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)
Sunday, November 20, 2022
Potatoes can be part of a healthy diet
A study from Pennington Biomedical Research Center says that potatoes are filled with key nutrients and packed with health benefits.
When we think of healthy vegetables, we don't think of potatoes, but we should. Potatoes have developed a reputation for causing weight gain and an increased risk for type 2 diabetes, and often find themselves on a list of foods to avoid, especially for individuals with insulin resistance. However, a new study from Pennington Biomedical Research Center, published in the Journal of Medicinal Food, says that potatoes actually did not increase that risk, are filled with key nutrients, and packed with health benefits.
Candida Rebello, PhD, an assistant professor at Pennington Biomedical, served as co-investigator of the study which examined how a diet including potatoes affects key health measures. Rebello, who is also a registered dietitian, said, “We demonstrated that contrary to common belief, potatoes do not negatively impact blood glucose levels. In fact, the individuals who participated in our study lost weight.”
“People tend to eat the same weight of food regardless of calorie content in order to feel full,” Rebello explained. “By eating foods with a heavier weight that are low in calories, you can easily reduce the number of calories you consume. The key aspect of our study is that we did not reduce the portion size of meals but lowered their caloric content by including potatoes. Each participant’s meal was tailored to their personalized caloric needs, yet by replacing some meat content with potato, participants found themselves fuller, quicker, and often did not even finish their meal. In effect, you can lose weight with little effort.”
The study involved 36 participants between the ages of 18 and 60 who were overweight, had obesity, or insulin resistance. Insulin resistance refers to a health condition in which the body’s cells do not respond well to insulin and glucose does not enter into the cells to make energy. Insulin resistance is linked to obesity, high blood pressure, high cholesterol, and type 2 diabetes
Participants were fed precisely-controlled diets of widely available common foods including either beans, peas, and meat or fish, or white potatoes with meat or fish. Both diets were high in fruit and vegetable content and substituted an estimated 40% of typical meat consumption with either beans and peas or potatoes. Previous studies have shown that eating beans and peas improves blood glucose levels in individuals with newly diagnosed type 2 diabetes. To increase the dietary fiber component of the potatoes, they were boiled with the skin intact and then refrigerated between 12 and 24 hours. Potatoes were incorporated into the main lunch and dinner entrées, such as shepherd’s pie and creamy shrimp and potatoes, and served together with sides such as mashed potatoes, oven-roasted potato wedges, potato salad, and scalloped potatoes with lunch and dinner entrees.
“We prepared the potatoes in a way that would maximize their fiber content. When we compared a diet with potatoes to a diet with beans and peas, we found them to be equal in terms of health benefits,” Rebello said. “People typically do not stick with a diet they don’t like or isn’t varied enough. The meal plans provided a variety of dishes, and we showed that a healthy eating plan can have varied options for individuals striving to eat healthy. In addition, potatoes are a fairly inexpensive vegetable to incorporate into a diet.”
Pennington Biomedical Research Center’s Executive Director John Kirwan, PhD, and Principal Investigator on the study said, “Obesity is an incredibly complex disease that Pennington Biomedical is tackling on three different fronts: research that looks at how and why our bodies react the way they do, research that looks at individual responses to diet and physical activity, and policy-level discussions and community programs that bring our research into strategies our local and global communities can use to live healthier lives. These new data on the impact of potatoes on our metabolism is an exciting addition to the arsenal of evidence we have to do just that.”
This work was supported in part by an investigator-initiated grant from the Alliance for Potato Research and Education and in part by a grant from the National Institute on Aging and from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center. The funders (Alliance for Potato Research and Education and the National Institutes of Health) had no role in the design, analysis, or writing of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors.
About LSU’s Pennington Biomedical Research Center
The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. The Center architected the “Obecity, USA” awareness and advocacy campaign to help solve the obesity epidemic by 2040. The Center conducts basic, clinical, and population research, and is affiliated with Louisiana State University. The research enterprise at Pennington Biomedical includes over 480 employees within a network of 40 clinics and research laboratories, and 13 highly specialized core service facilities. Its scientists and physician/scientists are supported by research trainees, lab technicians, nurses, dietitians, and other support personnel. Pennington Biomedical is located in state-of-the-art research facilities on a 222-acre campus in Baton Rouge, Louisiana. For more information, see https://www.pbrc.edu.
An unusual type of antibody that even at miniscule levels neutralizes the Zika virus and renders the virus infection undetectable in preclinical models has been identified by a team led by Weill Cornell Medicine, NewYork-Presbyterian and National Institutes of Health (NIH) investigators.
