Chronic fatigue syndrome leaves patients exhausted and struggling with brain fog—and it typically gets worse after mental or physical exercise, a phenomenon called post-exertional malaise.

Now, scientists investigating shortness of breath in chronic fatigue patients have discovered that they are highly likely to experience dysfunctional breathing, which could be caused by dysautonomia, abnormal control of innervation to blood vessels and muscles. Targeting treatments toward these breathing problems could potentially offer patients some relief from their symptoms.

“Nearly half of our chronic fatigue subjects had some disorder of breathing—a totally unappreciated issue, probably involved in making symptoms worse,” said Dr. Benjamin Natelson of Icahn School of Medicine, senior author of the article in Frontiers in Medicine.

“Identifying these abnormalities will lead researchers to new strategies to treat them, with the ultimate goal of reducing symptoms.”

Breathe easy

The scientists recruited 57 patients diagnosed with chronic fatigue syndrome and 25 control participants whose ages and activity levels matched the chronic fatigue cohort. Both groups took part in cardiopulmonary exercise tests over two days.

The scientists measured their heart rate and blood pressure, how effectively they were taking in oxygen, the oxygen saturation of their blood, and how hard they had to breathe to get enough oxygen. They also tracked how fast participants breathed and the patterns of their breathing, to identify hyperventilation and dysfunctional breathing.

Dysfunctional breathing is usually associated with asthma patients, but it can arise from many different causes. Characteristics include deep sighing in the course of ordinary breathing, overly rapid breathing, forcing an exhale from the abdomen, breathing from the chest without using the diaphragm so the lungs are never properly full, and a loss of synchrony between the chest and abdomen, so the different muscles which help with breathing aren’t working together.

“While we know the symptoms generated by hyperventilation, we remain unsure what symptoms may be worse with dysfunctional breathing,” said Dr. Donna Mancini of the Icahn School of Medicine, first author of the article. “But we are sure patients can have dysfunctional breathing without being aware of it. Dysfunctional breathing can occur in a resting state.”

Catching your breath

The scientists found that participants with chronic fatigue were taking in approximately the same amount of oxygen when they breathed compared to the control participants—their peak VO2 maxes were comparable. However, 71% of the participants with chronic fatigue experienced breathing problems—either hyperventilation, dysfunctional breathing, or both.

Almost half of the participants with chronic fatigue were observed breathing erratically during the test, compared to only four of the control participants.

A third of the chronic fatigue patients hyperventilated, compared to just one control participant. Nine chronic fatigue patients displayed dysfunctional breathing as well as hyperventilation. None of the control participants had this combination of breathing issues.

Both dysfunctional breathing and hyperventilation can cause symptoms similar to chronic fatigue, like dizziness, difficulty focusing, shortness of breath and exhaustion. Combining the two can also cause people to experience heart palpitations, chest pain, fatigue, and (unsurprisingly) anxiety.

These breathing problems, the scientists suggest, could be exacerbating chronic fatigue symptoms or even directly contributing to post-exertional malaise.

“Possibly dysautonomia could trigger more rapid and irregular breathing,” said Mancini. “It is well known that chronic fatigue syndrome patients often have dysautonomia in the form of orthostatic intolerance, which means you feel worse when upright and not moving. This raises the heart rate and leads to hyperventilation.”

Pulmonary physiotherapy?

This could mean that tackling dysfunctional breathing would relieve some patients’ symptoms. The scientists intend to follow up on this research to learn more about how dysfunctional breathing and hyperventilation interact. Although more research will be needed before treatments can be rolled out, they already have ideas for possible therapies that could improve breathing function.

“Breathing exercises via yoga could potentially help, or gentle physical conditioning where breath control is important, as with swimming,” suggested Natelson.

“Or biofeedback, with assessment of breathing while encouraging gentle continuous breath use. If a patient is hyperventilating, this can be seen by a device that measures exhaled CO₂. If this value is low, then the patient can try to reduce the depth of breathing to raise it to more normal values.”

Existing evidence does not clearly link paracetamol (acetaminophen) use during pregnancy with autism or ADHD in children, finds an in-depth evidence review published by The BMJ today, in direct response to recent announcements around the safety of using paracetamol in pregnancy.

The researchers say confidence in the findings of existing evidence reviews and studies on this topic is low to critically low, and suggest that any apparent effect seen in previous studies may be driven by shared genetic and environmental factors within families.

