It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Giving birth to a child after 40 is becoming more and more common – but it can entail an increased risk to the child. A new study based on data from over 300,000 births in Sweden shows that children of older mothers are more often born prematurely or with complications, especially when the mother is 45 years of age or older.
In large parts of the world, women are having children later and later in life. In Sweden, 4.8% of mothers were 40 years of age or older in 2022. Previous research has shown that older mothers differ from younger mothers in several respects such as having a higher BMI, a higher proportion having utilised assisted reproductive technology, an increased risk of certain diseases during pregnancy, and a higher proportion of births via Caesarean section. With this in mind, the researchers in the current study wanted to investigate how the mother’s age affected the health of her newborn baby.
Increased risk of stillbirth
In the study, which is published in Acta Pedriatica, the researchers looked at data from Sweden’s National Medical Birth Register, which is maintained by the Swedish National Board of Health and Welfare and includes all pregnancies from week 22 that lead to childbirth. A total of 312,221 children born to women over 34 years of age in the period 2010–2022 were included in the study, excluding twin births. The babies were divided into three groups according to their mother’s age: 35–39 years, 40–44 years, and 45 years and older. The researchers were particularly interested in how the health of the child at birth was affected when their mother was older than 39 years. The children born to mothers aged 35–39 thus served as a reference group.
“First of all, we could see that for babies born in Sweden, serious complications are rare, regardless of the mother’s age. But we also found that children of older mothers have a higher risk of stillbirth, premature birth, low birth weight relative to length of pregnancy, and low blood sugar compared to babies born to mothers aged 35–39 years. The study showed that the highest risks of all were to babies born to mothers 45 years and older,” says Sofia Voss, who is the study’s lead author.
Stillbirth is uncommon in Sweden, but occurred in 0.83% of pregnancies in women who were 45 years or older. This can be compared to a rate of 0.42% in women aged 35–39 years.
Concerning premature birth, 4.8% of these cases occurred in the group of mothers aged 35–39. Among women aged 40 to 44, the corresponding figure rose to 6.1%, and among women aged 45 or older, 8.4% of their babies were born prematurely.
Assists the healthcare system in planning the right interventions for older mothers
Previous studies have mainly compared babies born to young mothers with those born to older mothers. In the present study, the researchers were interested in getting a more detailed picture of the distribution of risk among the older mothers.
“By comparing different ranges of advanced age when giving birth, the study can also contribute to better, and better targeted, information for women planning future pregnancies. As the share of older mothers rises, our study can help to target screening and interventions to where they will have the most benefit. But it’s also important to inform the public so that they can make informed choices,” says Sofia Voss.
The study was carried out in a collaboration between researchers from Uppsala University and Linköping University.
Neonatal outcomes among infants of mothers with advanced maternal age: A national cohort study
Article Publication Date
23-Jun-2025
‘Closed loop’ learning barriers prevent doctors from using life-saving bedside ultrasound
A new study calls for reforms to improve the use of point-of-care ultrasound in hospitals. The technology’s underuse has been linked to missed opportunities for life-saving interventions in Prevention of Future Deaths reports.
Many doctors abandon a potentially life-saving medical scanning technology soon after training, because systemic barriers prevent it from becoming part of their routine practice, a study has found.
Point-of-care ultrasound (POCUS) enables doctors to perform rapid bedside scans using a portable device. This can quickly reveal life-threatening problems – including heart failure, fluid in the lungs, or internal bleeding – that can often be treated if identified in time.
Although thousands of doctors in the UK are now trained to use POCUS, research, including the new study, shows that many do not continue to use it in practice after completing their training.
The urgent need to improve access to POCUS has been raised by several sources. Shock to Survival, a framework jointly produced by the British Cardiovascular and Intensive Care Societies, for example, highlights the critical role that the technology can play in diagnosing and managing conditions such as cardiogenic shock.
Evidence from Prevention of Future Deaths reports similarly indicates that point-of-care cardiac ultrasound has been underutilised in assessing critically ill patients with shock, and that this has led to cases where opportunities for timely, potentially life-saving intervention were missed.
The new study, by researchers at the Universities of Cambridge and Exeter, and Royal Papworth Hospital in Cambridge, identifies six “vicious cycles” that explain why POCUS is being underused.
The root causes include limited expert support and workplace cultures that discourage less experienced clinicians from scanning. Researchers found that these factors created patterns of behaviour that inhibited the use of POCUS, even in settings where equipment and training opportunities were available.