Because Zika can cause birth defects when passed from a pregnant person to their fetus, this discovery could lead to the development of therapies to protect babies from the potentially devastating effects of this disease.
In research published Nov. 18 in Cell, the investigators isolated an ultrapotent immunoglobulin M (IgM) antibody — a five-armed immune protein that latches onto the virus— using blood cells taken from pregnant people infected with Zika. In experiments with mice, they determined that the antibody not only protected the animals from otherwise lethal infections, but also suppressed the virus to the point that it could not be detected in their blood.
Zika is currently circulating at low levels in many tropical countries, but that will inevitably change, according to co-senior author Dr. Sallie Permar, the Nancy C. Paduano Professor in Pediatrics and chair of pediatrics at Weill Cornell Medicine and pediatrician-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center and NewYork-Presbyterian Komansky Children’s Hospital. Dr. Mattia Bonsignori, chief of the Translational Immunobiology Unit of the Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, is a co-senior author.
“The important thing is that we’ve got to be ready for another outbreak of Zika,” Dr. Permar said.
At this point, doctors have no approved vaccines or treatments to offer patients. With further research, this antibody has the potential to help fill that gap, according to Dr. Permar. “There are two potential ways it could be used: To quickly reduce levels of Zika in the blood of pregnant people who have become infected, or as a preventative measure given to those at risk of contracting the virus during an outbreak.”
Transmitted by infected Aedes aegypti mosquitoes, the Zika virus usually causes a mild illness in adults. However, Zika virus infection in pregnant people can cause severe birth defects, including abnormally small heads and brain damage in their babies.
During a Zika outbreak that began in 2015, researchers in Brazil, led by co-authors Dr. Reynaldo Dietze, of Global Health and Tropical Medicine and the Federal University of Espίrito Santo, and Dr. Camila Giuberti, also of the Federal University of Espίrito Santo, collected blood samples from pregnant people who had infections. The team decided to focus on those who were infected with Zika, but had given birth to babies that appeared healthy, because they suspected these patients might harbor antibodies capable of preventing the congenital infection.
One of these patients gave birth to an apparently healthy baby even after having Zika detectable in their blood for nearly two months, an unusually long period. The laboratory teams, led by first author Dr. Tulika Singh, a former graduate student at Duke University Medical Center where Dr. Permar’s lab was located for part of this study and now a postdoctoral fellow at the University of California, Berkeley, found that their B cells produced an IgM antibody with a potent ability to prevent viral particles from invading cells.
The identity of this antibody, called DH1017.IgM, surprised the investigators because it belongs to a typically weaker, less mature type of antibody that is produced early in an infection. However, in this case, the potent function of this antibody depended on it being an IgM antibody. When the collaborators examined its molecular structure when binding to the virus, they found that multiple arms could latch onto a viral particle simultaneously. The findings suggest that IgM antibodies might be especially effective to protect against Zika virus and possibly other viruses, the authors suggest.
To develop the antibody into a therapy, the researchers plan to begin testing its safety and how effectively it can prevent transmission to a fetus in additional preclinical models. Recalling how pregnant people were left out of COVID-19 vaccine trials, Dr. Permar emphasized that when human studies for new preventive or therapeutic treatments are done for Zika, they must be included. “Pregnant people are the exact population that needs vaccines or immunotherapies for Zika,” she said. “It’s crucial to get anti-Zika vaccines and therapies that are safe in pregnancy rolled out as soon as there is evidence of an outbreak.”
This research was supported by NIAID grant R21-AI123677.
Many Weill Cornell Medicine physicians and scientists maintain relationships and collaborate with external organizations to foster scientific innovation and provide expert guidance. The institution makes these disclosures public to ensure transparency. For this information, see profile for Dr. Permar.
JOURNAL
Cell
Study: Turning wastewater into fertilizer is feasible and could help to make agriculture more sustainable
Drexel researchers' lifecycle analysis of nitrogen reclamation from wastewater shows a viable path forward
The wastewater draining from massive pools of sewage sludge has the potential to play a role in more sustainable agriculture, according to environmental engineering researchers at Drexel University. A new study, looking at a process of removing ammonia from wastewater and converting it into fertilizer, suggests that it’s not only technically viable, but also could help to reduce the environmental and energy footprint of fertilizer production — and might even provide a revenue stream for utilities and water treatment facilities.
A Sustainable Nitrogen Source
The production of nitrogen for fertilizer is an energy-intensive process and accounts for nearly 2% of global carbon dioxide emissions. In the last several years researchers have explored alternatives to the Haber-Bosch nitrogen production process, which has been the standard for more than a century. One promising possibility, recently raised by some water utility providers, is gleaning nitrogen from the waste ammonia pulled from water during treatment.