Regulatory bodies, clinicians, pregnant women, parents, and those affected by autism and ADHD should be informed about the poor quality of the existing reviews and women should be advised to take paracetamol when needed to treat pain and fever in pregnancy, they add.

Paracetamol (acetaminophen) is the recommended treatment for pain and fever in pregnancy and is considered safe by regulatory agencies worldwide.

Existing systematic reviews on this topic vary in quality, and studies that do not adjust for important factors shared by families or parents’ health and lifestyle cannot accurately estimate the effects of exposure to paracetamol before birth on neurodevelopment in babies.

To address this uncertainty, researchers carried out an umbrella review (a high-level evidence summary) of systematic reviews to assess the overall quality and validity of existing evidence and the strength of association between paracetamol use during pregnancy and the risks of autism or ADHD in offspring.

They identified nine systematic reviews that included a total of 40 observational studies reporting on paracetamol use during pregnancy and the risk of autism, ADHD, or other neurodevelopmental outcomes in exposed babies.

Four reviews included meta-analysis (a statistical method that combines data from several studies to give a single, more precise estimate of an effect).

The researchers used recognized tools to carefully assess each review for bias and rated their overall confidence in the findings as high, moderate, low, or critically low. They also recorded the degree of study overlap across reviews as very high.

All reviews reported a possible to strong association between a mother’s paracetamol intake and autism or ADHD, or both in offspring. However, seven of the nine reviews advised caution when interpreting the findings owing to the potential risk of bias and impact of unmeasured (confounding) factors in the included studies.

Overall confidence in the findings of the reviews was low (two reviews) to critically low (seven reviews).

Only one review included two studies that appropriately adjusted for possible effects of genetic and environmental factors shared by siblings, and accounted for other important factors such as parents’ mental health, background, and lifestyle.

In both these studies, the observed association between exposure to paracetamol and risk of autism and ADHD in childhood disappeared or reduced after adjustment, suggesting that these factors explain much of the observed risk, say the researchers.

They acknowledge some limitations. For example, the included reviews differed in scope and methods, they were unable to explore the effects of timing and dose, and their analyses were limited to autism and ADHD outcomes only.

However, they say this overview brings together all relevant evidence and applies established methods to assess quality, and shows “the lack of robust evidence linking paracetamol use in pregnancy and autism and ADHD in offspring.”

They conclude, “The current evidence base is insufficient to definitively link in utero exposure to paracetamol with autism and ADHD in childhood. High quality studies that control for familial and unmeasured confounders can help improve evidence on the timing and duration of paracetamol exposure, and for other child neurodevelopmental outcomes.”

In the United States, 1 in every 250 people has inherited a genetic variant that leads to dangerously high cholesterol levels from birth.

If high cholesterol isn’t lowered early, people with this genetic condition, called familial hypercholesterolemia (FH), have a high risk of having a heart attack or stroke as early as their 30s or 40s. But only about 1 in 10 of those living with FH (1.5 million Americans) are aware of their condition.

A new modeling study conducted by researchers at Columbia and Harvard universities finds that while screening children or young adults for high cholesterol and FH genes would prevent a substantial number of premature heart attacks and strokes, such testing is currently too expensive to implement.

Instead, their study suggests that if a universal screening program led to more intensive monitoring and lifestyle changes in all children and young adults with high cholesterol—including those without FH genes—cholesterol screening would become cost-effective. The paper, “Familial Hypercholesterolemia Screening in Early Childhood and Early Adulthood: A Cost-Effectiveness Study,” was published Nov. 9 in JAMA.

“Early recognition and management of high cholesterol, even in childhood, can prevent or delay heart attacks, strokes, and maybe even dementia later in life,” says Andrew Moran, associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and one of the study’s senior authors.

“Screening for FH is important for kids and young adults—and their family members—so we need to find a cost-effective way to screen early for FH. For young people with severely high cholesterol but without a known genetic cause, early cholesterol testing and management can also be the path to prevention.”

One in five adolescents has some abnormality on their regular lipid screen. The American Academy of Pediatrics and the American Heart Association recommended that all children have their cholesterol measured between the ages of 9 and 11 to identify cholesterol disorders, but less than 20% of children receive such testing.

Study details

The researchers’ model tested multiple scenarios of a two-stage screening strategy that first measured children’s cholesterol levels (LDL-C) and then conducted genetic testing to identify FH genes in those with high cholesterol numbers. This study looked at screening children at age 10 or age 18 and how the screening and subsequent treatments could prevent heart disease decades later.