“POCUS is being underused internationally, but it still feels like a problem that many people are unaware exists,” lead author Professor Riika Hofmann, from the University of Cambridge, said. “A lot of time and money is being spent on training, but if the working culture of hospitals doesn’t support it, that investment risks being wasted.”
“Our study is the first to explain why POCUS is not being integrated into everyday medical care. Unless we address this at the level of underlying culture, it won’t be used as intended, and lives could be lost.”
Co-author Dr Nicola Jones, from Royal Papworth Hospital, said: “Failure to utilise POCUS in the assessment of critically ill patients may contribute to missed opportunities for timely, potentially life-saving intervention. This has led to growing calls for a deeper understanding of the barriers to its use. Our study seeks to address those concerns directly.”
The researchers conducted interviews and focus groups with clinicians involved in the national Focused Intensive Care Echocardiography (FICE) training programme, which supports healthcare professionals to use POCUS to assess heart function in patients with serious circulatory compromise. The participants included a range of professionals, from those just beginning to develop their scanning skills to those with extensive experience, as well as others involved in delivering or supporting its use in clinical practice.
Although the research revealed some practical barriers to using point-of-care ultrasound, such as difficulties scanning particular types of patient, the standout finding was that these challenges tended to interlink and reinforce one another. The study identifies six cycles, or “closed loop problems”, which hinder the technology’s uptake.
One loop, for example, stems from the fact that trainees’ early efforts to use POCUS did not always produce high-quality scans. This fed scepticism among experienced clinicians about how much they should be using the technology, which in turn dented the trainees’ confidence and made them reluctant to use it.
Another cycle involves expertise. With few trained specialists available and limited protected learning time, trainees often struggled to get expert feedback on their scans. This limited their progress and, as a result, the development of a bigger pool of experts who could support future trainees.
A third loop relates to workplace norms. In some departments, scanning was not part of routine care and senior staff were resistant to its use. Trainees also worried about “treading on the toes” of senior colleagues who saw scanning as their responsibility. Without encouragement, they backed away from using POCUS, reinforcing the very norms that discouraged them in the first place.
To help break these cycles, the researchers propose three practical steps that could improve POCUS uptake without adding strain to overstretched health services.
Vary exposure: Instead of relying on repeated encounters with similar types of patients to master the art of POCUS scanning, the study recommends giving trainees access to a wider variety of scan images. A shared, international image bank, the authors suggest, would help develop their instincts for spotting cases where something looks amiss.
Seize teachable moments: Consultants should spot “teachable moments” that arise naturally during ward rounds or clinical discussions. These are brief windows in which a scan or image review can be undertaken, helping trainees to build their skills and confidence over time.
“Power up” learning. Hospitals could make better use of existing forums – such as quality assurance meetings – where clinicians already explain and debate scan results. These settings are valuable learning spaces where trainees would gain insights into expert reasoning and decision-making.
“These are scalable, sustainable solutions that could work even in very busy hospitals,” Hofmann said. “If we can halt the cycles we identified here, we should be able to increase the number of confident POCUS users and maximise the benefits for patients.”
A theory-informed approach to identify barriers to utilising Point-of-Care Ultrasound (POCUS) in practice: from vicious cycles to sustainable solutions
Article Publication Date
23-Jun-2025
More effective production of “green” hydrogen with new combined material
The chemical reaction to produce hydrogen from water is several times more effective when using a combination of new materials in three layers, according to researchers at Linköping University in Sweden. Hydrogen produced from water is a promising renewable energy source – especially if the hydrogen is produced using sunlight.
The production of new petrol and diesel cars will be banned in the EU as of 2035. Electric motors are expected to become increasingly common in vehicles – but they are not suitable for all types of transport.
“Passenger cars can have a battery, but heavy trucks, ships or aircraft cannot use a battery to store the energy. For these means of transport, we need to find clean and renewable energy sources, and hydrogen is a good candidate,” says Jianwu Sun, associate professor at Linköping University, who has led the study published in the Journal of the American Chemical Society.
The LiU researchers are working on developing materials that can be used to produce hydrogen (H2) from water (H2O) by using the energy in sunlight.
The research team has previously shown that a material called cubic silicon carbide (3C-SiC) has beneficial properties for facilitating the reaction where water is split into hydrogen and oxygen. The material can effectively capture the sunlight so that the energy therein can be used for hydrogen production through the photochemical water splitting reaction.
In their current study, the researchers have further developed a new combined material. The new material consists of three layers: a layer of cubic silicon carbide, a layer of cobalt oxide and a catalyst material that helps to split water.