“Recovering nitrogen from wastewater would be a desirable alternative to the Haber-Bosch process because it creates a ‘circular nitrogen economy,’” said Patrick Gurian, PhD, a professor in the College of Engineering who helped lead the research, which was recently published in the journal Science of the Total Environment. “This means we are reusing existing nitrogen rather than expending energy and generating greenhouse gas to harvest nitrogen from the atmosphere, which is a more sustainable practice for agriculture and could become a source of revenue for utilities.”
A Cleaner Way to Clean
Under the Clean Water Act of 1972 municipal water treatment facilities have been challenged to meet water quality standards for water that they discharge into waterways. Increasingly ammonia is seen as both a concern for aquatic environments as elevated levels of ammonia can result in overgrowth of vegetation in streams and rivers which can endanger fish species. The options for removing ammonia are generally time and space consuming and can be energy-intensive undertakings.
One option being explored by several facilities in North America and Europe is a process called air-stripping. It removes ammonia by raising the temperature and pH of the water enough to convert the chemical into a gas, which can then be collected in concentrated form as ammonium sulfate.
But deciding on making the investment to convert to air-stripping requires a complex study – called a lifecycle analysis — of its technological and financial viability.
Exploring the Option
The team, led by Gurian and Sabrina Spatari, PhD, from Technion Israel Institute of Technology, regularly perform these analyses to take stock of the full environmental and economic impact of various options for recycling and reuse of waste or side-stream products as sustainable solutions. Their analysis of this wastewater scenario suggests there is a complementary relationship that could result in a more sustainable path for both farmers and water management authorities.
“Our analysis identifies a significant potential for environmental mitigation and economic benefit from implementing air-stripping technology at wastewater treatment plants for producing ammonia sulfate fertilizer,” they wrote. “In addition to ammonia sulfate production as a marketable product, the benefit of reducing the ammonia load in the side-stream before it is recycled into the wastewater stream at the wastewater treatment plant provides an additional justification for adopting air-stripping.”
Using data from Philadelphia’s water treatment facility and several others across North America and Europe, the team conducted its lifecycle assessment and economic feasibility studies. They looked at factors ranging from the cost of installing and maintaining an air-stripping system, to the concentration of ammonia and flow rate of the wastewater; to the sources of energy used to drive the collection and conversion process; to the production and transportation cost and market price of the fertilizer chemicals.
Promising Results
Findings of the life-cycle analysis show that air-stripping emits about five to 10 times less greenhouse gas than the Haber-Bosch nitrogen-producing process and uses about five to 15 times less energy.
From an economic perspective, the overall cost of producing fertilizer chemicals from wastewater is low enough that the producer could sell them at a price more than 12 times lower than Haber-Bosch-produced chemicals and still break even.
“Our study suggests that recovering ammonia can be cost-effective even at low
concentration,” they write. “Although high ammonia concentration is environmentally favorable, and can simultaneously support marginal production of ammonium sulfate with lower environmental impact, particularly for life cycle energy, greenhouse gas emissions, and several human and ecosystem health indicators, compared to the Haber-Bosch production.”
In addition, the study suggests that water treatment facilities may enjoy energy savings by air-stripping the ammonia to reduce levels before the water it reenters the waste treatment process. This is because it would cut the time and processing needed to treat the water and fits in well with softening processes that help to slow chemical deposition on the treatment plant infrastructure.
While the team acknowledges that air-stripping would churn out fertilizer in smaller amounts than the industrial Haber-Bosch process, being able to collect and reuse any quantity of resources helps to improve the sustainability of commercial agriculture and prevents them from becoming water pollutants.
“This indicates that air-stripping for recovery of ammonium sulfate could be a small part – but an important step – toward recovering and reusing the massive amount of nitrogen we use to sustain global agriculture,” Spatari said. “And, significantly it presents an alternative for chemical production that does not have the same level of deleterious environmental and human health effects as the current process. This research suggests that water utility providers could also consider investing in technologies that would capture phosphorous and recycle it for agricultural use.”
The breakthrough is the product of a collaboration between two different laboratories in CSU’s Department of Mechanical Engineering. It was accomplished by combining two applied technologies, soft robotics and super-omniphobic coatings.
The soft robotic manipulator is made of inexpensive materials like nylon fibers and adhesive tape. It’s powered by an electrically activated artificial muscle. The combination can be used to produce lightweight, inexpensive grippers capable of delicate work, yet 100x stronger than human muscle for the same weight.
The result is something that flies in the face of our cultural concept of what a robot is, and what it can do.
Conventional robots are made of components that are heavy, rigid, and expensive. That makes them poorly suited for some tasks.