“Though FH is among the most common and severe genetic disorders, it’s still relatively rare,” says Moran. “Because of the high upfront costs of screening millions to find a relatively small number of people with FH genes, our modeling found that none of the combined cholesterol plus genetic screening strategies were cost-effective compared to usual care.”

The model found that if cholesterol screening led to more intensive cholesterol management among all those with high cholesterol (LDL ≥130 mg/dL) regardless of genetic test result, screening in young adulthood (around age 18) would be the most cost-effective strategy.

Could newborn genetic screening be more effective?

Going forward, FH screening may be cost-effective if it is bundled with other, established childhood screening packages, including newborn screening.

A recent study in JAMA Cardiology that trialed paired cholesterol and genetic screening for FH from the blood spots collected for newborn screening shows that newborn FH screening may be feasible at scale. The Columbia and Harvard teams are working with those investigators to explore best approaches to newborn or infant FH screening.

An added benefit of childhood genetic testing for FH would be the opportunity to cascade screening and treatment to other family members who may also have unrecognized FH, a factor that the current model doesn’t consider.

“We haven’t landed on the best way to screen early for FH yet, but with our modeling, we’re leveraging the best evidence and efficient computer modeling methods to arrive at the most promising approaches to test in real clinical trials of screening,” Moran says.

In a major new study, researchers from Intermountain Health in Salt Lake City have found that weight loss drugs used by patients who have high triglycerides do not increase their risk of pancreatitis or adverse cardiac events.

Since the first GLP-1 receptor agonists (GLP1RAs), more commonly known now as weight loss drugs, were approved in 2005, some clinicians have been hesitant to prescribe them to people who have very high triglycerides. That’s because these patients are typically at high risk of pancreatitis, and the drugs interact with the pancreas.

In the new study, Intermountain researchers found that GLP1RAs don’t increase the risk of pancreatitis in these patients—and for those who have never had pancreatitis, being on a GLP1RA medication led to a four times lower risk of developing the condition.

“Pancreatitis is incredibly painful and can be deadly. Once you have a patient with acute pancreatitis, you want no part of causing it again,” said Leslie Iverson, PA-C, cardiovascular prevention and research clinician at Intermountain Health.

“But these findings show no link between pancreatitis and patients with high triglycerides taking a weight loss drug. Even better, we found that these drugs may offer protection against ever having it in the first place.”

Study findings were presented at the American Heart Association Scientific Sessions 2025 in New Orleans on Nov. 9.

In the retrospective study, Intermountain researchers reviewed the electronic health records of patients treated at Intermountain Health between January 2006 and April 2025 and identified patients over 18 years old with type 2 diabetes and/or a body mass index over 27.

One of the key factors researchers included in their analysis was whether a patient had severe hypertriglyceridemia (HTG), with a triglyceride level over 500.

Severe HTG is a known risk factor for pancreatitis, which is why physicians may be less likely to prescribe GLP1RA medications to patients with the condition.

Of the 346,667 patients reviewed in the study, 3,834 (1.1%) were prescribed a GLP1RA medication. Overall, researchers found no increased risk of pancreatitis in patients prescribed a GLP1RA medication.

They also found no increased risk of pancreatitis in patients with HTG, including those with a triglyceride level over 500.

For those patients with HTG who never had pancreatitis before, they had a four-time lower risk of developing the condition, compared to patients not on a GLP1RA medication.

“Our findings show that HTG is not a reason to withhold this class of medication from appropriate patients, if they would benefit otherwise,” she said. “This is an important finding that helps enhance our treatment options.”

Iverson added that clinicians are also seeing triglyceride levels in patients go down because of being on GLP1RA medications. This makes sense, she said, as GLP1RAs address issues like diabetes and obesity that can raise triglyceride levels.

When doctors detect elevated levels of SerpinB3 in a blood test, it can signal that something is seriously wrong, from hard-to-treat cancers to severe inflammatory conditions.

SerpinB3 is a critical protein that often reveals when the body’s barrier tissues, like the skin or lungs, are under serious stress from cancer or chronic illness.

But new research from Arizona State University shows that SerpinB3, long recognized as a disease marker, also has a natural role in the body: helping to heal wounds.

Skin wounds remain a major challenge for medicine. Of the roughly 6 million wounds that occur annually in the U.S., many are difficult to treat and are often linked to diabetes, burns, infection or advanced age. Together, these hard-to-heal wounds cost an estimated $20 billion each year.

