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)
Thursday, September 17, 2026
MEDICAL MISOGYNY
Women less likely than men to be offered active medical treatment for the same conditions
New research from the University of St Andrews has found that women are less like than men with the same medical condition to be offered active management such as surgery, a stent or a strong painkiller.
The findings, published today (16 September) in PLOS One come from a review that sifted 1,112 published studies down to those that directly compared the care given to male and female patients. Of the 38 that analysed patient records, 33 reported a significant difference in the treatment men and women received.
Researchers from the University of St Andrews School of Medicine found that almost none of those studies pointed to any guideline recommending different treatment by sex, leaving open whether this reflects sound clinical judgement or unequal care.
Dr Andrew O’Malley, who co-led the study, said: “For clinicians, the findings are a prompt to check whether treatment is being offered on clinical grounds rather than assumption. For example, one study found that when the teams deciding who receives advanced heart failure therapy functioned poorly, women were less likely to be selected. Other work shows doctors more often attribute women's symptoms to anxiety and make more diagnostic errors with female patients, even when test results are positive.
Dr Miriam Veenhuizen, Honorary Lecturer in the School of Medicine, said: “While the direction of the findings was not a surprise the consistency was. The same pattern appeared in cardiology, surgery, transplant medicine and emergency care, and it survived statistical adjustment in most studies. It’s not entirely clear why this is happening, but it is likely because women were under-represented in clinical trials until recent decades, so many guidelines rest on data from men.”
Dr Veenhuizen added: "What struck us most was the imbalance in attention. Over the same period, 551 studies examined sex inequality affecting doctors and other health professionals. Only 41 examined what happens to patients."
The researchers now intend to test whether the same patterns appear in the outputs of generative AI systems, which are trained on this literature and on clinical records, and which could entrench these differences at scale if left unchecked.
Many women usually say the same thing during pregnancy: they walk into a room and forget why, misplace their keys or struggle to follow a conversation. This phenomenon, often called ‘pregnancy brain’ or ‘momnesia,’ has long lacked a clear biological explanation.
Now, a new study by researchers at Baylor College of Medicine and collaborating institutions and published in Science Bulletin, identifies a specific brain circuit in an animal model that becomes disrupted under the sustained high estrogen levels present during pregnancy. The findings offer the first biological explanation of how exposure to high-level circulating estrogen can temporarily impair memory.
A novel brain circuit links high estrogen levels with memory problems
“We worked with mouse models designed to mimic the sustained, high blood-estrogen levels of pregnancy. This models showed that elevated estrogen caused reversible memory impairment without affecting mood or motivation, suggesting a specific cognitive effect rather than a general change in well-being,” said senior author Dr. Zheng Sun, associate professor of medicine – endocrinology, diabetes and metabolism and of molecular and cellular biology at Baylor.
Digging into the underlying biology, the team found that estrogen receptor alpha, the protein that transmits estrogen’s signals into cells, is the dominant estrogen receptor in the brain reagion called the lateral hypothalamus. Furthermore, this region has abundant GABAergic neurons – brain cells that normally send calming, inhibitory signals to other parts of the brain. Using single-nucleus RNA sequencing, the researchers discovered that high estrogen levels suppress signaling in these neurons, leading them to fire more frequently. “When we genetically removed estrogen receptors from these hypothalamic neurons, both estrogen-induced and pregnancy-induced memory problems in mice were reversed,” said Sun, a member of Baylor’s Dan L Duncan Comprehensive Cancer Center.
The team also found that these overactive hypothalamic neurons project directly into a region of the hippocampus that is a hub for memory formation. Using chemogenetics, a technique that allows researchers to turn specific neurons on or off, the team showed that silencing this hypothalamus-to-hippocampus pathway protected mice from estrogen-induced memory problems, whereas artificially activating the same pathway was sufficient to impair memory on its own, even without elevated estrogen.
Reconciling mixed evidence
Estrogen’s relationship with memory has puzzled researchers for decades. For instance, hormone replacement therapy after menopause has been linked to cognitive benefits in some studies, while high estrogen during pregnancy or with oral contraceptive use has been linked to memory complaints in others. The new findings suggest a possible explanation – it may not simply be a matter of ‘more estrogen is better’ or ‘worse,’ but rather where in the brain that estrogen acts, and at what levels.
“Low-level, cyclical estrogen exposure appears to support cognitive function, which is part of why hormone therapy can help postmenopausal women,” said senior author Dr. Yanlin He, associate professor at Pennington Biomedical Research Center. “But sustained, high-level estrogen exposure seems to engage a different pathway altogether, one centered in the hypothalamus rather than the hippocampus itself. That distinction may help reconcile a lot of conflicting data in the field.”