Soft robots, on the other hand, can be lightweight and provide a gentle touch that’s difficult to achieve with conventional robots. They are far lighter and can be produced at a a fraction of the cost of their rigid cousins.
“A single gripper as large as my finger is one or two grams, including the artificial muscle embedded. And it’s inexpensive – just one or two dollars,” said Jiefeng Sun, a postdoctoral fellow in the Department of Mechanical Engineering’s Adaptive Robotics Laboratory and co-first author on the paper.
The soft robotic grippers are treated with a novel superomniphobic coating that makes the droplet manipulator possible. The superomniphobic coating resists wetting by nearly all types of liquids, even in dynamic situations where the contact surfaces are tilting or moving. When applied to the soft robotic manipulator, the coating enables it to interact with droplets without breaking their surface tension, so that it can grasp, transport, and release individual droplets as if they were flexible solids.
The superomniphobic coatings employed in the droplet manipulator were developed at CSU by associate professor Arun Kota (now at North Carolina State University) and postdoctoral fellow Wei Wang (now an assistant professor at the University of Tennessee). Wang and Kota also contributed to the article.
“It’s a very nice synergy between these two kinds of research. Dr. Kota was working on this very good coating, and we were working on this soft robot, to manipulate droplets, so we figured out this might be a good combination,” said co-author Jianguo Zhao, associate professor of mechanical engineering at CSU and director of the Adaptive Robotics Laboratory.
In the early stages of their research, the team had difficulty attracting the attention of journal editors. The COVID-19 pandemic presented an opportunity to point out the potential of their invention.
“Because of the pandemic, handling dangerous infective materials is a hot topic. So we added a blood manipulation experiment after the first revision,” said Sun. “That kind of helped us to get through the review process.”
The combination of inexpensive materials and innovative capabilities has exciting applications. In many liquid spill scenarios, human cleanup can be dangerous due to toxicity, risk of contagion, or other hazards in the surroundings. These droplet manipulators are inexpensive enough to be disposable, but capable enough to do precise, lossless liquid cleanup work no other robot has ever done.
“It’s a first, but it’s also a very unusual example of a high tech product that is not terribly expensive,” said Zhao.
On-demand, remote and lossless manipulation of biofluid droplets
Forecasting the health returns of tobacco tax proposals
Scientists with Virginia Tech’s Fralin Biomedical Research Institute at VTC are leading a five-year, $3.5 million study to predict the impact of tobacco taxes on health.
IMAGE: WARREN BICKEL’S RESEARCH PROJECT WILL FORECAST THE IMPACT OF TOBACCO TAX PROPOSALS IN A COMPLEX EXPERIMENTAL MARKETPLACE THAT CONTINUALLY CHANGES WITH THE INTRODUCTION OF NEW PRODUCTS.view more
CREDIT: PHOTO BY CLAYTON METZ FOR VIRGINIA TECH.
Scientists with Virginia Tech’s Fralin Biomedical Research Institute at VTC are leading a five-year, $3.5 million study to predict the impact of tobacco taxes on health.
Cigarette smoking is the leading cause of preventable death in the United States, causing more than 480,000 deaths each year, according to the Centers for Disease Control and Prevention.
“Taxes are one of the most effective ways to change behavior – they make people think about their choices, including their choice to use tobacco,” said Warren Bickel, a professor at the Fralin Biomedical Research Institute and director of the institute’s Addiction Recovery Research Center.
Funded by the National Cancer Institute of the National Institutes of Health, Bickel’s research project will forecast the impact of tobacco tax proposals in a complex experimental marketplace that continually changes with the introduction of new products, such as low-nicotine cigarettes or electronic cigarettes.
The work has potential to deliver research-based health policy guidance for new tobacco regulations as well as evaluate the health consequences of people’s economic choices.
“Taxes can help people achieve better health by discouraging them not to smoke. If you make the product more expensive, people will use less of it. They can also leverage people to move from the most harmful tobacco products to the least harmful,” said Bickel, who is also the director of the institute’s Center for Health Behaviors Research.
He will take tobacco-related health disparities into account by investigating socioeconomic factors.
“People with low incomes have a higher prevalence of smoking, and disproportionate tax policies could have far-reaching direct and unintended effects,” said Bickel, who is also a professor of psychology in the Virginia Tech College of Science.
To get clear answers, Bickel’s approach involves the Experimental Tobacco Marketplace, an invention of the Addiction Recovery Research Center. Participants have an account and buy tobacco products to reflect their typical purchasing. Co-investigators at the Fralin Biomedical Research Institute working on the project with Bickel include Jeff Stein and Allison Tegge.
