maternal age to mitigate GDM incidence and support informed reproductive planning. Further research is needed to investigate the mechanisms governing the relationship between parity and GDM risk.

Reference –

Yuqin Dai et al. (2025). Impact Of Parity On Gestational Diabetes Mellitus In Chinese Women: A Retrospective Cohort Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07620-1.

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Breaking a sweat: Using chloride in sweat to help diagnose cystic fibrosis

Sweat does more than just cool down an overheating body. Measuring the chemical makeup of an individual’s sweat-specifically the levels of chloride, a chemical component of salt-can serve as an early warning system to help inform the diagnosis of cystic fibrosis, a genetic disease that damages the lungs and digestive system.

A group of researchers at Penn State recently developed a wearable device capable of accurately tracking chloride ion levels in sweat, which is essential for evaluating hydration status and health conditions like cystic fibrosis and more. Their sensor allows for real-time tracking of an exercising person’s sweat through a hydrogel-based design that allows the device to operate with enhanced sensitivity, accuracy and efficiency, all while being reusable. Their research, available online, is set to publish in the November issue of Biosensors and Bioelectronics.

“The traditional method of measuring chloride ion levels is to go to a hospital and have the measurements taken, which is time consuming and expensive,” said Wanqing Zhang, a doctoral candidate in engineering science and mechanics and co-author of the paper. “The wearable sensors we developed process sweat and track chloride ion levels in real time, directly on a subject’s body. This gives researchers a lot of information about an individual’s health and, specifically for this study, can identify the high chloride ion levels that signify the presence of cystic fibrosis.”

Wearable sensor technology is not new, with several other devices-including those that detect specific biomarkers in sweat-originating just from research at Penn State. However, Zhang explained how different existing designs face different major issues. Colorimetric based sweat sensors, which change color depending on the presence of a specific chemical or reaction, cannot produce reversible readings. If the sensor detects high chloride ion levels, it cannot revert to a neutral state and measure low levels, meaning that researchers can only take one accurate reading before needing to apply a new sensor. Another design, known as a potentiometric sweat sensor, operates by measuring the potential energy difference between two electrodes. While these sensors offer continuous monitoring, they typically have a limited sensitivity and rely on expensive ion-selective membranes to function.

According to Zhang, the research team’s new sensor uses multiple types of hydrogel — a water-rich, gel-like material made of networks of connected molecules called polymers — to address these issues simultaneously.

The team’s sensor contains a sweat chamber, a cation-selective hydrogel (CH) with mobile cations and a high salinity hydrogel (HH) with high salt content like sweat. When sweat enters the chamber, the difference in salt concentration between the sweat and the HH causes the mobile cations in the CH to move from the HH side to the sweat chamber side, generating open-circuit voltage (OCV) between the two points. By tracking this voltage — which indicates how many chloride ions are present in the sweat sample — they can track the levels of chloride ions.

“In other sensor designs, it is extremely difficult or impossible to effectively track small fluctuations in the chloride ion levels,” said Huanyu “Larry” Cheng, the James L. Henderson, Jr. Memorial Associate Professor of Engineering Science and Mechanics and corresponding author on the paper. “By incorporating two different types of hydrogel into the design of our sensor, we can measure the change in OCV across the sensor in real time, meaning we can follow the fluctuation of chloride ion levels in our subject’s sweat.”

However, using just these hydrogel solutions posed some issues, Zhang explained. Hydrogel material is a network of hydrophilic polymers, or materials highly attracted to water, meaning that water and electrolytes could easily pierce into the gels. The team used a material, known as PVDF-HFP film, to isolate their hydrogels from excess water or electrolytes that could negatively impact the sensor’s accuracy.

“This was the primary challenge we faced during development — when we were using just the two types of the hydrogel, water would cause the gel to swell, degrading performance,” Zhang said. “By using the PVDF-HFP film like a barrier between the hydrogel, we were able to protect the hydrogel from excess water, so it could effectively stabilize and facilitate OCV.”

To test the sensor, the team conducted two different experiments. They first collected sweat from a subject exercising and analyzed it using the sensor separately from the subject’s body. They then monitored the sweat as the subject wore the sensor while exercising, tracking chloride ion levels in a software that graphs information in real time. The readings of both experiments were then compared to confirm the accuracy of the sensor’s readings.

The sensor collects data very quickly, measuring and visualizing chloride ion levels in under 10 seconds. According to Zhang, the sensor is significantly more sensitive than existing sensors, producing readings with an accuracy of 174 millivolts per decade – nearly triple the theoretical limit of 59.2 millivolts per decade seen in potentiometric sensors. In addition to excellent reversibility, Zhang explained how the sensor’s high consistency and independence from past readings ensures easy, accurate readouts without having to make connections between multiple past readings, improving reusability.

While their sensor was primarily designed to help identify chloride ion levels indicative of cystic fibrosis, Cheng said he believes the design is a strong foundation for future wearable devices that could sense other biomarkers.

“This sensor has opened the door for low-cost, scalable and wearable chloride sensors,” Cheng said. “We believe that the mechanics used in our design can be adapted to reversibly monitor other ions or chemical compounds that appear in sweat, like glucose, which would provide additional insight on a subject’s health. The mechanics could also be expanded to different applications and platforms beyond just wearable devices, which we are exploring now.” 

Reference:

Wanqing Zhang, Xianzhe Zhang, Ankan Dutta, Farnaz Lorestani, Md Abu Sayeed Biswas, Bowen Li, Abu Musa Abdullah, Huanyu Cheng, Hydrogel-based sweat chloride sensor with high sensitivity and low hysteresis, Biosensors and Bioelectronics, https://doi.org/10.1016/j.bios.2025.117805.

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