“It’s a very complicated structure, so our focus in this study has been to understand the function of each layer and how it helps improve the properties of the material. The new material has eight times better performance than pure cubic silicon carbide for splitting water into hydrogen,” says Jianwu Sun.
When sunlight hits the material, electric charges are generated, which are then used to split water. A challenge in the development of materials for this application is to prevent the positive and negative charges from merging again and neutralising each other. In their study, the researchers show that by combining a layer of cubic silicon carbide with the other two layers, the material, known as Ni(OH)2/Co3O4/3C-SiC, becomes more able to separate the charges, thereby making the splitting of water more effective.
Today, there is a distinction between “grey” and “green” hydrogen. Almost all hydrogen present on the market is “grey” hydrogen produced from a fossil fuel called natural gas or fossil gas. The production of one tonne of “grey” hydrogen gas causes emission of up to ten tonnes of carbon dioxide, which contributes to the greenhouse effect and climate change. “Green” hydrogen is produced using renewable electricity as a source of energy.
The long-term goal of the LiU researchers is to be able to use only energy from the sun to drive the photochemical reaction to produce “green” hydrogen. Most materials under development today have an efficiency of between 1 and 3 per cent, but for commercialisation of this green hydrogen technology the target is 10 per cent efficiency. Being able to fully drive the reaction using solar energy would lower the cost of producing “green” hydrogen, compared to producing it using supplementary renewable electricity as is done with the technology used today. Jianwu Sun speculates that it may take around five to ten years for the research team to develop materials that reach the coveted 10 per cent limit.
The research has been funded with support from, among others, the Swedish Foundation for International Cooperation in Research and Higher Education (STINT), the Olle Engkvists Stiftelse, the ÅForsk Foundation, the Carl Tryggers Stiftelse and through the Swedish Government Strategic Research Area in Advanced Functional Materials (AFM) at Linköping University.
The material can effectively capture the sunlight so that the energy therein can be used for hydrogen production through the photochemical water splitting reaction.Photographer:
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The new material consists of three layers: a layer of cubic silicon carbide, a layer of cobalt oxide and a catalyst material that helps to split water.
Penn-led researchers have turned a deadly fungus into a potent cancer-fighting compound. After isolating a new class of molecules from Aspergillus flavus, a toxic crop fungus linked to deaths in the excavations of ancient tombs, the researchers modified the chemicals and tested them against leukemia cells. The result? A promising cancer-killing compound that rivals FDA-approved drugs and opens up new frontiers in the discovery of more fungal medicines.
“Fungi gave us penicillin,” says Sherry Gao, Presidential Penn Compact Associate Professor in Chemical and Biomolecular Engineering (CBE) and in Bioengineering (BE) and senior author of a new paper in Nature Chemical Biologyon the findings. “These results show that many more medicines derived from natural products remain to be found.”
From Curse to Cure
Aspergillus flavus, named for its yellow spores, has long been a microbial villain. After archaeologists opened King Tutankhamun’s tomb in the 1920s, a series of untimely deaths among the excavation team fueled rumors of a pharaoh’s curse. Decades later, doctors theorized that fungal spores, dormant for millennia, could have played a role.
In the 1970s, a dozen scientists entered the tomb of Casimir IV in Poland. Within weeks, 10 of them died. Later investigations revealed the tomb contained A. flavus, whose toxins can lead to lung infections, especially in people with compromised immune systems.
Now, that same fungus is the unlikely source of a promising new cancer therapy.
A Rare Fungal Find
The therapy in question is a class of ribosomally synthesized and post-translationally modified peptides, or RiPPs, pronounced like the “rip” in a piece of fabric. The name refers to how the compound is produced — by the ribosome, a tiny cellular structure that makes proteins — and the fact that it is modified later, in this case, to enhance its cancer-killing properties.
“Purifying these chemicals is difficult,” says Qiuyue Nie, a postdoctoral fellow in CBE and the paper’s first author. While thousands of RiPPs have been identified in bacteria, only a handful have been found in fungi. In part, this is because past researchers misidentified fungal RiPPs as non-ribosomal peptides and had little understanding of how fungi created the molecules. “The synthesis of these compounds is complicated,” adds Nie. “But that’s also what gives them this remarkable bioactivity.”
Hunting for Chemicals
To find more fungal RiPPs, the researchers first scanned a dozen strains of Aspergillus, which previous research suggested might contain more of the chemicals.