In a new study, co-authors Jordan Yaron, Kaushal Rege and their colleagues with the Biodesign Center for Biomaterials Innovation and Translation discovered that SerpinB3 is part of the body’s natural wound-healing arsenal, helping the skin recover after damage.

The research points to new possibilities: Boosting it could improve wound healing, while blocking it may offer a way to fight aggressive cancers. The findings may also help explain SerpinB3’s role in inflammatory ailments, from skin conditions to asthma.

The research appears in Proceedings of the National Academy of Sciences.

The study grew out of a convergence of the team’s broader work on bioactive materials for wound repair and expertise studying a family of proteins called serpins—short for serine protease inhibitors. Serpins act as important regulators of diverse processes such as blood clotting and immune regulation throughout the body, with several serpins having apparent roles in keeping tissue breakdown and repair in balance.

“When we looked deeper into how our bioactive nanomaterials were helping tissue repair, SerpinB3, a protein originally implicated in cancer, jumped at us as a key factor that correlated with nanomaterial-driven wound healing,” Rege said. “This journey, which started from use-inspired research on biomaterials for tissue repair to uncovering the fundamental role of this protein as an injury-response mechanism in skin, has been truly fascinating. We are now building on this basic finding and investigating the role of SerpinB3 in other pathological conditions.”

Rege is a professor of chemical engineering and director of the Biodesign Center for Biomaterials Innovation and Translation. Yaron is an assistant professor of chemical engineering and faculty with the center. Both investigators hold academic appointments with the School for Engineering of Matter, Transport and Energy at ASU.

SerpinB3’s split identity

Many serpins are linked with disease when their balance in the body goes awry, showing up in inflammation, fibrosis and cancer. One member of this family, SerpinB3, has been used extensively in cancer tests as an indicator of aggressive disease.

SerpinB3—also known as squamous cell carcinoma antigen-1—was first discovered in cervical cancer tissue in 1977. It has long been applied as a biomarker of aggressive cancers in the lung, liver and skin, where high levels are tied to poor outcomes.

“For more than four decades, SerpinB3 has been recognized as a driver of cancer growth and metastasis—so much so that it became a clinical diagnostic. Yet after all this time, its normal role in the body remained a mystery,” Yaron said. “But when we looked at injured, healing skin, we found that cells moving into the wound bed were producing enormous amounts of this protein. It became clear that this is part of the machinery humans evolved to heal epithelial injuries, a process that cancer cells have learned to exploit to spread. This now opens the doors to understanding how this protein is involved in many more diseases.”

How SerpinB3 helps wounds close

By tracking which genes switch on during healing, the researchers found that SerpinB3 levels surged in wounded skin. The increase was especially strong in wounds covered with advanced biomaterial dressings, a finding built on the group’s earlier research, showing how such materials can boost the body’s natural repair signals.

In lab tests, adding extra SerpinB3 made skin cells move and cover wounds faster, working as effectively as a well-known healing booster called Epidermal Growth Factor. SerpinB3 works by activating keratinocytes—the skin cells that normally move in to repair damage. When switched on, these cells become less sticky and more mobile, allowing them to slide into the wound and rebuild tissue.

The protein also assists the body’s natural repair networks, guiding healing and new tissue growth. Treated wounds showed more neatly arranged collagen fibers, which act as a support structure, helping restore the skin’s strength and integrity.

Implications for care

The researchers note that more work is needed to understand how SerpinB3 fits into the body’s broader systems of healing. Because SerpinB3 speeds up repair, it could one day be developed as a treatment for stubborn wounds—like pressure sores and other ulcers that heal slowly over time.

By revealing SerpinB3’s double life, the study shows how a deeper understanding of the body’s own repair systems could lead to better treatments for wounds—and new strategies to fight cancer.

Coronary artery calcium (CAC) CT scans are becoming a more commonly used tool to effectively determine a patient’s future risk of heart disease and heart attack.

These minimally invasive scans measure how much calcium is already present in the arteries of the heart, so that clinicians can determine if a patient needs medical intervention or other preventive measures, including statin medications.

Now a new study from heart researchers at Intermountain Health in Salt Lake City finds that routine coronary artery calcium CT scans are also proving to be effective in uncovering other medical issues in patients, some of them life-threatening.