Confirming the link in pregnant women
To determine whether these findings translate to humans, the researchers assessed memory performance in women across different stages of pregnancy. They found task-specific memory impairments that emerged during late pregnancy, and that correlated with circulating estrogen levels, even after accounting for other factors that might influence cognition. This human data supports the idea that the hormone-driven circuit identified in mice may underlie the memory changes many pregnant women experience.
“Momnesia is real, it has a defined biological basis and is temporary,” said senior author Dr. Xianghua Zhuang, professor at the Second Qilu Hospital of Shandong University. “We hope this work helps validate what many women have described anecdotally for years, and gives researchers a concrete target for future study.”
“The memory changes observed in both mice and women were temporary and task-specific, not a sign of broader cognitive decline,” said senior author Dr. Xinguo Hou, professor at the Qilu Hospital of Shandong University. “Nonetheless, understanding the underlying circuit could eventually inform how clinicians counsel patients about the cognitive side effects of pregnancy or hormonal contraceptives, and could open avenues for therapies targeting this specific pathway without disrupting estrogen’s broader, beneficial roles in the body.”
Other contributors to this work include Xin Li, Nan Zang, Qianru Zhao, Yuxiang Sun, Udhaya Kumar Siva Kumar, Mengyu Hu, Wenjun Zhou, Yanyan Qi, Hu Chen, Longqing Xia, Jun Qin, Lei Sun, Chaitra Rai, Chao Cheng, Zhandong Liu, Li Chen, Yong Xu, Zhaoyong Hu and Hongjie Li. The authors are affiliated with Baylor College of Medicine, Shandong University or Louisiana State University.
The researchers were supported by the National Key Research and Development Program of China (grants 2023YFA1801100 and 2023YFA1801104), the Taishan Scholars Program of Shandong Province, NIH (grants AG069966 and ES034758), John S. Dunn Foundation, the Texas Medical Center Digestive Diseases Center (P30DK056338), the Gulf Coast Center for Precision Environmental Health (GC-CPEH, P30ES030285), a Frank Belton Kimmel and Sandra Kimmel Endowed Post-doctoral Fellowship and a training fellowship from the Gulf Coast Consortia on the Training in Precision Environmental Health Sciences Program (T32ES027801).
High-level estrogen impairs memory via estrogen receptor signaling in a hypothalamic–hippocampal neural circuit
Study supports effectiveness of RSV preventive antibody treatments for infants and provides new way to monitor viral resistance
Analysis published in Nature of more than 60,000 RSV sequences found resistance-associated variants to two monoclonal antibody treatments are rare and provides a roadmap to help guide the development of future prevention tools
SEATTLE — Sept. 16, 2026 — An analysis of more than 60,000 respiratory syncytial virus (RSV) sequences from around the world found that viral variants associated with resistance to current RSV prevention tools remain rare, according to a study published Sept. 16 in Nature.
The findings support the continued effectiveness of preventive antibodies and vaccines used to protect infants and other vulnerable populations from severe RSV infections, while providing new insights that could help guide the development of future prevention strategies.
“It's so incredible as a pediatrician, and as a mom, that we now have these prevention tools for RSV,” said first author Cassandra Simonich, MD, PhD, a research associate at Fred Hutch Cancer Center and a pediatric infectious diseases physician at Seattle Children’s. “We know these tools work really well in reducing severe RSV infections in babies. We want to ensure that these tools stay effective, and this study is a step toward ensuring our prevention methods keep working.”
RSV prevention tools include monoclonal antibodies for infants and vaccines for adults, which when given in advance of infection can prevent and reduce severity of the infection. Infants, older adults with weakened immune systems and people who are immunocompromised – such as when undergoing cancer treatment – are considered vulnerable to RSV and recommended to receive RSV prevention therapeutics.
The other prevention tool is to give an RSV vaccine to people who are in their third trimester of pregnancy, which then leads to anti RSV antibodies in the fetus. Those antibodies persist after birth to prevent RSV infection.
While prevention strategies have been successful so far, infectious disease experts have been on the lookout for signs that the RSV virus could adapt to resist the biological blockades created by preventive antibodies. Such signs of resistance would appear in mutations in new sequences of RSV.
“We really hope resistance does not become a problem for RSV prevention tools,” said Simonich. “But the monitoring up to this point had been limited because there wasn't a comprehensive understanding of the impact of any viral changes that are observed and what they actually mean for the ability of these antibodies to still effectively target the virus.”
Using a lab method called deep mutational scanning, Simonich and the study coauthors created a detailed library of possible RSV mutations that could indicate that the virus is changing in ways that could make preventive tools less effective.