The marketplace places the mix of products, prices, and specific regulations under experimental control for researchers to estimate policy impact in real-world circumstances.
In this environment, researchers can forecast the impact and health equity of tax proposals, including a proposal that equally levies taxes across all tobacco products, as well as others that issue tax based on a product’s nicotine content, potential for harm, or whether it has received a modified-risk designation from the Food and Drug Administration.
“We can implement policies in the experimental tobacco marketplace and provide information about the impacts on people’s tobacco purchasing,” said Bickel. “For example, if lawmakers or regulators restrict access to one product versus another, will it result in smokers making less healthy or more healthy choices? It is an ideal resource to investigate the harm-reduction potential of low nicotine cigarettes and alternative nicotine products.”
THE LANCET ONCOLOGY: Experts warn of a European cancer epidemic in the next decade if weaknesses in cancer health systems and cancer research are not urgently addressed
IMAGE: KEY FINDINGS OF THE LANCET ONCOLOGY GROUNDSHOT COMMISSIONview more
CREDIT: THE LANCET
Peer reviewed / Review, analysis and opinion
With an estimated one million cancer diagnoses missed across Europe in the last two years, the impact of the COVID-19 pandemic is predicted to set back European cancer outcomes by almost a decade.
A new Commission from The Lancet Oncology, “European Groundshot—addressing Europe’s cancer research challenges”, highlights the pivotal importance of cancer research in tackling the unprecedented challenges facing European cancer systems and makes key recommendations for how this can be achieved.
The Lancet Oncology Commission also identifies gaps in the European cancer research landscape and calls for a doubling of the European cancer research budget, as well as prioritisation of underserved cancer research areas, including prevention and early diagnosis, radiotherapy and surgery, implementation science, action on gender equality, and a deeper focus on survivorship
The COVID-19 pandemic has exposed weaknesses in cancer health systems and in the cancer research landscape across Europe, which, if not addressed as a matter of urgency, will set back cancer outcomes by almost a decade [1]. In a new report, authors emphasise that prioritising cancer research is crucial for European countries to deliver more affordable, higher quality, and more equitable cancer care, with patients treated in research-active hospitals having better outcomes than those who are not [2].
The new report, European Groundshot—addressing Europe’s cancer research challenges: a Lancet Oncology Commission, brings together a wide range of patient, scientific, and health-care experts with detailed knowledge of cancer research activity across Europe. Using accurate, timely, and granular data, the report shines a penetrating light on cancer research in Europe, highlighting current and future challenges and identifying gaps within the research landscape.
The Lancet Oncology Commission echoes the US Cancer Moonshot in setting out ambitious recommendations to develop a successful and resilient cancer research roadmap. However, the Lancet Oncology Commission argues that Europe cancer research should have a more grounded patient-focused, rather than techno-centric, approach and therefore a ‘Cancer Groundshot’ is a more appropriate aim.
“With the backdrop of the COVID-19 pandemic, Brexit, and the Russian invasion of Ukraine, it is more important than ever that Europe develops a resilient cancer research landscape to play a transformative role in improving prevention, diagnosis, treatment, and quality-of-life for current and future patients and those living beyond cancer,” says Professor Mark Lawler, Queen’s University Belfast, UK and Chair and lead author of the Commission.
He continues, “We estimate that approximately one million cancer diagnoses were missed across Europe during the COVID-19 pandemic. [1] We are in a race against time to find those missing cancers. Additionally, we saw a chilling effect on cancer research with laboratories shut down and clinical trials delayed or cancelled in the first pandemic wave. We are concerned that Europe is heading towards a cancer epidemic in the next decade if cancer health systems and cancer research are not urgently prioritised. Our European Groundshot Commission provides crucial findings on the current landscape of cancer research, exposes the key gaps, and demands the prioritisation of European cancer research agendas over the next decade”. [4]
European cancer research faces a triple threat
The European Groundshot Commission analysed data on the impact of the COVID-19 pandemic across Europe and found that clinicians saw 1·5 million fewer patients with cancer in the first year of the pandemic, with one in two patients with cancer not receiving surgery or chemotherapy in a timely manner. Additionally, 100 million cancer screening tests were missed, and it is estimated that up to one million European citizens might have an undiagnosed cancer due to the cancer backlog. Considering these findings, one of the European Groundshot Commission’s key recommendations is for the European cancer research community to accelerate the research response to the indirect impacts of the COVID-19 pandemic on cancer and that, now more than ever, there is a crucial need to ensure that cancer is appropriately protected and prioritised within current and future European research agendas.