“In nearly one in 10 of these kinds of heart scans, we’re finding other possible medical issues,” said Brent Muhlestein, MD, co-director of research at Intermountain Medical Center. “They could be nothing, as many abnormalities on these kinds of scans are. But they could be something more significant, as was the case for one study participant who had emergency surgery due to a finding on his CAC CT scan.”

The findings are part of the Intermountain CorCal clinical trial, which randomized asymptomatic, otherwise healthy patients to have their risk of developing plaque buildup in their arteries determined in one of two ways: either through current treatment standards or a CAC CT scan.

Of the 2,284 patients in the Intermountain study who received CAC CT scans, radiologists found other potentially significant medical findings in 247—or 8.5%—of patients.

More than half of these findings were lung abnormalities, but issues were also found in just about every organ included in the CT scan area, including esophagus, liver, kidney, breast, bone and other parts of the heart.

“These results show that proactive cardiac CT scans may be useful to identify other health issues for patients, beyond cardiac calcium levels,” said Dr. Muhlestein.

Findings from the study were presented at the American Heart Association Scientific Sessions 2025 in New Orleans.

Of those 247 patients, two-thirds were referred for follow-up care. Of that group, 23 patients were found to have thoracic aortic aneurysms, which are bulges in the part of the aorta in the chest, larger than 4.5 centimeters.

One of these patients was eight centimeters, which is considered an emergency.

“That patient went into surgery within a week of us finding it,” Dr. Muhlestein said. “We’re confident in saying we’ve saved at least one life through this study and that this tool may be useful in other preventive ways.”

Previous research from the Intermountain CorCal study has already shown that CAC CT scans may be effective as a way of determining which patients might benefit from statin medication to protect their heart health.

Whether it’s worth the time and expense to expand the work of radiologists reading these scans has yet to be determined, said Dr. Muhlestein.

“These findings don’t show whether every patient who was recommended for follow-up care needed it. But the findings from our study are significant enough that it’s worth asking that question. We’ll continue to explore these findings as a preventive health tool,” he said.

A husband’s optimism and confidence may play a crucial, if often unseen, role in helping babies arrive healthy and on time.

A new study from University of California Merced psychology researchers found that when married fathers reported higher levels of resilience—a quality that includes traits such as optimism, self-esteem, and perceived social support—their partners showed lower levels of inflammation during pregnancy and carried their babies longer.

“This is one of the first studies to show that a father’s inner strengths, such as his optimism and ability to cope with challenges, can ripple through the family in measurable, biological ways,” said Professor Jennifer Hahn-Holbrook, a co-author.

The findings were published in the journal Biopsychosocial Science and Medicine.

The research team, led by Ph.D. student Kavya Swaminathan, analyzed data from 217 mother-father pairs who participated in the Community Child Health Network study across five sites in the U.S.

Mothers provided blood samples during pregnancy that were analyzed for C-reactive protein, a marker of inflammation associated with an increased risk of preterm birth. Both parents also completed surveys assessing resilience-related traits such as optimism, self-esteem and social support.

Preterm birth, defined as delivery before 37 weeks, is a leading cause of infant mortality and lifelong health complications, including heart disease and developmental disorders. High maternal inflammation is a well-established risk factor. The UC Merced study indicates one reason why some mothers may be biologically protected: their partners’ emotional resources.

In married couples in this study, higher paternal resilience was associated with lower maternal inflammation, which in turn predicted a longer gestation period. Every day in the womb is better for fetal health and development. Among unmarried or cohabiting couples, that connection was not seen.

“This study is exciting because it highlights how the people surrounding a pregnant woman can shape her biology in ways that affect both her health and her baby’s,” Swaminathan said.

The study does not prove cause and effect, but offers strong evidence that emotional and social strength in the father can have physical consequences for mothers and babies.

“Fathers who feel confident and supported might engage in more positive daily behaviors, such as cooking healthy meals, offering encouragement and reducing stress at home,” said Hahn-Holbrook, a Health Sciences Research Institute faculty member. “Emotional connections may also play a role, since couples tend to coregulate their moods and even their immune systems.”

The study draws on the biopsychosocial model, which examines how emotional and social factors interact with biological factors to shape health. Previous research has shown that chronic stress can increase inflammation during pregnancy. The UC Merced study flips the lens to examine how positive psychological resources can protect against it.

Others involved in the study included UCLA Professor Christine Dunkel Schetter, one of several primary investigators, along with UC Merced psychology Professor Haiyan Liu and Stony Brook University Professor Christine Guardino.