The deep mutational scanning method was developed by Jesse Bloom, PhD, an evolutionary virologist and professor at Fred Hutch. Bloom is an Investigator with Howard Hughes Medical Institute.
“In the past, scientists have mostly identified RSV antibody resistance mutations by passaging the actual virus in the lab in the presence of antibodies,” Bloom explained. “With new techniques like the one in this paper, we can systematically characterize the effects of mutations to the key viral protein outside the context of actual pathogenic virus. We can then combine these measurements with biophysical modeling of antibody escape and analysis of natural viral sequences to understand the extent to which evolution might impact the effectiveness of these important antibodies.”
The team looked at 60,000 RSV sequences from public databases. The viral sequences were from cases around the world of people with RSV and included subtypes RSV A and RSV B, which circulate together. The researchers used deep mutational scanning to systematically measure the effect of thousands of possible mutations to the RSV fusion protein on antibody neutralization, and then used that information to score the sequences for their level of resistance.
“Our findings show that it was rare to find resistance to the RSV antibodies currently used for prevention,” Simonich said. “So that's encouraging for nirsevimab and clesirovimab because for both of these antibodies, it doesn't seem like there's any sort of sustained spread of resistance mutations.”
Simonich estimated that less than 1% of RSV sequences contain resistance mutations.
The researchers then integrated these comprehensive mutation libraries into Nextstrain, which is an open-access platform for monitoring pathogens. The team hopes the findings will help with ongoing real-time surveillance to monitor for resistance in RSV and examine if any RSV strains that are resistant become more common over time.
“The progress we've made in preventing severe RSV disease, especially among infants, has been remarkable,” Simonich said. “We hope these findings will help researchers continue to improve prevention tools and maintain their effectiveness over the long term.”
The research was supported by the National Institutes of Health and the Gates Foundation.
This work was also guided by infectious disease expert Helen Y. Chu, MD, MPH, a coauthor of the paper and a professor of medicine at the University of Washington School of Medicine.
Fred Hutch Cancer Center is globally recognized for trailblazing discoveries that have helped save more than a million lives worldwide. Based in Seattle, Fred Hutch is the only NCI-designated cancer center in Washington state and is home to Nobel Prize–winning scientists and cancer care experts who have made major breakthroughs in preventing and eliminating cancer and infectious disease — including bone marrow transplantation, immunotherapy and the HPV vaccine. Fred Hutch’s role as a hub for national research initiatives and clinical trial networks helps scale discoveries for greater impact. An independent cancer center, Fred Hutch also serves as UW Medicine’s cancer program. Learn more at FredHutch.org.
Mutational constraints on RSV F and its neutralization by antibodies
Article Publication Date
16-Sep-2026
Microscope image of target cells that are used in the Fred Hutch team's deep mutational scanning experiments. If infected with a pseudovirus used in the research studies, the cells will turn green. The scientists can then measure how antibody treatments reduce the amount of infected cells.
Cassandra Simonich, MD, PhD, prepares samples for deep mutational scanning research in the Fred Hutch lab of Jesse Bloom, PhD.
Credit
Fred Hutch Cancer Center
Nearly a decade of research strengthens case for vitamin D in pregnancy
MUSC study of 15,000 pregnancies links severe maternal vitamin D deficiency to higher risk of preterm birth
Dr. Carol Wagner and Anjali Borsum (above) found that among more than 15,000 pregnancies studied at MUSC, the women with the lowest vitamin D levels faced the highest risk of preterm birth.
A common and often overlooked nutrient deficiency may play a bigger role in pregnancy outcomes than previously recognized. In a recent analysis published in the Journal of Perinatology, prominent neonatologist and pediatrician Carol L. Wagner, M.D., and Anjali G. Borsum, an M.D. candidate at MUSC’s College of Medicine, found that among more than 15,000 pregnancies studied at MUSC, the women with the lowest vitamin D levels faced the highest risk of preterm birth.
Drawing from a large retrospective dataset collected between 2016 and 2025 and leveraging extensive support from the South Carolina Clinical & Translational Research (SCTR) Institute, including biostatistical and regulatory guidance, clinical research infrastructure, laboratory services and Nexus data resources, Wagner and Borsum identified a strong association between profound vitamin D deficiency and earlier gestational age at delivery. Wagner credited SCTR’s comprehensive support as instrumental to the study’s success.
Without SCTR, we as a team would never have been able to accomplish what we did. It’s a phenomenal infrastructure and an incredible gift to any researcher.”
While the team has not yet established a definitive causal relationship, the findings add to a growing body of evidence suggesting that optimizing a patient’s vitamin D status before and during pregnancy may improve both maternal and fetal health outcomes.