The Russia invasion of Ukraine represents another huge challenge to cancer research in Europe. Russia and Ukraine are two of the largest contributors to clinical cancer research in the world, especially industry-sponsored clinical research. Many Ukrainian cancer clinical trials include cancer centres in central and eastern European countries and the conflict will likely result in many of these major trials being delayed or failing to recruit. An additional danger is that industry might consider it too high risk to run cancer clinical research in countries bordering Ukraine—loss of private sector investment would be hugely damaging to cancer research in central and eastern Europe. The European Groundshot Commission recommends that, as a matter of extreme urgency, the European cancer community must gather data on the impact of the conflict on patients, cancer services, medicines and other shortages, and workforce gaps, in Ukraine and in neighbouring countries, as well as developing a plan to mitigate the impact of the war on cancer research.
“Whilst there has been a lot of news coverage on the Russian invasion of Ukraine, what has gone relatively unreported is its profound and continuing impact on clinical cancer research. We hope that our European Groundshot Commission will help to direct the necessary attention to the concerning and significant impact that the conflict will have on cancer research, including but not limited to clinical trials in Europe. There is already a burgeoning east-west divide in European cancer research and it’s crucial the Russia-Ukraine war does not cause this gap to grow,” says Dr Andreas Charalambous, President of the European Cancer Organisation” [4]
The European Groundshot Commission also predicts that Brexit will continue to negatively impact European cancer research. The Commission analysed data comparing EU28 (UK included) versus EU27 (UK not included) research activity and found a significant gap, one the Commission suggests is extremely unlikely to be bridged by increased research activity from the remaining EU27. Another key recommendation from the European Groundshot Commission is for European cancer research funders and the European cancer research community to mitigate the impact of Brexit and other political challenges by ensuring that the UK can continue to collaborate with European partners and contribute to European cancer research and innovation activities.
“UK cancer research in the post-Brexit world stands at a crossroads where strategic decisions will determine whether we continue to thrive and partner internationally or whether isolationism will reduce our world standing," says Professor Richard Sullivan, co-lead for the Commission and Professor of Cancer & Global Health at Institute of Cancer Policy, King’s College London. [4]
Professor Lawler adds, “If the UK is not involved in EU collaborative cancer research and not part of Horizon Europe’s research community, this will have an extremely detrimental effect on European cancer research activity. Ultimately, patients with cancer will the pay the price for this decision in terms of health-care outcomes.” [4]
Gaps in European cancer research and its funding
The European Groundshot Commission analysis into investment in cancer research in Europe in 2010–19 found that the total amount of investment, excluding the private sector, was about €20–22 billion, about €26 per head. The minimum equivalent figure for the USA over the same period was US $80·5 billion (around €76 billion and €234 per head). Considering this dramatic gap in spend per head, the European Groundshot Commission calls for a doubling of the European cancer research budget to €50 per capita by 2030.
The European Groundshot Commission argues that cancer prevention research in particular has not had the funding it deserves. A greater focus on preventing cancer would reduce the number of people who develop cancer and therefore allow more resources to be available for those who do require treatment. The report calls for a significant reprioritisation of cancer prevention, cancer screening, and early cancer detection research to reduce the burden of cancer for European citizens and enable those who do develop cancer access to more resources and the best treatments available.
“It is estimated that 40% of cancers in Europe could be prevented if primary prevention strategies made better use of our current understanding of cancer risk factors. There are already evidence-based and cost-effective cancer preventive interventions available [5], and we want to see more effective implementation and communication of these across Europe. Additionally, up to one third of cancer cases in Europe are more likely to have a better outcome if they are detected early but, disappointingly, we find that rates of screening tests vary widely between different European countries. More research is needed to understand why people do not participate in cancer screening programmes across Europe,” says Anna Schmutz, International Agency for Research on Cancer, France [4]
Gender equity in cancer research is another crucial gap identified in the European Groundshot Commission, with senior female authors making up less than a third of all authors for those European countries contributing the most cancer research outputs. The gender of principal investigators in Europe was also determined for 22, 291 cancer research projects: the majority of principal investigators were men with less than 33% women, reflecting the gender inequality that exists.
“Our data on female authors clearly illustrate the significant gender gap that exists in the European cancer research community. Greater research is needed into the reasons for why some European countries or regions have greater gender inequality in cancer research than others. Strategies based on these data would then hopefully improve the gender balance in cancer research in Europe,” says Professor Yolande Lievens, Ghent University Hospital, Ghent. [4]
The Commissioners hope that the findings and recommendations in this report will help the European cancer research community as they work towards a more equitable agenda where all citizens and patients, no matter where they live, will benefit equally from advances in cancer research.