By comparing chemicals produced by these strains with known RiPP building blocks, the researchers identified A. flavus as a promising candidate for further study.
Genetic analysis pointed to a particular protein in A. flavus as a source of fungal RiPPs. When the researchers turned the genes that create that protein off, the chemical markers indicating the presence of RiPPs also disappeared.
This novel approach — combining metabolic and genetic information — not only pinpointed the source of fungal RiPPs in A. flavus, but could be used to find more fungal RiPPs in the future.
A Potent New Medicine
After purifying four different RiPPs, the researchers found the molecules shared a unique structure of interlocking rings. The researchers named these molecules, which have never been previously described, after the fungus in which they were found: asperigimycins.
Even with no modification, when mixed with human cancer cells, asperigimycins demonstrated medical potential: two of the four variants had potent effects against leukemia cells.
Another variant, to which the researchers added a lipid, or fatty molecule, that is also found in the royal jelly that nourishes developing bees, performed as well as cytarabine and daunorubicin, two FDA-approved drugs that have been used for decades to treat leukemia.
Cracking the Code of Cell Entry
To understand why lipids enhanced asperigimycins’ potency, the researchers selectively turned genes on and off in the leukemia cells. One gene, SLC46A3, proved critical in allowing asperigimycins to enter leukemia cells in sufficient numbers.
That gene helps materials exit lysosomes, the tiny sacs that collect foreign materials entering human cells. “This gene acts like a gateway,” says Nie. “It doesn’t just help asperigimycins get into cells, it may also enable other ‘cyclic peptides’ to do the same.”
Like asperigimycins, those chemicals have medicinal properties — nearly two dozen cyclic peptides have received clinical approval since 2000 to treat diseases as varied as cancer and lupus — but many of them need modification to enter cells in sufficient quantities.
“Knowing that lipids can affect how this gene transports chemicals into cells gives us another tool for drug development,” says Nie.
Disrupting Cell Division
Through further experimentation, the researchers found that asperigimycins likely disrupt the process of cell division. “Cancer cells divide uncontrollably,” says Gao. “These compounds block the formation of microtubules, which are essential for cell division.”
Notably, the compounds had little to no effect on breast, liver or lung cancer cells — or a range of bacteria and fungi — suggesting that asperigimycins’ disruptive effects are specific to certain types of cells, a critical feature for any future medication.
Future Directions
In addition to demonstrating the medical potential of asperigimycins, the researchers identified similar clusters of genes in other fungi, suggesting that more fungal RiPPS remain to be discovered. “Even though only a few have been found, almost all of them have strong bioactivity,” says Nie. “This is an unexplored region with tremendous potential.”
The next step is to test asperigimycins in animal models, with the hope of one day moving to human clinical trials. “Nature has given us this incredible pharmacy,” says Gao. “It’s up to us to uncover its secrets. As engineers, we’re excited to keep exploring, learning from nature and using that knowledge to design better solutions.”
This study was conducted at the University of Pennsylvania School of Engineering and Applied Science; Rice University; the University of Pittsburgh; The University of Texas MD Anderson Cancer Center; Washington University School of Medicine, St. Louis; Baylor College of Medicine and the University of Porto.
The study was supported by the U.S. National Institutes of Health (R35GM138207, R35CA274235, R35GM128779), the University of Pennsylvania, the Welch Foundation (C-2033-20200401), the Houston Area Molecular Biophysics Program (NIH Grant T32 GM008280), the Cancer Prevention and Research Institute of Texas (RR220087, RR210029) and the National Science Foundation (OAC-2117681, OAC-1928147, OAC-1928224).
Additional co-authors include Fanglong Zhao, Xuerong Yu, Caleb Chang, Rory Sharkey, Bryce Kille, Hongzi Zheng, Kevin Yang, Alan Du, Todd Treangen, Yang Gao and Hans Renata of Rice University; Chunxiao Sun and Shuai Liu of Penn Engineering and Rice; Siting Li and Junjie Chen of MD Anderson; Mithun C. Madhusudhanan and Peng Liu of Pitt; Sandipan Roy Chowdhury, Dongyin Guan, Jin Wang, Xin Yu and Dishu Zhou of Baylor; Maria Zotova and Zichen Hu of Penn Engineering; Sandra A. Figueiredo and Pedro N. Leão of the University of Porto; and Andy Xu and Rui Tang of Wash U, St. Louis.
First author Qiuyue Nie and coauthor Maria Zotova, from left, purify samples of the fungus.