Why vitamin D might matter in pregnancy
Vitamin D is a vital nutrient that is known primarily for helping the body to absorb calcium and maintain normal bone, muscle, nerve and immune health. But as Wagner and fellow MUSC basic and translational scientist Bruce W. Hollis, Ph.D., discovered in earlier randomized controlled trials, vitamin D acts as a building block for hormones that play an important role in pregnancy.
“Vitamin D impacts literally thousands of genes in the body,” said Wagner. Research suggests that vitamin D helps the development of the placenta, the temporary organ that grows in a pregnant woman to nourish the fetus. It also appears to help support healthy immune function and may reduce the risk of serious complications like preeclampsia and gestational diabetes.
One crucial function vitamin D seems to serve is helping the mother’s immune system to adapt to pregnancy. Because a baby in utero contains genetic material from both parents, the mother’s body must learn to tolerate something that is partially foreign. Vitamin D may help to regulate that process, supporting a healthy pregnancy and fetal development.
Beyond pregnancy: Vitamin D’s broader health role
According to Wagner and Borsum, vitamin D may shape long-term health more than immediate outcomes. Some of the effects of deficiency may begin early in development, altering how genes function and potentially influencing the baby’s health for years, or even decades, to come.
Even outside of pregnancy, vitamin D deficiency is far more common than many people realize. Modern lifestyles often limit time spent outdoors, reducing the body’s ability to produce vitamin D from sunlight. At the same time, food sources provide only a small portion of the vitamin D most people need. As a result, many individuals do not reach healthy vitamin D levels.
Some groups are at higher risk for deficiency, including people with darker skin, those who work indoors, individuals who regularly use sunscreen and people with limited mobility or chronic health conditions that keep them inside.
The team stresses that sunscreen remains essential for protecting against skin cancer. However, people with limited sun exposure may benefit from discussing their vitamin D levels and potential supplementation with their health care provider.
“We have to balance the importance of sunshine and vitamin D with the risk of skin cancer,” said Borsum. “But this further emphasizes the vast role vitamin D plays.”
Emerging research suggests that vitamin D helps to regulate thousands of genes throughout the body, particularly those involved in immune function. Low levels have been associated with autoimmune diseases such as lupus and multiple sclerosis as well as certain cancers.
Challenges of turning research into practice and future directions
Despite growing evidence supporting the importance of vitamin D, Wagner said changing clinical practice can be difficult. Unlike prescription medications, vitamin D is inexpensive, widely available and cannot be patented, which means there is less commercial impetus to promote its use. “No one’s going to make billions off of this,” Wagner explained. “So, it then becomes a public health issue.”
As researchers continue to build evidence about the role of vitamin D in pregnancy and overall health, Wagner and Borsum see the next steps as educating health care providers, continuing to investigate vitamin D’s long-term effects and increasing public awareness.
“We learn about vitamin D’s role in bone health, but no one teaches us about the various roles in pregnancy, especially this relationship with preterm birth we are uncovering,” Borsum explained. “I always tell my friends and family who are thinking about becoming pregnant to make sure they are sufficient!”
As researchers continue to uncover vitamin D’s far-reaching effects, Wagner and Borsum hope the growing body of evidence will encourage more conversations about a nutrient that may shape health across generations.
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About MUSC
Founded in 1824 in Charleston, the Medical University of South Carolina (MUSC) is the state’s only comprehensive academic health system, with a mission to preserve and optimize human life in South Carolina through education, research and patient care. Each year, MUSC educates more than 3,490 students in six colleges and trains more than 1,175 residents and fellows across its health system. MUSC leads the state in research funding from the National Institutes of Health, including National Institute of General Medical Sciences COBRE awards. For information on our academic programs, visit musc.edu.
As the healthcare system of MUSC, MUSC Health is dedicated to delivering the highest-quality and safest patient care while educating and training generations of outstanding healthcare providers and leaders to serve the people of South Carolina and beyond. In 2026, for the 12th consecutive year, U.S. News & World Report named MUSC Health University Medical Center in Charleston the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.
MUSC has a total enterprise annual operating budget of $10.1 billion. The more than 37,130 MUSC members include world-class faculty, physicians, specialty providers, scientists, contract employees, affiliates and care team members who deliver groundbreaking education, research and patient care.
About the South Carolina Clinical & Translational Research Institute
The South Carolina Clinical and Translational Research (SCTR) Institute is the catalyst for changing the culture of biomedical research, facilitating sharing of resources and expertise and streamlining research-related processes to bring about large-scale change in the clinical and translational research efforts in South Carolina. Our vision is to improve health outcomes and quality of life for the population through discoveries translated into evidence-based practice. To learn more, visit https://research.musc.edu/resources/sctr