“This European Groundshot has a significant patient focus, which is very welcome” said Teodora Kolarova, Bulgarian patient advocate and Executive Director of the International Neuroendocrine Cancer Alliance, “Too often the patient viewpoint is ignored, but it is front and centre in this Commission. Patients need to be active participants in research, co-creating with their scientific and clinical colleagues. Another welcome focus is on central and eastern Europe—it is crucial that we see a critical upsurge in research in this region, so that the east–west divide is narrowed, not widened.” [4]
Prof Lawler adds “Gathering data and turning them into cancer intelligence has been our North Star in this Commission. Too often, opinion, even expert opinion, has trumped data in the genesis and implementation of cancer research policies. Simply continuing to dedicate resource and effort to a narrow research agenda is no longer desirable or viable: we must follow the data and act on what they reveal. We have an unrivalled opportunity to reimagine cancer research and its implementation so as to achieve our ambitious 70: 35 Vision, an average of 70% 10-year survival for patients treated for cancer in Europe by 2035. Let’s grasp this opportunity.” [4]
Writing in a linked Comment, Márcia Costa and David Collingridge, Editors at The Lancet Oncology, say, “European leaders must break down the political barriers that divide the continent, rising above popularism, to work together in the common pursuit of harmonising cancer research missions and national cancer plans, strengthening health systems, and supporting all patients with cancer, including those from neighbouring countries in need of international aid. The research, data, recommendations, and actions summarised in the European Groundshot Commission could be powerful drivers of change if all actors are willing to listen and to put artificial divisions to one side. After all, we are all Europeans, irrespective of the politics, and we deserve better.”
NOTES TO EDITORS
There is a press briefing organised by the European Cancer Organisation at 10:30am GMT / 11:30am CET on Monday 14th November. Contact Marilena Madsen (marilena.madsen@europeancancer.org) for details to join or to receive the recording.
There will be a free and open to all Lancet webinar at 9:00am GMT on Friday 18th November. You can register here.
A full list of authors and their funding information can be found in the report.
[1] Lawler M, Crul M. Data must underpin our response to the covid-19 pandemic's disastrous impact on cancer. BMJ. 2022; 376:o282. [2] Selby P, Liu L, Downing A, Bank Is, Wilson R, Stephens R, Meunier F, Rochon J, Morris E, Seymour M, Gregory W, Lawler M, Boaz A. How can clinical research improve European health outcomes in cancer? J Cancer Policy 2019; 20: 100182, 1-6. [3] Freeman V, Hughes S, Carle C, Campbell D, Egger S, Hui H, Yap S, Deandrea S, Caruana M, Onyeka TC, IJzerman MJ, Ginsburg O, Bray F, Sullivan R, Aggarwal A, Peacock SJ, Chan KKW, Hanna TP, Soerjomataram I, O'Connell DL, Steinberg J, Canfell K.J Are patients with cancer at higher risk of COVID-19-related death? A systematic review and critical appraisal of the early evidence. J Cancer Policy. 2022; 33:100340. [4] Quotes direct from authors and cannot be found in text of Commission. [5] https://cancer-code-europe.iarc.fr/index.php/en/ecac-12-ways
European Groundshot—addressing Europe’s cancer research challenges: a Lancet Oncology Commission
ARTICLE PUBLICATION DATE
15-Nov-2022
COI STATEMENT
ML declares honoraria from Bayer, Carnall Farrar, EMD Serono, Novartis, Pfizer, and Roche unrelated to this work and membership of the board of the European Cancer Organisation (ECO). AA declares Advanced NIH Fellowship unrelated to this work. AMB declares honorarium from Roche unrelated to this work and Presidency of Lung Cancer Europe. MC declares membership of the board of ECO and the European Society of Oncology Pharmacy. FC declares consultancy and advisory board membership of Amgen, Astellas/Medivation, AstraZeneca, Celgene, Daiichi-Sankyo, Eisai, GE Oncology, Genentech, Gilead, GlaxoSmithKline, Iqvia, Macrogenics, Medscape, Merck-Sharp, Merus, Mylan, Mundipharma, Novartis, Pfizer, PierreFabre, prIME Oncology, Roche, Sanofi, Samsung Bioepis, Seagen, Teva, and Touchime unrelated to this work. TC declares honoraria from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Roche, Merck Sharpe & Dohme, Pfizer, and Takeda unrelated to this work. LD declares consultancy from the International Cancer Research Partnership unrelated to this work. FDN declares grants from the AIRC Foundation for Cancer Research, Associazione Italiana per la Ricerca sul Cancro, and Fondazione Piemontese per la Ricerca sul Cancro-ONLUS, and consultancy from Pierre Fabre unrelated to this work. JJ declares consultancy from AstraZeneca, Exact Sciences, and Merck Sharpe & Dohme unrelated to this work. DK declares honoraria from Merck Sharpe & Dohme unrelated to this work. TKo declares grants from Ipsen, AAA Pharma, Novartis, Isotope Technologies Munich, Victory Net Foundation, and Camulus, and honoraria or support from Cor2Ed, Ipsen, ECO, International Cancer Genome Consortium unrelated to this work. CLV received support from AIRC Foundation. YL is chair of the HERO VBHC and member of the European Society for Radiotherapy and Oncology (ESTRO) Scientific Committee, the Belgian College of Oncology, and a personal investigator on the European Organization for Research and Treatment of Cancer/ESTRO E2-RADIATE project. PS declares support from ECO and the European School of Oncology. SO, KO, AS, CA, PN, KA, MA, AC, MPC, ACo, CLD, AE, SE, MG, BJo, OK, TKu, GL, FM, JP, TP, RP, BR, ITR, MJS, GSB, JVH, EV, WW, UW, and RS declare no competing interests.
Higher sense of purpose in life may be linked to lower mortality risk
A new study found that this association persists regardless of race/ethnicity and gender, but women may benefit slightly more than men from the health-protective effects of purpose
Growing research indicates that one’s purpose—i.e., the extent to which someone perceives a sense of direction and goals in their life—may be linked to health-protective benefits such as better physical functioning and lower risks of cardiovascular disease or cognitive decline.
Now, a new study led by a Boston University School of Public Health (BUSPH) researcher found that people with higher levels of purpose may have a lower risk of death from any cause, and that this association is applicable across race/ethnicity and gender.
Published in the journal Preventive Medicine, the study results did suggest that this association is slightly stronger among women than it is among men, but there was no significant difference by race/ethnicity.
“Having a purpose in life has been known to improve many health outcomes on average,” says study lead author Dr. Koichiro Shiba, assistant professor of epidemiology at BUSPH. “In another study I led, we found that the effect of purpose on lowering all-cause mortality may differ by socioeconomic status. In this study, we extended the prior evidence and found that the beneficial effect of purpose persisted regardless of gender and race/ethnicity.”
For the study, Dr. Shiba and colleagues at Harvard T.H. Chan School of Public Health (Harvard Chan) utilized data from the Health and Retirement Study, a nationally representative study of US adults ages 50 and older. The team assessed self-reported sense of purpose among more than 13,000 people, based on the “purpose in life” of the Ryff Psychological Well-being Scales, a widely used tool that measures different aspects of well-being and happiness. The researchers also examined mortality risk over an eight-year period beginning between 2006-2008.
The results showed that people with the highest sense of purpose indicated the lowest risk of death (15.2 percent mortality risk), compared to people with the lowest sense of purpose (36.5 percent mortality risk).
The team also gathered data on additional factors that can influence health, such socioeconomic status, other demographic characteristics, baseline physical health, and depression, and found that an increase in these factors was also associated with increases in a higher sense of purpose.
Dr. Shiba speculates that the stronger observed purpose-mortality association in women may be attributable to gender difference in the use of healthcare services, “one of the postulated pathways linking purpose and health,” he says. “Evidence suggests men tend to underuse necessary healthcare services, due to social norm. However, future study investigating the mechanisms underlying the gender difference is warranted.”
These findings can help inform future policies and other efforts to improve health and well-being.
“This evidence on effect heterogeneity tells us whether population-level purpose interventions can promote people’s health not only on average, but also in an equitable manner,” Dr. Shiba says. “Although evidence suggests purpose interventions would not lead to widening racial disparities in mortality, policymakers should also be aware of other sources of heterogeneity, such as SES and gender. Even though people may view purpose as a ‘psychological’ factor, its impacts on health cannot be explained solely by processes that operate in our mind and biology. We need to consider how the psychological factor interacts with our social world and ultimately impacts our health.”
The senior author of the study was Dr. Eric Kim, a research scientist at Harvard Chan at the time of the study. The study was also co-authored by Dr. Laura Kubzansky, professor of social and behavioral sciences at Harvard Chan; David Williams, Florence Sprague Norman and Laura Smart Norman Professor of Public Health and chair of the Department of Social and Behavioral Sciences at Harvard Chan; and Dr. Tyler VanderWeele, John L. Loeb and Frances Lehman Loeb Professor of Epidemiology at Harvard Chan.
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About Boston University School of Public Health Founded in 1976, Boston University School of Public Health is one of the top five ranked private schools of public health in the world. It offers master's- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.
